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HomeMy WebLinkAboutRAMPART #1 LT 5Rampart #1 Lot 5 #015-071-18 MUNICIPALITY OFANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-071-18 Expiration Date: 1. GENERAL INFORMATION Complete legal description RAMPART #1 LT 5 Location (site address) 5601 E 99TH AVE ANCH, AK Current property owner(s) Mailing address Real estate agent BENEDICT & ANECIA RAEL 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day pho 5 6 7 8 9 JAN 21 8 L 9 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic F Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �b Date of Payment Receipt Number p`�i1�-133 COSA # 05C a 01613 Date: Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 1-21-20 . n AI `''V ®a•f if Po .7 g^q t 0-0 'bff° eaifaVl 6. DSD SIGNATURE , y System #1 Approved for 3 bedroomspf f f :. ° ® f ®®'� • a . E o f pf f+ f O f f • f P P System #2 Approved for bedrooms O ee MICHAEL N. ANDERSON a Disapproved w ej P • ` Conditional approval for bedrooms, with the following stlWW'fi Sv,,-'-,, ' r Original Certificate Date: L --�, ( _2 as o 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 Checklist blue sheet COSA Checklist Legal Description: RAMPART #1 LT 5 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled *73? Total depth 74 ft Cased to 74 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12°+ in. Date of flow test for COSA 1/9/20 Static water level at beginning of test 28.7 ft. Comments *WELL DRILLED PRIOR TO 1973 B. TANK DATA Age of tank(s) 50+ years Tank type/material CONCRETE Measured operating fluid level in septic tank + ❑ Standpipes/foundation cleanout per record drawing Date of pumping 10/12/19 D. ABSORPTION FIELD DATA LOG CRIB Which system tested (date installed) 1968 ❑ ALL standpipes present per record drawing Total measured depth from grade 8.5 ft (max) Measured depth to pipe invert from grade 2.5 ft (min) ❑ N/A — pressurized field X Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-071-18 Structure served by this system Well production at time of test 3+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 6.14 mg/L Al Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 1/9/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 1/9/20 Results [D Pass For 3 bedrooms Fluid depth prior to test 12 in Water added 500+ gal New depth 14.5 in Elapsed time 1440 min Final fluid depth 12 in Absorption rate 500+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' 44 *44' Yes Community Sewer Manhole/Cleanout > 100' 1-1 Yes if No ft Q Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25' 7/1 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *81 ' ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No ft 0 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 91 ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5'✓❑ ✓0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ®✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓0 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' 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS * PRE -1968 SYSTEM PLUS MOA WAIVERS 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 COSA guidelines in effect on this date. COSA Checklist yellow sheet C`� 'r AT s @ o IleMICHAEL N. ANDERSON6;p x e. C 9f69 F , � ' e e, 0 r-- 1[ 0 0 O cn O n GRAPHIC SCALE: 1 Inch = 20 Feet 10 0 10 20 40 N89`57'30"E 130.05 10' UTILITY E_ASEWE„T _ COMERED STEPS,, '' 11 1 45.7 49.2 ONE STORY CANT WOOD FRAME GARAGE UNDER 4 HOME t 43.3 2' CANT WELL 1N89°�7.'3�"E 0 1■ O N O cn d - 0 W � r D W W clf t- D F- En O = Wil O m W >� = W < }_- w p _z V1 00- z �o i. O :> P4 W Z cit T, tk0 to � �Wa A a as cd a � bo a O O O— _� = 0 �_ m U) ro .— Q .� Q N � .G Qco N r. N0 bN �co 05 f ..3: m bg: m�oo�o m O ! Cc, 05 03 ;4 � N � a 0 4' '40 0_0 0R. ma ,wP'cav°0°DHto. , U�a�x".GC7 xa�sa, ° O 'CS 7t '2' .0 >1 �°4-°� �a0 0000 C` 00 0 y .i 0 0 a.0 0 v y... i. P m o G � 4 P a m Nitrate Advisory Certificate of On -Site Systems Approval # OSC201013 Subdivision: Rampart #1 Lot 5 A water sample revealed a nitrate concentration of 6.14 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 'Mad�ng Address P O Box 196650y*Anchorage, Alaska�99519 6650 * inrww inum org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. { Ma�hng Address Px O Box 196650 *Anchorage, Alaska 99519 6650 *www mum'org Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St, P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING nn Parcel I.D. 0/5^-07/-/S HAA # � rR cq Expiration Date: 1. GENERAL INFORMATION Complete legal description /. D i 5,- Rei td A -- Location (site address or directions) 5 too 1 r- :qqai. Current Property owner(s) _W IP&VA Day phone 3116- 1/041 Mailing address Lending agency Day phone . Mailing address Real Estate Agent r1, 4 �1k., f=,c t�,ec �,c�<s tom. V Day phone 7 �5 -7 ZY 7 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: _ 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:, Individual Well Individual On-site e Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm f e6,bu� 9 vekbt61-9 � �• Address ,203 ts'i/6-k4 AtZy3 Engineer's Printed Name (� G�tn S'D✓+iJaK� 5. DSD SIGNATURE _Z�_ Approved for _'7-j— bedrooms. Disapproved. Phone x274-3�1L- Q4ao/ Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: &.C, �� . C_c,_ Original Certificate Date:�j�(�p (R. QUM) Municipality of Anchorage o Development Services Department Building Safety Division On -Site Water & Wastewater Program ° • " 4700 South Bragaw, St. P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: RAKN91*4 . ' Lo -VS Parcel ID: 015-011- A. /g-01I-A. WELL DATA Well type If A. B, or C provide PWSID # _1A Well Log (Y/N) N Date completed ?W 73 Sanitary sea[ (Y/N) Y Wires properly protected (Y/N) _ Total depth1y v ft. Cased to �R. Casing height (above ground) n. FROM WELL LOG AT INSPECTION Date of test (0- 30- O `{ Static water level ft, 'a -4R. Well production g,p,m, All g.p.m. WATER SAMPLE RESULTS: Coliform _A—colonies/100 mi. Nitrate mg.A. Other bacteria N 12 colonies/100mi. Arsenic: ✓ mg.A. Date of sample: _�A_Vlvy Collected by: ; ' vIrk1AK4n B. SEPTICIHOLDING TANK DATA Tank Type/Material WncrAo_ gloci. Date installed t?rior % l9 oS Tank size 1000_ gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N) —y- Depression over tank (Y/N) _IV High water alarm (Y/N) —641A Date of pumping -7/14/0 Pumper A* C. ABSORPTION FIELD DATA ; > Date installed c'' '• I968 Soil rating (g.p.d.lf:2 or R2/bdnn) Uk �4*4" System type Ls, 11r;6 Length R. Width R. Gravel below pipe _ja R. Total depth B,� ft. Eft. absorption area j&r�tt1 Monitoring tube _� Depression over field A/ Date of adequacy test 6-30-0 4 Results (Pass/Fail) _ For 3L bedrooms Fluid depth in absorption field before test .28- in. Water addedILOgai. New depth in. �ry Elapsed Time: - w Final fluid depth -gy in. Absorption rate >= _ 4150 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) _� If yes, give date D. LIFT STATION Date installed "Pump on Datum E. SEPARATION DISTANCES Size in gallons 'Pump ofP' at_ in. Cycles to ed Manhole/Access ) High water a nn level at Meets ala & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: r0+ Septic tahknin station on lot-$�s- yy L.S.C.SOn adjacent lots Absorption field on lot Afty 81 1 L5 -On adjacent lots (004 Public sewer main N/A Public sewer manhole/cleanout Vl k s Sewer /septic service line �� r Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: t Building foundation Cl Property line I0+ Absorption field 31O Water main NIA. Water service line 1O+ Surface water NSA Wells on adjacent lots IDO } SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: c . Property line B.u5'VIA A5ilding foundation Water main ' Water Service line I0+ Surface water Driveway, parkingivehicle storage 10+ Curtain drain -�— Wells on adjacent lots 100+ F. COMMENTS 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 oris date. Engineer's Printed Name /e l!4 C►f9pyYK14tM47. Date -1-04-, 11, 2.04 1,1 . 00 HAA Fee $ i Weer Fee $ _ Date of Payment % I0 7 y Date of Payment Receipt Number b w +'i-- Receipt Number (Rev. 12101) 7 w in. F.�T ..IINC ■TL.a u unr t<nu w N.OY ■IS.R 0 M Q 0 O hi 1Y89'S7'3o"E uo.oS0 Z� 5 el ff/3T/N�. •r Nvu a q9= CANT � I WtYL y of ` N89' S713011E / 30.03' O 2, 9/57- lqae- .431 UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNES THE SURVEYOR TAKES RESPONSIBILITY FOR THE OnAL TRANSACTION ONLY AND ASSUMES FINANCIAL LABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCARE LOT V.W% Y SURVEY TYPE SYMBOLS FOUNOATOIN AS -CULT ........... FINAL STRUCIM A!I B T SET MAR D ASPHALT DRAINAGE .......... o FOUND REBAR .p,._ya MOOD FENCE 0 CONCRETE ❑ ROT RJJI ... AS-RJL7 ... LOT 1RKY ... TQOYIARIV 1="I AS -SLOT ... ND mRNDa 4'I � RtCOFMfJTd ASRar .. _ Nei erw.rw. >.r ® ASSUMED EIEV. if—M—N- METAL FENCE ® N000 DECK IT SURVEY CERTIFICATION PLOT RAN Irw/ �wI M I M ✓.�.rT VIN/ b w..wN�r ti�NM .. 4. w N 1.... ... r ...�4 N ✓fir r wnw.M M i FOUNDATION AS -&AT w� HrV w YiI. W/ r M \nYO..w MMNM./Y FINAL STRUCTURE AS -BUILT L 1+tiLMrl. �.�M'M1 wMMNMrY �r w. M...Ow w rw 111x1 TO I ONLY THOSE IMPROVEMCNTS ABOVE GROUND AND VISIBLE WILL BE VE SHOWN. FENCES. WELLS. SEPTIC CLEANOUTS. SIDEWALKS. DRIVEWAYS. NE ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SNOW NS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. LT. ALL DISTANCES ARE RECORO UNLESS OTHERWISE NOTED. Prepared by Robert E. Johns, Jr. & Assoc. Professional Land Surveyors 542 E 12 AVE ANCiORACE. ALASKA 90.501 Sonic 1 n 30' R. Loi S.F. R. Plat FL. No. v JULY 19,20041243712420', 901 DOWWOM, LOT 5, RAMPART SUBDIVISION ADDITION 140.1 .est: ,•; .•:!dt .. 1 :fv:... •. .. •4 u r'c'L -,;. .. ...Me .. Wit. • •.1•��. ...V . �1.. _..._. i'... .E' . .t.::t i': Y3_[7.^ (: Y�.t�L.... ftt•• .��.�•`� it.t .•:: :� ::7.. .,•� Detcrlr'l�(•7. of f:�rcv_Lion ' 1 .M1 ..r. •_-_._. � 41:1 C4:.i713} � :'Q1,'. Si LE• of ratc)•.•..8"1 ...�..�2 G_ -y:�: d7f0:ij Nib C3' '•tsC. ��71�` [�L^ ' 1 �'`.e� �•rrc11/ Y� _'�_�_ ' S4 < i _.. �._ •i•i1G. 'i::•. :..."� tit:.._.-.. 3Ort ,.• ....:i0•.T•• • • • 'Loll .. .I,,�s .t.::t i': Y3_[7.^ (: Y�.t�L.... ftt•• .��.�•`� it.t .•:: :� ::7.. .,•� Detcrlr'l�(•7. of f:�rcv_Lion ' 1 .M1 ..r. •_-_._. � 41:1 C4:.i713} � :'Q1,'. Si LE• of ratc)•.•..8"1 ...�..�2 G_ -y:�: d7f0:ij Nib C3' '•tsC. ��71�` [�L^ ' 1 �'`.e� �•rrc11/ Y� _'�_�_ ' S4 < i Municipality of Anchorage Development Services Department • Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. s �'r P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Tobben Spurkland Legal description: Rampart #1 Lot 5 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ® Discrepancy in information submitted. Lggel discription ❑ Topographic information missing or Inadequate. _ ® Incomplete; missing bistance well to septic wervice line ? ® Incomplete; missing NA for distance septic to surface water f —1& 4 ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. Well pits are prohibited '%c `�o �4� • Pca� �q13 n``� Name of reviewer: Jeff sn,��o_a:cc� d.s`1orz�co. ��wcr,.m��l Date: 8-4-04 �s 5p' .lEl(Yl Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK $ _ f o - o cf of ;of /A l.a sPtc-i l'op'. / 5TCi7 a /,717- a.r.e, 6ra�e&,— s w•�Jrov'`c�'Oj (�, �oUVP� � ►/'aG� f Municipality ofAnchorage W P.O. Box 1966.50 • Anchorage, Alaska 99519-fifi.50 • Telephone (907) 343.8301 • Fac (907) M-8200 4700 aragnw Sheet • Anchorage, Alaska 9!1,507 x�V.muni.org Mayor Mark Be#ich Building Safety Dhisiott 2/15/2005 Tobben Spurkland, P.E. 203 West 15`h Avenue Anchorage, Alaska 99501 Subject: Waiver Request for Rampart #1 Subdivision, Lot 5 Waiver Request #WR050007 Parcel ID 4015-071-18 HAA# IIA040369 Dear Mr. Spurkland: Your request for a waiver of the required 50 feet horizontal separation from the septic tank to private well has been approved. The approved separation distance is 44.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department.: If there are any fiuther concerns or questions regarding this waiver, please call our office at 343-7904. %Sincerely, c� ^ " Julie MakelaMakela, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department • +� Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Sunt P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR050007 PID#: 015-071-18 Date Received: 2114/2005 fInzzmv Ri3EL' Aft 0 HA#: HA040369 Permit#: Waiver Requested: 44 feet from septic tank to private water well on subiect lot Criteria: Geology Points: A. Water Table B. Sou Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 4�.iz y.4 a.R n.9 Total: 11 0.-1 ............................................................................... Waiver Is Granted: _� Waiver Is not Granted: Ust Conditions or Reasons for above: Date:TS — By �ame of Reviewer .............................................................................• Rec#: 63875 Amount: $9 Date Paid: 2192005 Rampart #1 Subdivision, Lot 5 Parcel ID: 015-071-18 Waiver for 44 feet from water well to existing septic tank on subject property Issued January 15, 2005 General 1. Total coliform and other bacteria were not detected for the water sample collected from the well on the subject lot. 2. A nitrate result of 3.42 mg1L was reported for the water sample collected from the well on the subject property. 3. The nitrate result for the water sample from the subject well Is consistent with recent results for water samples collected from wells located In the vicinity (Rampart #1 and Summit Estates Subdivisions). 4. The well on the subject property was Installed in 1962 at a total depth of 74 feet. The static water level on June 30, 2004 was 27 feet. The well is cased to a depth of 74 feet. The well logs for surrounding properties indicate that the wells in the area are completed in a confined aquifer. The confining layer appears to consist of approximately 30 feet of Gay and silt. 5. The septic tank on the subject property was installed in approximately 1963. The septic tank is constructed of concrete with a total depth of 7.5 feet from original grade. 6. Prior to May 30, 1969, the minimum separation distance between a septic system (tank and absorption field) and a private water well was 50 feet. The absorption field is located approximately 80 feet from the private well on the subject property, therefore, a waiver is not required. 7. Due to lot size and location of septic systems and water wells on surrounding properties, there does not appear to be a location on the subject property to meet the current minimum separation requirements for a wastewater disposal system or water well. ADEC Criteria Points Water Table 5.7 Depth of well 74 feet Total depth of septic tank -7.5 feet 66.5 feet x/18.5 = 1/25 x = 0.7 + 5 Soil Sorption 4.4 Soil descriptions from well log for adjacent property (Summit Estates, Block 3, Lot 5) Silty sand & gravel 7.5-10 feet Clay 10 -18 feet Silt 18 - 27 feet (2.5/19.55 x 2.5) + (8/19,5 x 6.0) + (9/19,5 x 3.5) Permeability Soil descriptions from well log for adjacent property (Summit Estates, Block 3, Lot 5) 2.8 Silty sand & gravel 7.5-10 feet Clay 10-18 feet Silt 18-27 feet (2.5/19.55 x 1.5) + (8119.5 x 3.0) + (9/19.5 x 3.0) Water Table Gradient 2.9 Subject property is generally level. Assume 0% slope Horizontal Separation 0.9 44 feet between well and septic tank on subject property 0.3/25=x/19 x=0.2+0.7 Total Points 16.7 As per ADEC waiver guidelines a point value of 16.7 is almost sure to be free of any form of contamination from household sewage. T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99519 Subject: WAIVER REQUEST LT 5 BK 1 RAMPART SUBDIVISION PID 050-071-18 Gentlemen; September 1, 2004 We are applying for a waiver of the separation distances required between the septic tank and the well serving this lot An As Built Survey shows that the separation distance between the septic tank and the well on lot 1 is 44 feet. The separation distance between the well and the septic system is 81 feet. The septic system and well were installed prior to 1968. Prior to 1969, the required separation distance from the well to both the septic tank and absorption field was 50 fceL The septic tank is constructed of concrete. The tank was inspected during a well and septic test on June 30d, 2004. During this inspection it was noted that the liquid level in the tank was 50 inches. Fifty gallons of water was added to the tank. This caused the water level in the absorption field to immediately rise. This indicates that the tank is intact and not leaking. The absorption field was installed prior to 1968. It is a log crib. Soil logs for lot 5 Block I Rampart subdivision are not available. The absorption field design was based upon use of 85 —125 sq. feet/per bedroom. This would indicate that the soils are sand and gravel. A document search for soil logs on the neighboring lots indicate that the soil layers of the area consist of good quality sands, gravels and silty sands. We are enclosing soils test in the area to show the types of soils encountered. No well log is available for the well. A request for approval of individual sewer and water facilities approved on March 23, 1973 states that the well is 74 feet deep and that its construction was approved. During the well and septic test conducted June 30, 2004 the static water level was 27 feet below the top of the well casing. A document search for well logs on the neighboring lots indicate the following soil layer, sand gravel, gray clay, sandy silt, gravelly silt, and pure clay. Most of the wells and lots were developed in the early 1970's and were approved by the municipality. We are including the well logs of the neighboring lots that we were able to find. Wavier Request: 44 feet from septic tank to well. REF.: "ADEC Seperation distance wavier guidelines." A. Water Table: B. Soil sorption: C. Permeability: Bottom of tank @ 7.5 ft. Well Depth= 74 ft 66.5 ft min. separation - 5.58 Soils are sandy gravels and silty sands. From soils logs on file .5 x 1.5 +.5 x 2.5 - 2 Soils are sandy gravels, silty sands and clays From Well logs on file - 1.5 D. Water Table Gradient: E. Horizontal Separation: 44 ft separation a .8 See drawing - 1.0 Total - 10.88 Special Considerations: The house foundation is between the well and the septic which will prevent the possibility of water contamination due to septic system overflow. The septic tank is constructed of concrete which does not corrode. It is intact and should remain so indefinitely. Water sample collected from this well indicate that no bacterial or chemical contamination has occurred during the last 35 years. Water samples collected in on June 30, 2004 show no bacteria. however the Nitrate levels were 3.42 mg/I for lot 5. This is equal to or below the nitrate levels of other area wells. Many of the surrounding lots have requested and received separation distance waivers. Conditions at Rampart Lot 5 are similar. There are no alternative sites on the lot to relocate the septic system. I leath authority approvals have been issued on 1- 15-1981,9-29-1976, and 3-20-1773. At this time we are applying for a On Site System Approval, and request that a formal waiver be granted. 1 have included a site plan, showing the well in question and the location of the septic system. Yours T. Sp and P.E. Permit Fees: 920.00 Date of Payment: 2/14/05 Receipt Number: 63675 W 2 Fc6. 13, 2005 Wa6 Ta�1e . Gra�►e.. :. Well Sev� Hio Lv L HZO To, 6►P— 44' T. SPURKLAND P.E. WEST 15TH. AVENUE SUITE 203 ANCHORAGE. ALASKA 99502.3904 (907)279-3916 Fax (907}276-6013 RESIDENTIAL WELL INSPECTION LEGAL: Lot S Block 4 Summit Estate OWNER: Richard Sullivan LOCATION: 5480 E 99'". Avenue TYPE OF WELL: Private, Single Family WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET: Yes WAIVERS GRANTED: None WELL YIELD FROM WELL LOG: 6 Gallons per Minute WELL YIELD FROM TEST: 3 Gallons per Minute, Limited by pump DATE OF INSPECTION: June 20, 2003 TEST PROCEDURE: Well was pumped at a constant rate while the draw down was monitored with an acoustic probe. At the beginning of the test water level was found at 268 feet from the top of casing. At a pumping rate of 3 gallons per minute the water level did not change. The well was pumped for 160 minutes.. A total of 450 gallons was pumped.. TEST FOR E.COLI AND TOTAL NITROGEN: Well was tested for E.Coli and total nitrogen on June 18, 2003 RESULTS: E.Coli 0. Other Bacteria 4 Total Nitra[e-N —J.18 mY/1. _ Max. allowable Total Nitrate -N 10 mg/l.-10 Colonies of Bacteria Allowed TEST RESULTS: This water quality of this well meets the requirements of the Municipality of Anchorage. THIS WF.LI, WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE, FOR MORE THAN FOUR HOURS The Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceeds this requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. isn awnUad 2-10-06113161 ICT end E SCiSlCT6E ENVIRONMENTAL SERVICES -SG Drinking Water Analysis Repo 0 7cjj�1cac NUDDM111UCilOM60N1MV.11t[i1De.eP011. 63uS�1 MUST BE COMPLVMD BY WATER SUPPLIER ❑ PUBLIC WATIR SYSTEN roe IRNATE WAT81 SYSTtat ❑ and MWaf C) ww h.aN SAMPLE COLLECTION: a.w Z ....q .e. fl w.a cAr.. ?� raw D.r ❑ ww MA. SAMPLE TYPE 16916301 a 2/ 2 200 W POTTER DRIVE ANCHORAGE, ALASKA 99510 Tel: 907'W2343 For. 9OT-MI-5301 to Rar No. Jr -, 1050680=( VON o36"bia'" jltowne ❑ Treated Water vr Tann 101 t0 f1 PM 0v. u RepntSemple Untreated Walter L>L 5 (Ielerto lab Ro. Loadw.. Q spaclN Purpaw earoewn QQS SPL2Kl AND Awe to LauD b bym: 0o �rne $6 collector Other: TO BE COMPLETED BY LABORATORY Sam lk Realvl! : q Dale: e2-Y-t>S ❑6'noleow30tounad: flames RAY be wWaw Temp: Delivery Method: Recelved BY ❑ RUSH SAMPLE Phots is Fa M: Col.manlc ............................................................................•............................................................. nru,nln,NeHfyy7 e.1ialTtFflRatPoW'a_11K'na Form 121703.MA aM n HOER gicterloloolal Water AnaNela Ree M NNo4wo (*AI RSSum ANC PaK JUN !1 TOW Coma" OoaeRti*e AnWda aeee�,1q��S C Colt Anstrat y— _ Sect b CSmt Phoned Q FOled N1"RANK 1R.TER IISSULTS: ' Alulytlwl ea1U10d: 011001011001teNt '� C dpiwloonL DebJM1ne' Membrane Flw Veranm 1: soeW . inc MM4MlJG (PIA) r T""a'a" 0 Satisfactory `L1", ec. ❑ Unsatisfadory Te11C.Tw Maalwe Yown DotdImme: a p ItI IZ• Q Reported 11Y: --- • FormeFW-0033 12117103 nru,nln,NeHfyy7 e.1ialTtFflRatPoW'a_11K'na Form 121703.MA TOBBEN 5PURKLAND P.E. RAMPERT 11 LOT 5 SEPTIC SYSTEM DESIGN 203 W 157H. AVENUE W/LUAM S HOUTEN DATE. FEB. 13, 2005 (NCH. AK. 99501 907 279-3916 11 5601 E 99TH AVENUE SHEET • 1/1 GRID: 2437 PERMIT #SV03 XX PID I/ 015-071-05 RMP01051.DV5 9 B 76 5 1 + 3 1 BLOKI I I m � WELL LOG / F01/ND 9 i 8 1 7 6 5 I I I 3 12 BLOCK 2 I I Nlu LOG — FOUND 1 !0 i 1/ i 12 I 13 ' 11 CI 15 1 16 13 ( I I I 9 e 7 1 I I 6 I 1 BLOCK 3 1 ( I I 5 I I I I 3 I WA TM I i S"PLBS 13 .5 I 3 5 1 I I I (I i I I 34 I— — WELL � 6 7 8 6 Q 7 8 IVFUNI I ` BLO 4 OF ,V��� I SOIL LOG FOUND SOIL LOG FOUND ---------b-- ••.••� — — — - — — — - - '�- - {t:'nt °:� - - - - 7 - - - 6 - - - - .»..T.........».....»............»..:}..... %o BEN SPURKLAND. TDB ­ •. JS •,_ No. CE -2225 TOBBEN 5PURKLAND P.E. RAMPERT 11 LOT 5 SEPTIC SYSTEM DESIGN 203 W 157H. AVENUE W/LUAM S HOUTEN DATE. FEB. 13, 2005 (NCH. AK. 99501 907 279-3916 11 5601 E 99TH AVENUE SHEET • 1/1 GRID: 2437 PERMIT #SV03 XX PID I/ 015-071-05 RMP01051.DV5 .14 1 r INSPECTION APPOINTMENT DATE RECEIVED TIME TIME TIME 6. TYPE OF RESIDENCE N DATE DATE DATE/ ^ INSPECTOR INSPECTOR INSPE T R MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF H & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO1'CNYIRONMENTAL � T�:3TECfION 825 LStreet- Anchorage. Aloka 88601 ENVIRONMENTAL SANITATION DIVISION JlAN 15 1981 Telephone 264.4720 FOR APPROVAL OF INDIVIDUAL WATER AND SEWERU.'TLT4 X E D REQUEST DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten 110) days for processing. 1. PROPERTYOWNER I'CC 7 dirtpr t Ant, C, whin PHONE 3710- 13.10 MAILING ADDRESS SR 318! VJCL& r/IOL AV 911tP7 PROPERTY RESI DENT (it different from above) PHONE lel—yy 39 f . e .4 AH n.a. 51-ocic &r4 2. BUYER Wil)1arn SC_ko'jIH 2n HN MAI LING ADDRESS 3. LENDING INSTITUTION N. -S. A . $fte.'Be.ntd4p-0i PHONE MAILING ADDRESS IUor-{ivn L(' els _1 Q, sko_ u& 4. REALTOR/AGENT VPHONE Polar Rea tYah 1C Ta"a— MAILING ADDRESS 110I E. 76,0kv- 9SDa- 5. LEGA DESCRIPTION n �0+ 5- Work 1 Barn "+ S&64v,z,t STREET LOCATION 5(ofe s- 6. TYPE OF RESIDENCE NUMBER OF,SEDROOMS ❑ One ❑ Four ❑ Other DI SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ® Three ❑ Six 7. WATER SUPPLY PQ 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.) S. SEWAGE DISPOSAL SYSTEM - 18 INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. 6/79) ll� THIS SIDE FOR OFFICIAL USE ONLY t. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ 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 SOILS RATING ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL - - 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS m-- APPROVED FOR �� BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompan certificate) ❑ DISAPPROVED DATE =2-q,�I 72010 (Rev. 6/79) RFLunicipali y 02 Aiichorapgle r%, 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE F.I. SULLIVAN. MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION January 20, 1981 Alice J. 11olinger/loin C. Whitney Star Route 3181 Wasilla, Alaska 99607 Subject: Lot 5 Block 1 Rampart Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be delivered to this office from the Chem Lab, 5633 B Street, for our review. (2) Locate and expose the standpipes to the septic tank and the seepage area. Raise the standpipes twelve(12) inchs above ground level. This is to insure the minimum distance requirements are met between the well and sewer system. (3) The septic tank pumped with a receipt submitted to this office. (4) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Please notify this department for a reinspection when the noted descrepancy has been corrected. If there are any further questions, please call this office at 2G4-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw r Tobben Spurkland P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 Frank Tadda Polar Realty 1101 E 76th Ave Anchorage, Alaska 99502 Feb. 2, 1981 Start test SEWER ADLQUACY TEST Legal: Lot 5, Block 1, Rampart SID Location: 5665 E 99th. Ave. Owner: Alice Hollineer Residence: Three Bedrooms, Splitt level Water: On Site Well Sewer: t10 Municipal Records: See attached Drawing for location. rom pumping record: Tank: 1000 Cal. + Absorption System: Crib. Date of construction 1964 Date of Test: Jpn. 319 1981 Test Procedure: System was inspected on J n 29, 1981. Tank vent consists of 6x6 concrete blocks. Contents of tank was extremely heavy. Vent of crib is a 6 inch AC pipe. Liquid level in crib was found to be 22 inches. No deposits or floating matters. On Jan 30 1000 gal of water was discharged into the pit and the following readings of the liquid level taken. Start test 25 inches Add 390 gal 31 add 300 32 add 400 32Y2 End of discharge after 30 min 26 next morning 14 The tank was pumped on Jan. 30. Approximately 1000 gal was removed. Approximately 12 inches of heavy slgdge remains. This system absorbed the 1000 Cal of water in less than 1 hour. It meets the municipal code in regard to tank size and absorption rate. Tobben Spurkland P.E. E ct94-ti zc.� O Toll 36ed,.00m � 'Reas;dehcL � , _. a,„ k %000gi n B "AC P,�C- 6 Evvez2 S eST EEM LOCATIoN RT Lorro BK I,RA"PA RT X665 r-- 944. 1 R ANCHORAGE AREA BOROUGH artment of Environmental Quality " Street, Anchorage, Alaska 99503 274-4561 Date Received Member 9. 1976 Time of Inspection 9-/6-7�o / Date of Inspection oryL ( E FOR APPROVAL OF le SEWER & WAT$R FACILITIES �u.c h hada. 1. Approval requested by FOR Real Mailing Address: 724 East 15th Avenue "`_— Phone- -Y72-0571 2. Property Owner: David Schumann Phone: 344-3590 Mailing Address: Box 78C Star Route A 3. Legal Description: Lot 5 Block 1 Rampart Subdivision c� 4. Location: East 91st Avenue, 4th house on the right 00-.A&, Ile, 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Individual A. Type _114� B. Depth C. Construction D. Bacterial Analysis 73' 7. Sewage Disposal System: on-site system a, jyu..O ''Q /97'3 A. Installed C. Septic Tank: 1. Size D. Seepage Pit: E. Disposal Field 8. Distances: B. Installer 2. Manufacturer 1. Absorption Area 2. Material Total length of lines A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Rec' % t for Approval of Individual F�,r & Water Facilities Legal'Description Lot 5 Block 1 Rampart Subdivision Comments Approved Disapproved Date Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 1 cerLlry LnaL FIC InTVT11='6wn w'1w11'cu if, �.� .may....... .-. -rr• -- -- - --- - accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date r..� a orad MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 REQUEST FOR APPROVAL OF r CE I V ED. INDIVIDUAL SEWER and WATER FACILITIES i> 1. Type of Inspection: CMRO VA FHA CONY Other X 2. Property Owner: David Schumann Mailing Address: Box 79 C Star Route A Day Phone: 344-3590 3. Name of Buyer: Mailing Address: Day Phone: 4. Name of Lending Institution: Mailing Address: Phone: 5. Name of Realtor or Agent: Totem Realty Mailing Address: 724 'cE. 15th Avenue Phone: 272-0571 6. Legal Description: Lot S Block 1 Rampart Subdivision Location: E 91st off Birch Road (4th house on right) Type of Facility to be Inspected: Sewer and Water No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 73 feet 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation " enclosure attached 72007(3/76) r GREATER ANCHORAGE AREA BOROUGH^ Department of Environmental Quality 3500 Tudor Road, Anchorage. Alaska 99507 279-8696 Date Received 3/15/73 Time of Inspection 10:00 a.n: Date of Inspection 3/20/73 REQUEST FOR APPROVAL OF INDIVIDUAL SERER S WATER FACILITIES FOR . 7., A. Type - Drilled B. Depth 74' C.' Construction .Approved D. Bacterial AnalysirSatisfactory S M - v, -Sal SvStem: Individual cesspool and septic tank ewage A. Installed prior to 1968 B, C. -Septic Tank. 1. Size 8X8 2, D. Seepage Pit: 1. Size SX8X6 2 Installer Manufacturer Young 1Ob` :) G1^4 Material Log crib E. Disposal Field: Total Length of Lines B. Distances: (pit) A. Well To: Septic Tank 85' Absorption Area 100'+ , SapSiZlTSs N/A Nearest Lot Line 16' Other Contamination B. 'Foundation to Septic Tank 48' '> Absorption Area 1001 C. Absorption Area to Nearest Lot Line 18' Conventional - First National Dank 1. Approval Requested By: Estar Bumgardner - Shennum Agency Address: 236 E. Fifth Avenue Phone: 279-3511 2. PfopertV owners Robert B. Donaldson Phone: 344-3271 ----- 3. Legal Descf'iption: L5. B1. Rampart Subdivision 4, Location: East 91st. off Birch Road 5. Type of Facility to be Inspected: Single family Number of Bedrooms: Three 6. Well Data: Individual 7., A. Type - Drilled B. Depth 74' C.' Construction .Approved D. Bacterial AnalysirSatisfactory S M - v, -Sal SvStem: Individual cesspool and septic tank ewage A. Installed prior to 1968 B, C. -Septic Tank. 1. Size 8X8 2, D. Seepage Pit: 1. Size SX8X6 2 Installer Manufacturer Young 1Ob` :) G1^4 Material Log crib E. Disposal Field: Total Length of Lines B. Distances: (pit) A. Well To: Septic Tank 85' Absorption Area 100'+ , SapSiZlTSs N/A Nearest Lot Line 16' Other Contamination B. 'Foundation to Septic Tank 48' '> Absorption Area 1001 C. Absorption Area to Nearest Lot Line 18' :'i �fquest for Approval of �dividual Sewer b Yater Facilites Page Two Based on prior approval by this 9.' Comments= Department. O Date 3/23/73, ved/r,,f„�! %rr✓ Disa;proved Approval Valid for One Year From Date Signed i:;CJ L L a ar men o nv rona.ental Quality Greater Anchorage'— Area`�orouq F DIAGRAM OF SYST5! I certify that the information contained in this request for approval to oe o true and accurate representation of the subiect sewer and water facilities located et: Signed Date GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received <3- IJ = %3 Time of Inspection AD ' d -y Date of Inspection _3_.�0-'1,3-� REQUEST FOR APPROVAL OF INDIVIDUAL SEXIER S WATER FACILITIES FOR 1. Approval Requested BY, Phones. �7�%_ 35�� Address: c 99So 2. Proaerty Owner: /�s-lir:, f » Q *� ��r^J Phones ,3 61f1— 3. Legal Description: 4. Location: arc. T c� ��/ Urfa r. �— %,�•�. ,.l / 5. Type of Facility to be Inspects Number of Bedrooms: rZ 6. Well Tates �,Y' .0b� �U" ` � �j'�A ,,/Depth '"d: Eacterial Analyst C. Construction � ' 7. Sewage Disposal Systems A. Installed 6/r B. Installer C. Septic Tank: 1. SizelV.�2. Manufacturer_ D. Seepage Pit: 1. Size2. Material ('/1 E. Disposal Field: Total Length of Lines 9. Distances: A. Well To: Sept �Ta- � 6 /, Absorpio -Area Nearest Lot Line%� Other Contamination B. Foundation to Septic.Tank /4 Y �� AbAorptiocJn Area C. Absorption Area to Nearest Lot Line r, n Request foT Approval off lividual Sewer b Water Faciliti Page Two 9. Comments: • � l.+w.-cG . AonrovedA�c -' - o� min A3sapproved Date 3 ? 3 73 Approval Valid for One Year From Date Signed Greater Anchorage Area Borough. Department of Environmental,Quality I certify that the information contained in this request for approval to be a true and accurate representation of the subiect sewer and water facilities located at: Signed ' // Date `(/ f `G ll; FHA Form 2573 F. Aw�.d f954 FEDERAL HOUSING ADMINISTRATION Dd,., N.. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.—TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE Anahmgep., ., .. SPONSORMORTGAGOR OR PROPERTY916t Ifflemm andBirch r=4 SUBDIVISION NAME ■ New installation .. e Into additional bedrooms? (if Yes, ho� fflony?) Yes No WATER SUPPLY 8Ys E) Community system [jj Individual ZSA■ent ■ ■Community system r. Individual© ■ ..................................................................... ■r■r■■.■.......■.■■.■....■....r....■..■......■........■C■■■■■....■.... ■r■rr■■■rr■■■■■ ■■■■rrrrr■■rrrr■rrr■rr■■■rrr■ ■rrrrr■■rrrr■■■■■rrrrr■■ ■■■rrrr■■rrr■■■rrr■■■■rrr■■r■■r■■rrrrr■■r■rrrr■rrrrrr■■rrrrr■■rrrrrrr■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■_■■■■■■■■■r■■■■r■■■r■■rr■■■■rrr■■■■rr■■■■■■rrr■■■■rr■■■■■rrr■■■■■ r■■■■■■■■■■r■■r■rr■■■■r■■rr■■rr■■■■■■■r■■■■rrrr■■■■rrrr■■■■rrrrr■rrr■ ■■rrrr■■rrr■■■■=rrr■■■rrr■■■■■■■■■rrr■■■■■■■■■■■■rrrr■■■■■rr■■■■■■rr■■ ■rrrr■■■rr■rr■■ ■■■rrrr■■rrrrr■■■■r■■■■■rrr■■■rrr■■■■rr■rr■■r■rrr■■■■r ■rr■■rrr■■■rr■re■■rrrr■■rrrr■■■rrrr■■rrr■■■■■■rrrrr■■■■■■■■■■■rr■■■■■■ ■■■■rr■■■rrr■■■ ■rrrr■■r■=rr■rrrrr■■rrr■■■■■r■■r■■■rrrr■■■■■■r■■■=■r■■ ■rrrrrrrr■rrrrr■■rrrrr■rrrrrr■rrrrr■■rrrrrr■■rrrrrr■rrrrrrr■rrr■rr■rrr REPORT OF INSPECTION—INDIVIDUAL SEWAGE -DISPOSAL SYSTEM PRIMARY TREATMENT consists of ❑ Septic tank. ❑ Cesspool. Septic Tanks Distance from well, feet. Material, Number of compartments Total liquid capacity, gallons. Capacity inlet compartment, gallons. Inside Irngth, feet. Inside width feet. Liquid deph, feet. Cesspools Distance from: Well, feet; foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, fret. Inside diameter, fent. Depth feet. Liquid capacity, gallons. Lining material SECONDARY TREATMENT consists of ❑ Tile disposal field. 0 Seepage pits. Ocher fWll—PO1N111a�Iq MIIMIN pLYplpq l'll {1 (aILJ) • .. —61 uo!uadsw Jo ateQ dq pavadsul •dtuotpny 'plea" N--1 ❑ •dtuno) ❑ •amS ❑ :dq spew uoom isul •due P. Y .q!yxa panwdJe yt!m dldwo:I lou scop ❑ scop ❑ uwsellnsul •uopdwnsuoa umny Joj dJovejsnes lou $! [3 t! 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Y�iDtefi ~tact::! tS:rcon cn vi:::ln t:.a DwY-rY r"'$ cnC �a t.a tr: 4n:r�ccb F L. 4cl4ccnl I: raa, t:.4t no kn�ror4rn:nG 4a yroy:fr/ t/ n j c:;4aat C:•ro7a on ENO DtiD:d/ / � urttan eed tbd tA"6 cru n4 r4o'..rc,'.. 6•cc::»l�:.•♦ G+s H :: ji a 4 w.w vl r t/4wrr.tAL 4n K.w j.roicrt/ icl•.r:«GS:.�. i.cr::..�. DISCLOSURE PAGE 14 OF 14 Llo Cofz'S G• . t '3'.: Fronts }{:1?ar•en �o •/ no `•yFG . •••.•..••'`��•�� f, , , .,� 4 � /o' Brie. Es•� 'aa/frlf• \ � O �(•✓ctoSC4 � turcy � 4g' 1 • 3 - jloJffl ~ i� O r 'SCOLt //'i0• 1 57'.70'e 'o M 0 fi EAST NINETY FIQST AVE. ality of tified The Graphics Dept. fthe ni they arei changing E.A91strtoea E 99thrAvenue. that they 4iP•J1LT' c C�ect� 1 Lova rnvo•/cd 1:a (a faw!y 4': r:^C it°r rG Vt ._... pn.� 641 1::0 `1.,: •PG R r Sf/! 1) fro. / LLM . «:mC.n7 tr:cL+ct, J•..._c. 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