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Home My WebLink AboutSKYHILLS PH 1 BLK 1 LT 15kyhills Block 1 Lot 1 #011-262-3§ Munic, ipalityofAnchorage Page 1 ot "Devel~r~r~t Se'rv[c~s DePadmeni Building Safe~ De~ent On-Site Water a~ Wasl~aler P~mm, 4700 S. Bragaw SL .P.O. Box 1~6~ ~chorage, AK ~51~6650 ~.d.an~omge.ak.us (907) ~7~ ON~I~ WA~TEWATER DISPOSAL SYSTEM AND/OR WELL [NSPEC~ON REPORT Permit Number: SW000176 PID Number: 011-262-35 Crown Pointe~ Inc. WastewaterSystem:.,'New U~rade P.O. Box 112313 Anch. AK 99511 ABSORPTION FIELD 345-6277 rive (5) o~,~ :.~ LEGAL DESCRIPTION .1.2 I 1 Skyhills Phase I 4 5 ,,. 50 ~,. Well: ~ New. ~ Upgrade o,~: 3 A~U n. ~,.700 ,e ASTM D3o3dPvc ~,.Sanders & Sanders 6/26/00 ~:'~ J ~'~:. . ,,. J~' *~:~, TANK SEPA~TION DISTANCES ~ sep~c ~ Holding g 8.T.E.P. ' ~ O~ Tank Field Station Tank S~r~ ~ncHora~e w~ N/A N/A N/A N/A N/A Steel .Two (2) t~w"~ >100'>5, >100'>10, N/AN/A N/AN/A ~ ~.~ ~. ~,~.LI~ STATION ~ >5' >10' N/A N/A ~. ,. . ~ None Noted ~"~*~ ~: BENgH MARK Front [ntry Deck southeast Corner . · . 100.0 ~t.. ,: - . ~,.%~.~ ~ - Inspectigns performed, bY: ~EA Dates: 1" 6/26/00 Depadment of Health and Human Se~ices approval Reviewed and approved by~~~ Date: /-~0/ ......... Municipality of Anchorage * Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650. Anchorage, AK 99519-6650 - 343-4744 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW000176 PID No.011-262-35 89°56'19"£ 50' A B S1 25.5 28.6 S2 28.6 38.8 C4 38.2 66.4 C5 - 71.1 83.8 M1 67.9 82.1 Alternate Site TH LOT 1 r- c4 ], ' ~ House~ Ser~Xsl~ PLAN AS-BUILT SCALE 1" = 50' 50' ./ ,t :1 "=50'.. ! Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 -Anchorage, AK 99519-6650. 343-4744 On-Site Wastewater Disposal System or Well Inspection Report I~ermit Number SW000176 PID No. 011-262-35 Page 3 of 3 5 17' 82.0 87.8 m mn 1,500 Septic Ta ~ 81~ 1.5' 2' 10' 20' 69.2.' 73.0 =: ,~' Geotextile Fabric '-. Drainfield X ~62.1 Rock 69.2 MUNICIPALITY OF ANCHORAGE Department of Health end Human Sen/ices On-Site Sen/ices Program 825 L Street, Room 502 P.O. Box 196550, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jun 19, 2000 Expiration Date: Jun 19, 2001 Permit Number: SW000176 Legal Description: SKYHILLS PH 1 BLK 1 LT 1 Design Engineer: 0014 Anderson Engineering Owner Name: Crown Pointe, Inc. Owner Address: PO Box 112313 Anchorage, AK 99511- Parcel ID: 011-262-35 Site Address: Lot Size: 41201 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 'Ibis permit is for the construction of: [] DisposalField [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. Fram October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~'~ ~ issued By: ~ Lf'~ Date: Date: ~ "/~7-~ ANDERSON ENGINEERING ' · P:O. BOX 240773 ' ' r ' . · 'ANCHORAGE, AK 99524 : : 522-7773, 522-6779 (FAX) ' .: June 5, 2000 Municipality of Anchorage Department of Health and Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 1, Block 1, Skyhills Subdivision, Phase I .. ' Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 1, Block 1, Skyhills Subdivision, Phase I intends to construct a new five bedroom home on the property. We are therefore requesting a construction permit be issued for a new septic system to serve the house. The Site Plan shows the location of the new system along with the alternate site. The backup documentation provides the parameters used in the design of the system and provides the configuration of the system. The lot is served the Municipal water system and the system will be constructed a minimum from the water service line. The test holes placed On the lot in 1998 at the locations shown revealed well graded sand and gravel with some silt with a percolation rate of 1.7 minutes per inch. No groundwater was encountered in either test hole and none was found during the ensuing monitoring ped,od. We are therefore proposing a deep trench system ~ith a maximum depth of 10.5 from original ground. 'The length of the trench will be 50 with. an .effective depth of 7'. The owner intends to place fil in the a. rea of the trench with a minimum of 3' over the trench for protection from frost and freezing conditions: The 'existing drainage on the lot is shown on the site plan and is primarily from south to north at varying grades with some slope from east to west. The absorption trench will be placed parallel to the contours in an area with a grade of less than 10%.' Grading will be accomplished once the system is complete so drainage is away from the trench and septic tank but in the direction of the current drainage pattern. If the system is constructed in accordance with our design the following statements apply: ' ]. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The subdivision is currently served by the Municipal water system. ' 2. The system, ii constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. Lot I, Block l, Skyhills Subdivision, Phase June 5, 2000 · ' Page Two Sincerely, The system, if constru(~ted as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. ' ' The system, if c(~nstructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Michael E. Anderson P.E. Attachments ~L 10 '0 0 '4 1 4 .PROJECT. LOCATION MAP ·, Scale: 1 "= 200' N 90°O0'O0"E 220.79' I I I I I · N 89~56'19"E TH73. Five' SITE PLAN 133.66' ' ~.~Alternate ~ite · TH7 ,ine · './ NOTE: 1. e e ./. 1,500 Gallon :Septic Tank 50''Long. X 3' Wide X 7' Effective'Depth Absgrption Trench Water Service Line Must Be 10'-Minimum 'From Septic Tank or Absorption Trench. .. SCALE1"=50' LOT 1, BLOCK 1, SKYHILLS SUBDIVISION, PHASE I DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom Home Parc. Rate: 1.7 Min./Inch Application Rate: 1.2 GPD/SF Deep Trench System 1,500 Gallon Septic Tank 7' Drainfield Rock 5 Bedrooms X 150 GPD ! 1.2 GPD/SF = 625 SF of Absorption Area 625 SFI14 SF/ LF of Trench = 44.6 LF Trench Length Therefore: Construct a Deep Absorption Trench System With One Lateral 50' in Length with 7' of Dralnfleld Rock Beneath the Distribution Pipe. Distribution Pipe In Trench Placed at 3.5' Below the Original Ground Surface. Total Depth to be 10.5' From Original Ground Surface. Insulate or Mound Over Trench to Provide a Minimum of 3' of Cover. NOTE: 3' 0" ' Natural Backfill '7 ' 0". Geotextile' Fabric 4" Perforate~ PVC (Slots Drainfield Rock : '1 3' I "' TYPICAL DEEP TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Aw,ay. Provide 3' Cover Over Trench and 4 Over Tank or Maintain 10' Separation From Water Service Llne~, Munici~fl~ of .chomge. DEPARTMENT OF H~LTH & HUMAN SERVICES '6~'~" _ SOILS LOG PERCO~TION ~ST ,, FOR: DATE PERFORMED: LEGAL DESCRIPTION: 5 6 7 8 9 10 11 12 LT J.! BLX'.~/Sky, Hills Subdivision I I I I I I ! ! ! 16- 20- ! ! WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN COMMENTS Pert cavit~ was IF YES. AT WHAT ~ OL DEPTH? '-~ p E Reading Date Gross Net De, th to Net T~me Tm~e Water 4f Drop PERCOLATION RATE I''1 (m,nutes/,nct~) PERC HOLE DIAMETER ~) r, . . TEST RUN BETWEEN ~'~ FT AND ~ FT presoekec~. I I ~IFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AhO MUNICIPAL GUIDELINESZ".]. C ~;B.e J. ]:, .q. DC[ e ]' 8 o nih EFFECT ON THIS DATE DATE. Mun~li~ of Anchom~. , '~ . NT OF H~LTH & HUMAN ~ 825 'L Str~ Anchorage. Alaska ~2~ ~~~"~' SOILS LOG ~ PERCO~TION TEST e~ DEPARTMENT OF HEALTH & HUMAN SERVICES PERFORMED FOR: L H ' Construction CATE PERFORMED:_~-- LEGAl.DESCRIPTION: LT ~-IBLK ~.~ Sky, Hills Subdivision . ~ ....... . ..:; · ..-"~ 6, , 8- ~I 10 - WAS GROUND ~ATER ~/ ENCOUNTERED, · ,,. ' 12 · DEPTH? -- ~ ' 13- ~W~r ,t ~ _ PERCOLATION RATE ~ [m,nute~,,ncl~) PERC HOLE DIAMETER . ?EST RUN BETWEEN ~ I~ I~ ~ ' FTAN0 ..~.~-..~-~. F T COMMENTS Perc cavity vas .nresoaked · ' ?HAT THIS TEST WAS PERFORMED IN't C ael Anderson ACCORDANCE WITH ALl STATE AND MUNIC PAL GUID~L IN[:.~ IN gl:Kg:PT ~'~N T~-II~I I'~&?~ e ' '' • f t� Municipality of Anchorage 5 F 9% �; i_ On-Site Water&Wastewater Program . �y 7� a`��_ (907) 343-7904 AN- p 1 2010 a � CERTIFICATE OF ON-SITE SYSTEMS AP"= oVAL ti 0� 68L9 Parcel I.D. 011-262-35 Expiration Date: - —20a0 1. GENERAL INFORMATION Complete legal description SKYHILLS PHASE 1; BLOCK 1, LOT 1 Location (site address) 8436 SKYHILLS DRIVE*ANCHORAGE,AK Current Property owner(s) SHARON AND ROBERT VISSER Day phone 907-229-6183 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: • Single Family (w/wo ADU) n Duplex Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for. N/A Distance: - Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ J.-U Waiver Fee $ Date of Payment Lt 111 tq Date of Payment Receipt Number 10QPSB6 Receipt Number /t COSA# l dicta tO? 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE,AK, 99507 �7 Engineers Printed Name JEFFREY A. GARNESS, P.E. Date JI'Zi3,11 9 Engineers Comments: In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the 4��111111 guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the s♦<*C OF 1 44. condition of the system's on the dates of the evaluation.Separation distances were measured to readily identifiable features. ...,c P�C� Hidden defects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septic Ar \'.••••''•••••••• .• • I. •• •• •.• systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during `),_ • # the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system's.These * 4 1• /\ •'* t conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the / system's;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the 0 •• / • current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the • r y •. Game '';i,Li information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not 1.0 C E 5 - authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. • cl' �: 6. DSD SIGNATURE �v. PROFESS' P�4- LICENSE 44ill.. `��_4* System#1 Approved for bedrooms. #LICE'9a System#2 Approved for bedrooms. Disapproved. `�<� 't *SVII` •. Conditional approval for bedrooms, with the follow stip atiaf�:{�NQ z o WAS1EWgER o 1pROGRAA o ,.� G., 4'A �CFR\IV14. -' WNW By: Original Certificate Date: The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev.10/12112) COSA Checklist Legal Description: SKYHILLS PHASE 1; BLOCK 1, LOT 1 Parcel ID: 011-262-35 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test m Date drilled Water storage tank volu gallons Total depth ft Well disinfec or coliform test? ❑ Yes ❑ No Cased to ft (form bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected _--� Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) in. Collected by Date of flow test for _ s A Date of Sample Static w_ - evel at beginning of test ft. omments A W V\l U► B. TANK DATA C. LIFT STATION Age of tank(s) 19 years ❑ Required maintenance comp/- -. Tank type/material " ., Age of lift station -ars ❑■ Standpipes/foundation cleanout per record drawing Lift station mat- I Date of pumping r \--, �--1 Z c.319 Corn :- s: 1J 1 A D. ABSORPTION FIELD DATA Which system tested (date installed) 6/26/00 Adequacy test date 3/25/19 ❑■ ALL standpipes present per record drawing Results E Pass For 5 bedrooms Total measured depth from grade *14.5 ft(max) Fluid depth prior to test 1 in Measured depth to pipe invert from grade 9.9+ ft(min) Water added 1111 gal ❑ N/A— pressurized field New depth 6 in ❑ Monitor tubes go to bottom of drainfield. If not, state Elapsed time 225 min depth into effective 6.58 0Code-required soil cover over field Final fluid depth 2 in Absorption rate 750+ gpd ❑ System presoaked N/A (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies: AT MT COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout> 100' ❑Yes if No ft ❑Yes if No ft Neighboring Tank > 100' El Yes if No ft Private Sewer/Septic Line > 25' ❑Yes if No ft Absorption Field on Lot > 100' ❑Yes if No ft Holding Tank > 100' ['Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' ❑Yes if No ft ❑Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑Yes if No ft ❑Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' E Yes if No ft Driveway/Parking > 0' E Yes if No, comment Absorption Field > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑✓ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft ** Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' E Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑✓ Yes if No ft Driveway/Parking > 0' ❑✓ Yes if No, comment Property Line > 10' ✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑✓ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft * Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ✓❑Yes if No ft Surface Water> 100' ✓❑ Yes if No ft F. ENGINEER'S COMMENTS *PER MOA RECORDS **ASSUMED PER RECORD DRAWINGS 51" OF LIQUID IN SEPTIC TANK ON 3/25/2019 ,, ,.. ,. .0. .. ,*,, ,.. ,. .0. .. ,*, , G. ENGINEER'S CERTIFICATION 0 c OF A 4A I certify that I have determined through field inspections and review �0 6,— *'•�ON of Municipal records that the above systems are in conformance with * ;. • 9 H )\ •. UO MOA COSA guidelines in effect on this date. VA VA VA VA Q •.Je;'r:• A. orn:ss.• 000 9. 'E 795 e,z'�O 4prP,. '''3(11..Z.�.�.1`1,,00 4 eap / o\ o COSA Checklist yellow sheet Q\-\.,..s�o f esso 0 #AECC884 Oo PLAT NO. 98-134 SKYHILLS SUBD., PHASE 1 LOT 1 , 201 BSOCK 1 41,N 90°00'00"E 220.79' • 30' SEPTIC SYSTEM 0 O tn1 o W t jlr. I to *1 `- G u,'DING ; d ° f 06-M eCt 0 of NES " 15* SO.g Z S XVI I Jft !. on AC,�N� P. P. 1 • 25.4' • N 89°56'19"E 133.66' / 6.o?0• . o Alp o. ti•o OEC ► / o R tT &o co a0 0 04h .7 7 o ‘6-0. o gri r 1 " = 50' z w -� N X ca 1 'O, 3 likitilt .a µo f Cl) ., lit O ZOO i lith ‘3P; . C BUILDING DETAIL SCALE: 1-=20' 30' NOTE: UMITS OF A.C. PAVING ARE SHOWN APPROXIMATELY DUE /� TO SNOW & ICE AT THE TIME OF THIS SURVEY. A S -B U I L T 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE GASTALDI LAND PROPERTY DEPICTED ABOVE AND THAT NO loksi■me* ENCROACHMENTS EXIST EXCEPT AS INDICATED. 4. OF 4, 1. SURVEYING. LLC 4 - c.,••....... .q IT IS THE RESPONSIBILITY OF THE OWNER TO ♦ P.•' ••. S .)EFF A. GASTALDI. R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS. if • .: 2000 E. DOWLING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT • 49T ...1- • ANCHORAGE. ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. • PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA jr a 87 GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR • ' Jeffery A. Gostole; ESTABLISHING BOUNDARY OR FENCE LINES. •�1�" '••.3�1`�t.•' ` 4r SW2222 3/20/2019o.A j•.. d c.,''.1 ANCHORAGE RECORDING DISTRICT, ALASKA rOjessuonot L°� 4 F.B. JOB NO. NOTE: NO CORNERS SET THIS DATE •'4 NM** 00-10 SHS111 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L' Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (9O7) 343-4744 CERTIFICATE 'oF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-262-35 .HA.Afl ' 'O ! OOO 7 " ' '"" ' '~ '" , : EXpiratio~ Date; 1. GENERAL INFORMATION ' - ' : ,' :' :. ..:-' Complete legal description L(~t 1', Bl(~ck'l,'Skyhiii~ Subdiv[sio~'l~as~ I : ' "' Location (site address0~directibns) ~. '.. .~: '. :-..- ' -" """ .... " :' '" · dy ) " ' ' .Current Prope own r s ' Crown Pointe Inc. - - - "- ' Day phone 345 6237 .':' Mailingaddre, ss.,. P.o.'B~!lf23!i;~'An'ch~r~.qe,'AK9951;I'':', -i:. ., '"'""t.'!: ., ".. . "'. ~-ending'age~c~,'.,,"' ?- .-.,:i:': '. :. "~.:.i:':,i'!",'.'.'!i'~:'.!.i" .::.:; .:'~':;.: .- . ~ .,... ' ......... : ' ' D ' '~ -.,.. -' ' .. . -:-.,' ._ ~. .... ' . ay phone. : .,,' ... - . Mailing addr ..~'~ :',; . ,-; , - : -': ' :- ' ' .'- .' ' .' ' · ealEstateAgent. -.. ..... · .... · .... .,_ - ,- ...... · /...'.:: . -:,.,'.- ...: : .,'. :. ' .... ._'..',* ;'. · . . · ..~,,:.~ayph0ne....',. ...,,. ',.....: :. : .',.-Ma ngAbdr~'s~"* '" :' ': .... . ,.. Unlessollerwisereauested HA~,,,~.~K'~5'~'' '..,',~;,.'.'""2...."" .' ' .' :.', .,:.':. - ~. ~ ~. :, ,: '.-' '.,,',."',,~ :- ., - , ,. ........ · , ..'~..,,,,~,~,~uuyur~r~ror c~(up HAA~ick dunhv' : ' "' 7" "' 2. NUMBER OF BEDROOMS: :': ' :'Fiv~(5):,',' '""' ::~' ,' '":~.'"-'/' ....... ' ":??!-' ' ' · TYPE O F WATER SUPPLY:',' '.'-, '.".; ...... :". 'rvo~,-..--,'.,....;--' .... ', · ~'," '- .',,,-: · .' · " :'.; _''" - .... '-, ' ~'," :.'"'" .' '.',!.~F,~.~r,v!A~/~'WATERDSPOSAL. ' ' 10avauaWe ''...:-. ' , - -r~': ',~ ," .',' _:"'; .... .'- :.". .... ;.. - - ~', ~ · ,... .. - , . , ,,,:.........',. ,',, u ' .';..: ' : ,- . inolv dua On-s te ' ' ",.. '..; . r~ -',:, ' .... ' ' ,' · ' ndvdu~ Watdi;Stom'n~" ': ' ' "."'r-i ':' "'".;" ".'; '-":":'' "".'"-'"~':-' '" ",' 'iL'Ce; ':.. , 'c.. . .,.. '.. ?:~..; ,-'"-'.', L J:; :',-",'. ,:mdividaa HCdn~tafik~;;.:..':.;~;.:[7-1 . .~. , · CommuntyCass · · We ,, rtl ...... .- ....... ~... .... ..,. ~ .... . . ........ ,-~ .... ~-,ommun i ~Jn-s t ..... : Pubic Water System 17TI · ~ ,. ,~, '- ........ ~ ~ .. ............. ,---, .... · I-'ue c ~ewer · - ..... I'--I · .~ ' .. ' '' '"'' ' ' ' '.~ :,, .' .*, ,.' .~,.,~ .' .; .',,.~..:;,,'.,.., ,,'~,..:' L:. ... ~ ., :..~'. ~',.': ,.'. ', ;". .... .,.The Mumc~pahly of Anchorage Depadment Of Health ~nH'H.,~;,,:,," '"'' :.:--:.'-? '"' - "; :';'." -. - ':; , ' ' ." · : ' AU her ly Appi:~va ~'HA, A~ base~ ;'~',;.:~'--'~',':': .... ',- -~':,'7 ;':,,"'..'?t',', ~erv~es, tL~I?I~ ;5) Iss,ues..Ced ficates'of Health . ' ' '.". · "::'-', .... - '), " · ' Y'!'Y.~un, tne, repres,e, matonsg~ven nparagraph5b~,~& ndeo n~.n .... ' ' '' ' '" · .. ,, .,.tv,. engineer, registered n the Stat~ of AI~.~,.,,"~'..,:,,'--'-.' ', · - '; ......... . ~ ..... e ....t profess~ona ..., ,. · '-' ',. of title (ex(~pt be~,4 'Sh'~tJs~i b~',4}~;;.~'~'.'~"~e.'s. .-°(?e.a;'m. 'A,,u-!,h-~r!~y Appr°.v. al ar, e (e~uir~ fei: t&~'tCa?si'e~: .'",. .... , · , . ,, ~' ~, ,.*,,~!.'~uuyaslnglelamlyon-ste'waste~aler i " ' · suppysystem DHHSas'o ssues'~4~,~,.- ..... .~::.._-.,.~. . ....,. ,~ .., dsposaland/orwater· ", -." · 'ar' ' -' ........... '"~'~°.uv',-',,.!uques'[ !o nome owners..L;eni~Cales'of Hea ' · e vahd for 90 da s from the d 'nf i,~&;i,.-; ~'-:- --:-'--:~'- '- ....... ;'; .... . . , th Author t¥ Approva ' , ' . ·" ..... . ..... Y .... . ,a!~ .:_ ._r_~ ,? l~u~)en~es served by a private 07 CI.~' C '~ ... w~m new water sam e resu s th~,n:Rn 'd.{,~ ',;~.4 ;'-. "~, ,' o I and may be re ssued P ts les · ~ ~ ........... . . . ........ ., ,.,,.,, t. eru~ca es are va ~d for one.year for. properties served by "" ',: Class A or. El, wells or a pubhc wa er sv "Th,~ ~,,~ ;-., ,4 ,.,_,*, -, ,,, ,..., ·. m . , ,., , ...... ..... ~,,. Y . , orage is not responsible for' 'q .ssioh.. ....... ..stem.·._~ ,., .... a -o~ ,~ncn ' erro, r~ 'or' s In the profess~ona eng neer s work - ~' '- ,., · .~ -' ,- , '-, , -. ~.:5.,~STATEME INSPECTION BY GINEER . · . ' . :':", :'::' ,'.'~,s ~'~rti~ied by"my s~'al a~ed heri]to ~,r{d ~s:~f the Validaiion' aa{e SI~ow~ bel(~w, I verify that my ir~vestig~tian ." ', ba~ed' 6n procedures Outlined in the 'H~alth ~,6thc~rity'Appro~;~l Guidelines for this Health Aulhority Approval ..': '..application shows that lh(J on-~ite W~,ter supply and/or wa~tewal(Jr disposal system is safe, funclional ahd ,: .: ~ adequate for Ihe number of bedr0oms'a~d type of {lruclfii'~'indica ed herein. I furlher vet fy lhat based on the : .': '-' "' .' i'nformat on 'obla n'ed fro~ Ihe M,',nicipality'of An(~ho['age fi e~' an~l from r~y investigation and inspecli6n the on~ "': "'.- . ~ile water ~uppl~;"ahd/or v,/a~st&~ater dispos~l s~,~tem is in ~ai-nplia~c& With all ~pplicab e-Mu~icip~al 'and Stat& . . ".; J.~des,:ordinance~'a'nar~g'dlaton~i~'effect'at'the'tm~'of ~sta aton ....... : : '-.'.'. : . - ,,,-. :.....- ... . :.:'..:.: /. ::.. . - . - ' '"' Name of Firm 'Anders(~ En ~e~n - Phone 522-7173- - .... ' - P.O B(~;~773 r~,~ ;'AK'9~]$2~' '':" ' '' ' .... " '" ' ' · :; .-'Address., ' . :'~,nc[~ e ...... · · · '-" ...'..E. ngme~er.s P['ln!e~ Name ' '.. Michael E.'Ander~on p E' '=' ;'-:: ;' :":: 2; Daie' "-:'1)04/0~ .?:'! :' "' ';. "' · ' .......................... "' 'r , - · · ~,%,~-~-*~,.t~. ,, .... ,' ~. ..... ~' , ', ............. · ......... -' . ~- '~"~ '~d *~ ~, ..... · · ~,.,,-..~- ............. . ~. ,~. . ...~ ~,. · ..... ~ ..... ~,~.~,. ,~,'. ~, ~ .... .- . . ...... . ....... , , . .... , ..,. ...... . .......,.. ~ ~ -,,'.~'.~e~.~'~ . ,.,..",,~,; ,, -~,..: , .,, .... . . ... .,.. , .. ...... ., . , .... ..,.. .,, ..';~.j,.~ , . . . ~.. ... ,~..~,.. -;,, .... · : · .: .... ; ,'.. .... ~ ....... . .... : ,. _;..,. : ,¢.,~;~-'[.,'~;"r.,'~?~.,..~ro,,~~. ........... .... .,.,,.. ...................... ,~ .0 . . .: ,'~..."'7~.."X :' ,:':6 "DH14e e r:,~^'r.m= .. · , - '. ~ ' ...... ' '" ..... '" ":' ', "' ":La.¢-'~'~'~'c'~'~'"vL'~g~'¢''~'','' ' .5- ' . , , . - · · · ....... , '. ', ., ~t'7;~i[~-, - ~--,,l: ".-, -, .. · ~...! :.~ :.: ~,. Approved for :~L-'7,... bedrooms .-,',. ,~L'..-? -:' .'. ' ..- ..~',~:~';;-, ..,: ',.';,-C',9 ..'t~7: . ;":'.'" " .'. ' · ~-' '-,-, .. · ., ' ' -" ":,'- "~ ; '." ·" .':,'t-,.;~:",~ ,r ,, :,~,~.~, ~'.-,-'.- ,~, -, , .. , ..... , , , . , .. ~ ..: ,,,. . ,. ,...... ~ , , ._e;~:'/~:..~.,',~, ...... ~'-,',':.-: '" '.'; :',:'.-'.'D-=,,,-,,,,,;,-,~ -" r._ -., ..- .. : .:-:'. ..... . ...;. ,,, ,;,,. ,-.,~.~.c,~,,:,;~,,;,~;',,g?, .....~. .:, ....;,. ,.,. . .~,~ .. .-,. . .... ; ., ., , . , . , ,- .....-.-. · ~. : '~,.~.~'~,. . -, . -~ ,.;,.. ,..,' .... : Condtona a rova for '?' ....... · ' "- ' ' ...... ' · ' .... ,"' ,,,.-..:.:..., . : ,',,.. .......... ,pP,, .,, .- ...... ~edrooms.,wIlh the f(~llowlng shpulatlons .,-.,, ..... :- .,. Legal Dasc~ption: A. WELL DATA Well type AWWU Date completed Total depth Date of test' Well production Municipalit} o Anchorage Department of Health and Human Services Division of Environmental Se~ices On-Site Services Section 825 'L' Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (SO7) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST Lot 1. Block 1. Skvhills Phase i IfA, B, or C p,-~7~ide PWSID # __ Sanaary saaI [] Cased to FROM WELL LOG WATER SAMPLE RESULTS: . · CcdIform c~onies]100 nd Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Materiai Septic/Steel Date installed 6/26/00 Tank Clean°uta Y Foundatioll deanout Parcel I.D.: 0.11-262-35 Well Log W~res properly protected [] Casing height (above ground) AT INSPECTION g.p.m g.p.m in. Nitrate Other bacteria colonias/lO0 mi '- 1.500 gal Number of Compartments Two (2) Depression over lank ~ High water alarm N_ Date of pumping New Const. Pumper N/A ADSORPTION FIELD DATA Date installed 6/26/00 S=1 rating (g.p.dJ~ or fl;/bdrm) 1.2 GPD/SF System type Deep Tren;:h ' Length 50 ft Width ;~ It' Gravel below pipe 7 It Total depth 16 ff Effective absorption area 700 Ita Monitoring tube _Y Date of adequacy test New Construction Results (Pass/Fail) For Fluid depth in absorption field before test in. Water added Depressioe over Ilald ~L bedrooms gal. New depth in. in. Absorption rate >= g.p.d. If yes, give date N/A Elapsed Time: min. Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type) D. LIFT STATION - NONE ON LOT Date installed "Pump on" level at in Datum E. SEPARATION DISTANCES Size in gallons 'Pump off" level at Cycles tested Manhole/Access in High water alarm level at in Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: No Well on Lot Septic tank/lift station on lot Absoq)tion field on lot Public sewer main Sewer/septic se~ice line On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM sEPTiC/HOLD NG TANK ON LOT TO': Building foundation :5' Water main >10' Drainage >100' Property line. >5'_ Water se~ice line _~>1O' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Pr(~perly line >10' Water Sewice line >10' Curtain drain Ngnq N~d F. COMMENTS Building foundation >10' Surface water >100' Wells on adjacent lots >300' Absorption field___.>5' Surface water Water main >10' Driveway, parking~ehlcts storage >25' Engineer's Pdnted Name Michap~ ' - ' , ' Dateof Payment Receipt Number ReCeipt Number (Rev. 10/99)