Loading...
HomeMy WebLinkAboutRAMPART #1 LT 6Rarnpart #1 Lot 6 #015-071-09 r GREATER ANCHORAGE AREA BOROUGH `P Ppp-wencEq�e 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 o n a DEPARTMENT OF ENVIRONMENTAL: QUALITY �s axm o90gN'ZED JW December 4, 1972 William Cardwell 9290 Lake n+ Dar w -a •STiii2lPr/� , Ok g Anchorage, Alaska 99502- V 9 6_0 7 956V96_a7 Subject: Permit to install sewer -system Dear Sir: A permit was issued to you by this Department for the installation of an on-site sewer system and at this time we have no record of this system having been installed. Please complete this form and return it to this Department at your earliest convenience. yes no 1. The system has been installed. [] 2. The system will be installed later this year. 3. Void my permit; the system will not be installed. 4. The system will be constructed during the next construction season. Your cooperation is requested as we have a great number of outstanding permits for 1972 and we would like to clear our permit files out as much as possible. Thank you, I. & ohn R. Lee, R.S. Environmental Services Supervisor a January 12, 1971 l,qr, 11ill.ian? Cardwell F'.C. ("Off 9290 Lake Otis Parka -ray Anchorage, Alaska 99502 SUBJECT: Permit and Application for Sewage Disposal System, Lot &, Mock 1, Rampart Subdivision Dear i=fr. Cardwell: June 16, 11170, 'ir.raoff obtained a portrait fro3a this Department for the installation of a sewage disposal system. As of this date, the permnit is still outstanding . Please advise this Departs.ieat if you have installed, or still intend to install, a. .sewer system on the subject property and wis;a your perroit kept pen4inp; in our files. Sincerely, C.S. '1cP�oc;,�aie Environmental Health Aide rn Occomhar 17, 1971 A. Williar and 11 9200 UK Ws Part.,. Aworagf, Plakka olk-, SUM -0; A- Sit, Sayr UsAllation, Lot 6, Bloc, Ramnart SuMvIsion. asar ! r. Corow u � V. l"M you nizainvo a P rmit Arm WarAmrst for t , [}t inL. SAW to m in talhp av two akpvl incaLlon. ri.aq, advi 011 ' par tmno Iv 1?77 if YOU still 01jr LO in tall tna svqtym 1C wrAW to ycq� ,?our, yrnit falid in our filos. himmIN, C. SIS; :jKpCqnje. Envirommal Control Micer 01 dAAB- 4 •+ s GR.EATEF71NCHORAGE AREA `TROUGH Case No. HEALTH DEPARTMENT 327 Eagle St. 1 279-2511 I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. DATE f 6 �Z APPLICANTS SIGNATURE Y • CREAT"T', SNIT 3 17 Eilu�� ,'U TRFUT CAS!, William Cardwell 8/23/71 0 Rampart aM Reports X Depth 1 2 3 1 1 Gray Sandy Gravel 4 5 6 7 8 9 10 (GW) LoCation 5ileat'Ak was Ground water Encountered? No At 'V'Nat 'cnz S,'�erage x j - }e jpt b .0 JA f je n c7" "0 Bottom! Of Pj.t feet q_fdr2�t �ae area is re u in Test Perforred rr R. E. Carlisle Dant,a Cert; Pied By; National Testing Services, Inc. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES�� CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date /O� 6Iaz 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) q (a) Legal Description (include lot, block, subdivision, section, township, range) /,3 0 -� Location (address or directions) �✓r•=e� qtr r � % � � /�t/� all (b) Property Owner ��"'�"'" ���"� Telephone: Home �/ / �'' ? Business Mailing Address 3201 C Street, Anchorage, Alaska 99510 (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: or: Check here, if hold for pick up. List contact person and day phone number below. H✓)tidy PoW5 3 r9-6 TYPE OF RESIDENCE Single -Family] Number of Bedrooms _ 13 3. WATER SUPPLY Individual Well/ Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (Rev 8/86) Front 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health 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 ins gection. Name of Firm �Y�T�?s�P Telephone�y¢-1 Address Date Engineer's Seal f 3 r coo+a(c Vii) ra � 6. DHHS APPROVAL ��/ Approved for bedrooms by Date / ld,�h6, ZY& Approved de Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (Bev 8/86) Back MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTIONHEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 F E 8 2 2 3988 284-4744 p /� RECEIVED LegaS 6 Description: F 2 q fol Ie 0 �N`4 Ac, A. WELL DATA Well Classification Si Nydc FA," Z If A, B, C, D.E.C. Approved (Y/N) N% Well Log Present (Y/N) AJ Date Completed floor°x. / 274) Yield 1f 4- :F o"' Total Depth 2,0 ✓ )�_ Cased to _ 22' Depth of Grouting N oM! Static Water Level 3S me Pump Set At gs Casing Height Above Ground / • Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) N Separation Distances from Well: To Septic/Holding Tank on Lot e W ; ;On Adjoining Lots g7 •� d To Nearest Edge of Absorption Field on Lot xOr ; On Adjoining Lots 1004— To O04'To Nearest Public Sewer Line IVId To Nearest Public Sewer Cleanout/Manhole 'yZe± To Nearest Sewer Service Line on Lot Water Sample Collected by -,)x #0® Date /012&)1r7 Water Sample Test Results �� �l L11 � f °r i11 ,�L Comments � pp rim GAdt%u.*cy T� f d e.vl s� Wdl �% 2�8 /A� r13' t+/�s'e Zolowo%y9 &R 6'Qe VArl',f.e.ce /e/7ctj B. SEPTIC/HOLDING TANK DATA Date Installed J&*AJ C /770 Size /o 00 No. of Compartments UN/(, a -'Al CYO U,'5$ K$') Standpipes (Y/N) %/ Air -tight Caps (Y/N) % Foundation Cleanout (Y/N) Y ' Depression over Tank (Y/N) N Date Last Pumped /0 -1,5-97 Pumping/Maintenance Contract on File (Y/N) �; for Holding Tank High -Water Alarm (Y/N) s Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation To Property Line 3 Q t To Disposal Field 2 6 s s To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course .cl Comments 7'4^,X e,41 y fpr _r_e_-r7_ Page 1 of 2 72-026 (Rev. 8/86) Front C. ABSORPTION FIELD DATA P1 Soils Rating in Absorption Strata => Z •fid`"' Type of System Design Date Installed Ju"e 7d /'fir % # Length of Field Width of Field g Depth of Field 9 3 0 d a,7on Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present (Y/N) x Depression over Field (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test, 7 0 �Dgfau ed 3 &d r °o m_5- r Separation Distance from Absorption Field: To Water -Supply Well /0 r� To Property Line i To Building Foundation 2 To Existing or Abandoned System on Lot /y,11 On Adjoining Lots ac 1 -71- To Water Main/Service Line To Cutbank (if present) 4 To Stream/Pond/Lake/or Major Drainage Course N10 r To Driveway, Parking Area, or Vehicle Storage Area r,'v c u Ay Comments Pu M prd Yte51 4 ),5, fi 2, L a w e r 0 0-/ Pl 4e"d 1-✓4)er /Cry m,cfl_ Uof)ce fj7-c/ A e, Cd J LIFT STATION Sur�¢ae 6Rytse .lD eofte l Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Receipt No. /0 G / 0 ell? Date of Payment Z 2 Amount: $ Page 2 of 2 72-026 IRev 8/86) BaCk Date MOA No. ngin'eefs S�T� f3 e Vii; r: �� oU !p c': • p ?.055 �` gars BESSE, EPPS & POTTS 2220 EAST 88 AVENUE - 1 ANCHORAGE, AK 99507 (907) 349-6451 WATER WiELL TEST ®ate: 2O 8? Subdivision: Lot: Block: ! SG 0a /v cth, f 4 K. r" i ent's Name: ANN,' e /// A t Address: 3Z,v/ I'miti.al Reading on Meter: ,,.GTL S : =--_.-. it3GRM 24-c._= �_ icns NOR r HERN TESTING LARbRATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907-479-3115 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 907-277-8378 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT E ❑ PUBLIC WATER SYSTEM I.D. # XPRIVATE WATER SYSTEM NAME MUNICIPALITY OF DEPT. OF HI ENVIRONMENTAL LIAR E Mailing Address city State Zip Code SAMPLE DATE: a3 Phone' Mo. Day Year Purchase Order No. SAMPLE TYPE: Af Routine ❑ Special Purpose ❑ Check Sample (for original contaminated sample with lab reference no. ❑ Treated Water Untreated Water Sample Time No. Location Collected Collect by Laboratory Ref. No. 2 3 4 5 6 7 8 9 10 Signature of Representative✓°%'`�?� FOR LABORATnRY I1SF nNI Y IBE COMPLETED BY LABORATORY :CTIBWeived at: Anch. ❑ Fbks. 38 Date Received a I&F EDme Received /Of E Next Sample Due COMMENTS: SATISFACTORY CNAFGE PREPAID TRANSMITTAL SPECIAL INSTgUCTI0N5 MALI HBlFDF PICOKUP IBE COMPLETED BY LABORATORY :CTIBWeived at: Anch. ❑ Fbks. 38 Date Received a I&F EDme Received /Of E Next Sample Due COMMENTS: SATISFACTORY UNSATISFACTORY U RESAMPLE R OTHER BACTERIA OB TOO NUMEROUS TNTC TO COUNT Direct Verification Final Cmint Ls BGS Re • cos •�l� of T Coliform Colonies per 100 mis Reported by Date / S�'�' 500 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99';9 907-479-3115 2505 FAIRBANKS STREET ANCHORAGE. ALASKA 99=03 907-2778378 Besse, Epps, & Potts 2220 E. 88th Avenue Anchorage, Alaska 99507 Attn: Andy Potts Source: Rampart L-6 B-1 Sample ID*: A022388-7 Parameter Unit Nitrate -N mg/L Result 1.4 Date Arrived: 2/23/88 Time Arrived: 1045 Date Sampled: 2/23/88 Time Sampled: 1025 Date Completed: 2/26/88 ADEC MCC* 10 c i Reported By: iL Date: 2/26/88 Carol J. Garrison, Vice -President * MCC = Maximum Contaminant Concentration NORTHERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST. SUITE A FAIRBANKS. ALASKA _�7;9 907-479-311= 2505 FAIRBANKS STREET mg11 ANCHORAGE. ALASKA __x503 907-277-8378 Quality Control Report Client: B.B.P. ID#: A022388-7 Listed below are quality control assurance reference samples with a known concentration prior to analysis. The acceptable limits represent a 95% confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring the accuracy of your results. Standard ID# Parameter Unit QC Result Acceptable Range EPA 378-12 Nitrate -N mg11 7.9 7.2 8.0 Reported By: C✓L�` Date: 2/26/88 --------------- ------- Carol J. Garrison, Vice -President n NORTHERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT ❑ PUBLIC WATER SYSTEM I.D. # K PRIVATE WATER SYSTEM kANA/! C 14A 1:41 NAME Mailing Address State 907-479-3115 907-277-8378 TO BE COMPLETED BY LABORATORY Received at: Al Anch. ❑ Fbks. Date Received /4)�����'7 I Time Received ��y9 Next Sample Due Zip Code 11 COMMENTS: SAMPLE DATE: L 24)V Phone 4Gj %� Mo. Day Year Purchase Order No. SAMPLE TYPE: SATISFACTORY SO UNSATISFACTORY U RESAMPLE R yV Routine ❑ Treated Water OTHER BACTERIA OB ❑ Special Purpose ❑ Untreated Water TOO NUMEROUS TNTC ❑ Check Sample (for original contaminated TO COUNT sample with lab reference no. ) Sample Time Direct Verification Final �No. Location collected Collected by / Laboratory Ref. No. Court LSB BGB Resuh* comments 1`t^71 Lto �i .3.3a P'07,9,,,oh Vi¢rN3�G�W o 0 S lvJ Q� A17 4r 2 3 4 5 6 7 8 9 10 Signature of Representative FOR LABORATORY USE ONLY CASH CHARGE PREPAID TXATTAL I SPECIAL INSTRUCTIONS MAIL HOLD UPfl PICKUP *No. of Total Coliform Colonies per 100 mis Reported by - I/�-- Date I (�I I� NORTHERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST; SUITE A FAIRBANKS. ALASKA 39709 907-479-3115 2505 FAIRBANKS STREET Time ANCHORAGE, ALASKA 99503 907-277-8378 Besse, Epps, & Potts 2220 E. 88th Avenue Anchorage, Alaska 99507 Attn: Andy Source: LIS, B1 Rampart (Fannie Mae) Sample ID*: A102187-2 Parameter Unit Nitrate -N mg/L Result 1.1 Date Arrived: 10/21/87 Time Arrived: 0848 Date Sampled: 10/20/87 Time Sampled: 1530 Date Completed: 10/23/87 ADEC MCC* 10 i ieported By: Date: 10/23/87 Carol J. Garrison, ice -President �A NORTHERN TEES TING Parameter LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A 378-6 FAIRBANKS. ALASKA 99709 907 a 79-3115 2505 FAIRBANKS STREET 0.84-1.02 ANCHORAGE ALASKA 99503 907-2778378 Quality Control Report Client: BEP ID#: A102187-2 Listed below are quality control assurance reference samples with a known concentration prior to analysis. The acceptable limits represent a 95% confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring the accuracy of your results. Sample # ------------------------ Parameter Unit Result Acceptable Limit EPA WS 378-6 Nitrate -N mg/L --------------------- 0.92 0.84-1.02 K Reported By: Date: 10/23/87 Carol J. G rrison_ Vice-Prr�c;rinn+ 'SAIGHT "y V 4 FW- \A0, )L YV HOME SERVICES, INC 15900 Francesca Drive Anchorage, Alaska 99516 345-1890 or 345-2444 CUSTOMER 'jesse EPPS E 220 ": 06th An,norame, Alaska 99517 Block Lot o t�a7npart Sub. -1-11 2 2 INVOICE # I/ I DATE DESCRIPTION AMOUNT JPU:flp Septic at, 3600 r": 99th 5, 0 'ear hillside Arch TOTAL REMARKS Y� 16 W, L C i, tzl Gallons Septic Cesspool Holding Tank • PROBLEM AREA—CALL FOR MORE INFORMATION • NEEDS TO BE DONE AGAIN IN 6 MONTHS • Good Shape p_,Sluclge buildup on bottom El Jim cap missing or El Cut standpipe to 1' above ground needs replacing Standpipes Time ZI-Floater on top 0 Needs Septictrine -PLEASE PAY FROM THIS INVOICE- a M t1 OVE, N 99c' S-7' 30".E' 13o,02' 1 SURVEYOR 13 CERTIFICATION 1 HERESY CERTIFY THAT 1 HAVE SURVEYED THE PROPERTY DESCRIBED ON THIS PLAT AND THE IMPROVEMENTS SITUATED THEREON AMC LOCATED A$ SHOWN ON T�THIS PLAT. �7� DATED THIS � � 1LDAY OF.�1 1 19! 7 (w 4� N g9r' S7, 00 ",E' /30.00' 7 M I OI /0'dbl:lr t�,sqf" LEGEND 0 LOT CORNERS FOUNDATION --�— DRAINAGE ARROWS NOTES= 1. IT SHALL BE THE RESPONSIBILITY OF THE BUILDER OR OWNER TO VERIFY THAT BUILDING LOCATION .SHOWN MEETS ALL SUBDIVISION COVENANTS AND ZONING. ORDINANCES. E. IT IS THE RESPONSIBILITY Of THE BUILDER TO VERIFY ALL ELEVATIONS WITH RESPECT TO ALL UTILITIES,6 DRAINAGE. S. THIS PLAT REPRESENTS THE PARCEL OF PROPERTY DESCRIBED BELOW TAKEN FROM THE RECORDED PLAT DESCRIBING THAT PARCEL. INSTRUMENTS RECORDED PRIOR TO OR AFTER THE FILING Of THE RECORDED PLAT ARE NOT SHOWN ON THIS PLAT. 4. THE INFORMATION ON THIS PLAT IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS , THE PLAT ZS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCES. As- ,BUILT L07- 6 $Lbc-K / Rfi/n PAR T Sub ar USSE, EPPS a POTTS 2220 E. 88th. AVE. 349.6451 ^ ANCHORAGE I ALASKA 99507 344-1352 DRAWN BYE A"� 9CALE� /'r ^ in r (,.-C DWO. NO. CHK. BY, DATE, /01911,4'7 I FLO. SK,� 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 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) M'i:5r 41 E t—) EftM Qq= &A SZ), Location (address or directions) (b) Applicant Name WW1. C_aP l.'N!s� Telephone: Home 56i' 3Es4Business Applicant Address�R E a ^�c �'/�6 _tom i t, 1) C N►IL„� (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder�p Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent' Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms S3 14 y4 . t" 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. " SEWAGE DISPOSAL Onsit013 Public ❑ Community ❑ Holding Tank ❑ f Note: If community well system, must have written confirmation from the State Department of Environn 6r tal Conservation attesting to the legality and status. Page 1 of 2 72-025 n 1 �� Ir 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION a 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 inspection. Name of Firm kAN I 4Z7Nu-r_cls ,L +telephone �.4J!5 _3 Addre Date ®F 114 ee ' Engineer's Seal M.•0• •V Pi e. es •Ielpa 6esop dee •e �Ia.o. e�lNe •..I/R� :• THOM A. FISCHER a' g CE. 6793 5� -W 00 •• •e �� 6. DHEP APPRO L Approved for �� G bedro ms by `�'' 4. `'�'"`mDate Approved Disap oved Cond onal "11011HN r,�e�pbgditional Approval Lt'a ILI 1 :A\ !, CAUTION The Muncipah y 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 irl,drder 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. ISs Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: td -1 A. WELL DATA , Well Classification --r->JR w A -1-c- If A, B, C, D.E.C. Approved(Y/N) Well Log Present (Y/N) ' ate C+o�msplleettteed-ASSaAM 1r7_70 Yield Jho Total Depth 30,49a a7 ased t Depth of Grouting Static Water Level Pump Set At 1 i1Llk�� Casing Height Above Ground Sanitary Seal on Casing (Y/N) YEM Electrical Wiring in Conduit (Y/N) 'n, Depression Around Wellhead (Y/N) a Separation Distances from Well: �_4n 7L Com. f_—" Irtu7l ! To Septic/Holding Tank on Lot `}err^ �,g� Ot"ToFffn` djoining Lots -`.' f �. To Nearest Edge of Absorption Field on Lot ' ; On Adjoining Lots (0Z j ( TO a� 66`76 F `i`/3 � To Nearest Public Sewer Line �,� To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by F > ; Date C � Water Sample Test Results sa�n7(s pftna("z "( Comments by `c \,�c rT� spit w� t B. SEPTIC/HOLDING TANK DATA I y%� t eoSPi IJC3 s� Date Installed_uN►c j6 Size ACCO Ori *No. of Compartments f LA Standpipes (Y/N) �— Air -tight Caps (Y/N) 'OLS Foundation Cleanout (Y/N) Depression over Tank (Y/N) 00 Date Last Pumped C/ Pumping/Maintenance Contract on File (Y/N) N 1- ; forl �- Holding Tank High -Water Alarm (Y/N) = Temporary Holding Tank Permit (Y/N)d 1 Separation Distances from Septic/Holding Tank: To Water -Supply Well_78"�'Tu C-10` �ea—To building Foundation �6`'t' C. Q To Property Line d t� To Disposal Field 2 4' C r To Water Main/Service Line ''r"` To Stream, Pond, Lake, or Major Drainage Coursemi p Comments.. V "'�I� Q4_ •'�G� {� i tiG L Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 65 Type of System Design Date Installed P*Z'P-"IT Length of Field— p1 � � c •iv Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present (Y/N) YA_= Depression over Field (Y/N) Date of Last Adequacy Test ih O/A� Results of Last Adequacy Test or f - gaom Separation Distance from Absorption Field: To Water -Supply Well 1 "�' t �s "Z� c' Q' f To Property Line Z / r To Building Foundation zgI N C -,O • To Existing or Abandoned System on Lot On Adjoining Lots To Water Main/Service Line tea To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area —{ d/ Comments T'tAMP-M. Q`J� Wit{ -LC- -t-+5 l+sTp ?Vr. "4410# r -Q -T" Xg-at) ::S. -- —1�`4n p4A-% , 1.a�Z. © in 1 w4wys Lperram t/ D. LIFT STATION Date Installed mansions Size in Gallons Man ole/Access (Y/N) "Pump On" Level at Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycl during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments -_ ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company Receipt No. 3 S_ 3Lo (o Date of Payment of - t a'g� Amount: $ ` !-� c00 Page 2 of 2 72-026 (11/84) MOA No. ®OF A4 %kit p,�v,i4A A Ar ki AV • •,'% Engineer's Seal %..... •.• ........ i\..A �, • THONI FIS ER `+ e•j•'• . CE - 6793 �t m f��i�'4'•• •..... •.•04 #���im ®w .1�!"�1'§d'niht q C :DISTRICT OFFICE 437 ' E° STfjEET0 MITE 303 ANCHORAGE o ALASKA 99501 Whitewater Engineering Constructor P.O. Box 3-4016 Anchorage, Alaska 99501 274-2533 0 —. .. A SUBJECT: Horizontal Separation between Well and Septic System. Lot 6, Block 1. Rampart Subdivision Anchorage. Alaska 0621 -WA -0731 Dear Sir: The Department has reviewed the subJect waiver request ate"= hereby approves the horizontal separation between the we;k.l. and septic system. The system, as it was constructed. mot - State State requirements of September, 1971,1., Any alteratia ;..9r.„_ renovation of this septic system will require upgrade to current regulations. This system is adequate for a 3 bedroom single family residence only. Sincerely, teven W. g, P.E. District ngineer Municipality of Anchorage October 1, 1985 P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907)264-4111 TONY KNO WLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Thom Fischer, P.E. Whitewater Engineering PO Box 3-4016 Anchorage, Alaska 99501 Subject: Waiver Request WR85-036, Lot 6 Block 1 Rampart Subdivision Dear Mr. Fischer: This department hs reviewed your request for a waiver to the 100 foot required separation distance between the well and absorption field on subject lot. Based on the information presented to the department, this waiver cannot be granted. This waiver denial can be appealed to the Alaska Department of Conservation. If you have questions regarding the procedures used in evaluating this waiver request, please give me a call at 264-4720. Sincerely, U .4-'71�(a�� Stephen S. Morris Civil Engineer On-site Services SSM/ljw Y Al4.0MrwZAA'A&_ D. 11600 l�CANOE . ANCHORAGE, AK. 995/6 lUJ PJM JIJ �S l�Jt9J 09071 545—MOS SOILS LOG —V" tPERCOLATION TEST SOILS LOG Cl PERCOLATION TEST PERFORMED FOR: VYl CA-ex:w-jtc'-'U _ DATE PERFORMED: I A LEGAL DESCRIPTION: C=> C S ® , 2 3 4 J" ND`iV�Z 5- 6- 7 7 8 moo: 9- 10- A5 10As 11 i �7 12 13- 14- 15- 16- 3 1415 17 * ;WFIII 18 0 19 •'. CE - 6793 20 COMMENTS SLOPE SITE PLAN WAS GROUND WATER w 4� S _ ENCOUNTERED? `v L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: � �(SCAl-yN CERTIFIED BY: DATE: I .�- _�°" �.- ,�.:.�.. ��.{,tom R4 WITict P i4 :roo-& _"�":�"� �� 1 �'.R` ;"w+��'. •d`a4fka•^•i.. w..mr� `�.w: 't"�"�R� 4 ���M1�",:y4"�,,�.. �'�e p'�". Cor ?. Pte, p t4 A 4 ,ta .a g� "i at Z, 4 IS -'08 P n RnX q-Anl R • ANC;HnRAC',F Al ARKA 9 99.c;nl lj VIA . ,. _ ,._ .. _ _.. � � *��a N._G � �.-�+>u�ra��.l. _. � s�... �P�., ..... b,� i 4�.-;.� `w+�.iC�".. _ :. "�'�4 •'�"`g i.�•;4s�, x�,��`S _. � IL r f xo- ��-�' � "i; S• _ � F '-*t m . �e.:a tea.. !'d." r€..k� ,� �'eY 3�.a��' _... } .„.a e t °M4 Wet ..` t�� _... ' fi `1.' � `i�«` ..��Y,�`+M_.. wpy$IyA�Re. � ' 9� cg pmZ. .._.. ��M1 9 Nn°.4`.Rr l �• .B t�F�xa.... _. C'i'ar.'...>.. `RS �i .... RLLt .®Mcs %. _ { 'd trti�'ArtR.. dRP 'We.. f... 'atmF .._. �h �d'W f ,;zc u.tl x T. A Sec _ Kam-, y�' 4 r°4...0. _ _... .. i D { `t inn ay I VL -0 �. mvaz _..a e ....._. i.'�1E:R�. "1 i'.�''#"Y':� +..R�'i�'°�^ i:#''*;�9n. `.. ri,.,Ev 6��. _.. ,c .. eat � ....�. _ .. _. .. qo- ._. _ b �^^•:q'x'�`^: �f _. �m^"'y�w?�.x �'�e $d. �'.” _k'E"' �... �tia'.'�'�C��v t...('S�.$�m.. __ ...... rl ... � ``�� � R.- ��.. � �'�a`yekE>:,. k 'n�Jr-d:.� �.x'a•v��.;� ax _.... ,..,.� _..... _..i . itrl-'Al40 i .. Vm Oe Y-ru ♦�0" ... k 5 x S „rf € !'�&°i..+� �m S f e �`TE�6.. �� af' / € �9 �'t"�� a. OF�� •..• Ar je� Asic CA. A4Tm*w" ZIP- r,r* , gTii r.4.. or 0066000 �® At — . THOM k FISCHER : a '* AV • E - 6793 Q, a F,Lie W 40, .reio•a'h RnX-dni F t • ANC;H(�RA(�F Al ASKA 99501 No a �7)I N IeT f 1 ; - tl �� 1 t lddddd„,,y 1 y 1• Y ,i xi e F lQ • ?,, •„ a °°�' existence of any easements, covenants, ((�� gag,, rvg,•• or restrictions which do not apPs;dt LI tkilo` �; r;r�p11 Jr-, on the recorded subdivision plat. Under no circumstances should any data t �� fry ts• �Q hereon be used for construction or for "r �Pe �ae�+.:::a.•`°� ? '® + t establfshfng bo ar of en liras. �7)I ; - tl �� 1 t t 1 xi e F AvE 4' a ,; •,e �•s•� •666.� EXCLUSIONNOTE: it is the owners' responsibility to determine the lQ • ?,, •„ a °°�' existence of any easements, covenants, ((�� gag,, rvg,•• or restrictions which do not apPs;dt LI tkilo` �; r;r�p11 Jr-, on the recorded subdivision plat. Under no circumstances should any data t �� fry ts• �Q hereon be used for construction or for "r �Pe �ae�+.:::a.•`°� ? '® + t establfshfng bo ar of en liras. /3®. 00 SURVEY CERTIFICATION: I hereby cartdty that I have surveyed the property sh ,w, and scribed hereon and that the Improvements situated thereon are within the property mb, and encroachments exist other than noted. PLEASE. NOTE: It Is the contract LEGEND: SET FOUND w . 56 .' p i �';ei AVSYOFIi _pr's responsibility to chock -top 5/8” REBAR ® ei &h of foundation In relation to HUB 6 TACK 0 IN DpN, by 272.9231 finish grade and building set- MONUMENT e 1'17A$ilA 662-5291 backs In relation to lot tinea AL -CAP 6 eNxo.: _ ,t and.aasements. r PK NAIL X f �I�PdY r "- "----•..— "- IRON PIPE oeio:_ ELEVS. - DATUM r.e •. �7)I ; 6ef 1 /3®. 00 SURVEY CERTIFICATION: I hereby cartdty that I have surveyed the property sh ,w, and scribed hereon and that the Improvements situated thereon are within the property mb, and encroachments exist other than noted. PLEASE. NOTE: It Is the contract LEGEND: SET FOUND w . 56 .' p i �';ei AVSYOFIi _pr's responsibility to chock -top 5/8” REBAR ® ei &h of foundation In relation to HUB 6 TACK 0 IN DpN, by 272.9231 finish grade and building set- MONUMENT e 1'17A$ilA 662-5291 backs In relation to lot tinea AL -CAP 6 eNxo.: _ ,t and.aasements. r PK NAIL X f �I�PdY r "- "----•..— "- IRON PIPE oeio:_ ELEVS. - DATUM r.e •. �. ti CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. `r TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL. CENTER 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: (') see h on back I.D. NO. ���:tifEwA'ir'� )EW-Tz WKz7T-- water System Name Phone No. I 1 b oo CANCI-E7 �&p Mailing Address 81�Gf bid City State Zip Cotte SAMPLE DATE: 1 o. Day Year � Mo. SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sample t ❑Treated Water with lab ref. ❑ Untreated Water ❑ Special Purposee SAMPLE Time Collected NO. LOCATION Collected By (o;r RLI I 2 Pyr Sh/3D- s 4 5 '' TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: pr"satisfactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via speciall/l delivery mail. Date Received Time Received tf O0 9 cfir Analytical Method: ❑ Fermentation Tube 4 Membrane Filter Lab Ref. No. Result' Analyst I'Yoo- '72 FID L i C1� L i CR I 1 m I J m *No of colonies/100 ml or No of Posqrve portions 06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1983 READ INSTRUCTIONS Membrane Filter. Direct Count Coilform/100ml Verification: LTB BGB Final Membrane Filter es s Coliform/100ml BEFORE �% _ Date Reported By Time: f �� a.m. p.m. COLLECTING SAMPLE TNTC = Too Numerous To Count REQUEST FOR APPROVAL Or INDIVIDUAL SEWAGE AND WATER FACILITIES (Fill out in Triplicate) y;, Name .of person requesting 26 Name of property owner_ 3. Legal description g� ✓.. tY 4. Number'of bedrooms in house Y.. 5. Water Analysis: a. Bacterial b. Detergent 6. Well data: ,(' f � f �a , - . a. Type b. Depth6-1 d "... c. Casing Size' d. Distance from well to closest existing or proposed.: N . 1. Sewer line• 2, Septic tank, 3. Seepage Area___. 4. Cesspool' S. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. . 7. Sewage disposal system. a. Age of system p b. Septic tank capacity in gallons, c, =--.- Name of septic tank manu£acturgr V 1. If "home made" show diagram on reverse side of this form. d: Disposal field or seepage pit size and type Lax 1. Distance to property line�o house foundation. e, Percolation,Te'st'results f. Percolation Test performed by R- Use the reverse side of this form to show diagram. Diagram should include the foilowing information: property lines; -well location, house location, optic tank location, disposal area location, location of percolation test, and direction of ground slope. 9. The information on this form is true and correct to the best of my knowledge. Signature of Applicant Date Signed j TO BE FILLED OUT BY HEALTH DEPARTMENT PERSONNEL FTbe above described sanitary facilities are hereby approved, subject to the following conditions: Conditions: Q The above described sanitary facilities are disapproved for the following reasons: Sig ature of fiselil..: '' L Date Approval is valid for one year following the date of approval. CPJ:cw