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Home My WebLink AboutREED LT 6Reed Lot 6 #051-102-07 0, 11 fl f' M0,r"r-=T,-n n Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904Pae 1 0"f, ON-SITE WASTEWATER INSPECTION REPOAUG 2 216 RT Permit Number: OSP 161213 PID Number: 05110207 Dwelling: 9 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ■❑ Upgrade Name: DIANE PORTER ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 23026 HOMESTEAD DRIVE ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 854-4068 3 JTotal - GPD/SF - Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade - Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot REED 6 Fill added above original grade Ft. Gravel length - Ft. Township Range Section Gravel width Ft. Beds: Number of Lines ' Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line - Ft - - Ft. Well +100 d _ _ +25 TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANHORAGE TANK Capacity 1000 Gal. Surface Water +100 -' _ _ Material STEEL Number of compartments 2 Lot Line +5 R - - NA Foundation +5 -- _ _ LIFT STATION Manufacturer Capacity Curtain Drain +50 — - - - _ Gal. Remarks OLD TANK CRUSHED DISPOSED OF Pump on level at - in. Pump off level at - in. High water alarm at - in. PER MUNICIPAL CODE _ TANK REPLACEMENT ONLY Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer GUARANTEED SERVICES Drainfield U N K CO/MT 3034 Inspector CHARLES BALZARINI BENCH MARK (Assumed elevation) 100 ft Inspection15'8-19-16 Location and description es: 2nd - TOP OF DECK FOOTING 3rd 4th COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL�*'Ahji&. Ik i;tamp OF 4 .• Conditional Approval: Datej ' ;rte®®® r T Nr H •� � .hars . Balzarinioo �� Ir • CE -13854 Approved �.A�cn�X Date 1 j 2p Inspection Report_9-1-12.doc 92. -+100' BOTTOM OF HOUSE SIDING. SCHEMATIC ELEVATION - SCALE: NTS LCi G %�j' �� rZ � ln/7 ✓ L� i .Lci!l�. LET C&M ENGINEERING SERVICES 907-854-5558 LEGAL DESCRIPTION: REED LOT 6 OWNER: PORTER DATE: 8/20/16 1 REV: I DRAWN: CBJ REF: SEPTIC RECORD DRAWING On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161213 Tax Code Number: 05110207000 Work Type: SepticTank Upgrade Permit Effective Dates: August 09, 2016 to August 09, 2017 Design Engineer: C & M Engineering Subdivision: REED Site Legal Address: REED LT 6 G:1359 Owner/Address: PORTER DIANE E PO BOX 670487 CHUGIAKAK 995670487 Site Mailing Address: 23026 HOMESTEAD RD, Chugiak Lot Size in Sq Ft: 11166 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receiv( Issued MUNICIPALITY. OF Community Development Department" Development Servkes Division On -Site Water 8� Va%tewater Program C. 0 ON-SITE SEWER/WELL PERMIT APPLICATION t R Phone: 907-343-7904 Fax: 907-343-7997 PaelI.D. 051 tool O% Property owner(s) � +1/*.*/tvDay phone Mailing address -A?A 96 H004F CO7Z'41�:> Site address i%ZA1L ij^m p r Legal description (Sub'd., Block & Lot) yz4ek___? L9 f Legal description (Township, Range & Section) _ Lot SizeALkk__Sq. Ft. APPLICATION IS FOR: (0 all that apply) Absorption Field ❑ Septic Tank Single Family (SF) 10Upgrade Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms �5_ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) 10Upgrade �' k/wo ADU) Renewal ❑ Duplex (D) . ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that he above information is correct. I further certify that this is in accordance with owner or authorized agent) Permit/Rush Fees: fljuWaiver Fees: _ Date of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. Waiver No. Permit App_9-1.12.doc Municipality of Anchorage OFA ( iq Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 a % 499 G V m . -Charles l�aizarini RE: RE: Proposed Septic System Repairs for Reed Lot 6 ®� . ®s E/1,Ui1k.•.a�® 0 Tc_ C9 ei�o Dear Reviewer, The above referenced property is currently served by a 3 bedroom septic system. The existing tank is showing signs of advanced corrosion, and the baffle has failed. We are requesting approval to replace the existing tank with a new moa approved 1000 gallon steel septic tank, as soon as possible. All work shall be completed in accordance with MOA standards and the following Specifications: The existing tank will be pumped and disposed of properly, in accordance with moa requirements. The new 1000 gallon tank shall be of MOA approved construction with two 4" cleanouts. The tank shall be installed level, and within the excavation created by removing the old tank. The bottom of the excavation shall be leveled and compacted sufficiently to prevent settling of the tank. The new tank shall be insulated with no less than 4' of cover, and the manufacturer's maximum burial depth shall not be exceeded. The ground surface shall be sloped to prevent ponding. Dual after tank cleanouts shall be installed within 5' of the new tank, between the tank and leachfield. The new tank shall be installed in accordance with the separation distances required by 15.65.050A. The tank will be installed: Greater than 5' from the property line, building foundation, and drain field. Greater than 10' from any water main or service line. Greater than 100' from any surface water. Greater than 100' from any private well, and greater than 200' from any public or community well Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzariniCo)gmail.com with any questions or concerns. Sincerely, Charles Balzarini. PE �1 HOMESTEAD DRIVE I ASO �k R,yD/US\ OLD CLASS C \ WELL(NOT IN USE) REED LOT 7 PUBLIC WATER SEPTIC i REED LOT 8 PUBLIC WATER SEPTIC LEGEND O CLEANOUT • MONITOR TUBE ® TEST HOLE 0.5% \ SLOPE INDICATOR SEPTIC AREA SEPTIC AREA ` HOUSE SURVEY WELL RADII REED LOT 6 `SUM NO FOUNDATION. D SHED REPLACE EXISTING TH • RILES G��Bjj;& INC OLD WELL(NOT IN USE) REED LOT 5 PUBLIC WATER SEPTIC W/ NEW 000 GALLON TANK. PR PERLY DEMOLISH AND DISP SE OF OLD TANK. SUMP � - REPAIR AFTER - -SEPTI EXISTING LEACHRELD REED LOT 9 PUBLIC WATER SEPTIC SEPTIC AREA REED LOT 10 NO WATER/SEWER C&M ENGINEERING SERVICES 907-854-5558 LEGAL DESCRIPTION: REED LOT 6 OWNER: DIANE PORTER DATE: 8/07/16 1 REV:O 1 DRAWN: C81 REF: SITE PLAN MUNICIPALITY OF ANCHORAGE p DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT m NAME PHONE NEW __�_ �� .�_ ��`�rf �_.lr>5.5 ❑ UPGRADE MAILING ADDRESS I' . Cit\ _ .. 0 U'4 7 o /6— ,S kLci_ LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS f� C_= .3 Well Absorption area Dwell g PERMIT NO. DISTANCE TO: - r i 8 o ,S(0 tJ y. e(A eq I_-2 Manufacturer n Material // No. of compartments wa �-�/ 'GLC GC_� f'_ cLv iS-7F'�.-✓ _. N iLiq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth 0,(1) r-) DISTANCE TO: WellDwelling PERMIT NO. O r l- _ ________ Manufacturer Material 0 Liquid capacity in gallons w DISTANCE TO: Well / Found 'on Oil .� Nearest lot line PERMIT NO.. _ < C7ti w Z No, of lines r Length of each line Total lengt of lines Trench width, Distance betwe n lines ~tea _ 1 'J inches N71 Top of the to finish grade Material beneath tile Total effective absorption area 7 Length Width Depth PERMIT NO. ui C7 Q I— Type of crib Crib diameter Crib depth Total effective absorption area �a N Well Building foundation Nearest lot line DISTANCE TO: CI ss Depth Driller Distance to lot line PERMIT NO. J }]. W DISTANCE TO: Building foundation Sewer line Septic tank � Absorption areas) U OTHER r " PIPE MATERIALS 030,3 (/ SOIL TEST RATING 40 / _ INSTALLER � .lob RE'MjARKS/ -- ,f { - d-L]t.LVI of oYl C1 L�i�.�_ IZ7�LL.� .CMS 1 �F�i Yl� e)C)�Cz %ems _ .._-11",Sf2FC°1� Fc c. onc!_rvu;r�,.�rle-� k�h�cl_6ril 3 -f - I Ci / n i �1e 1l. APPROVED DATE LEGAL- I ��. U2 ti ' T s A) C, I w ! �!c �' ALASKA NUIROWMAL COnTnOL HMO, InC. engineerinq & enuironmenlal Studies Janurary 30, 1985 Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 Attention: John Kennedy Subject: Lot 6 Block n/a Reed Subdivision The septic system on the subject property was installed in July 1984. The installation encroaches on the utility easement (south) and the property line (west). The measured separation is 9.2' (west) and 9.4' (south). Separation from adjacent wells, as indicated on the as -built, also limited the location of the system. -to -W This office requests a waiver X9.2' (west) and 9.4' (south) on the subject property. If AECS can be of further assistance, please contact us at 561-5040. Sincerely, L. D. Montgomery - 3-7—) Approved By: ,fes— �; Oub Bd. GGR 3JCaE -oo 6 f•�, F, % Lor y C. geld, Jr, cPJ^� a o. 2251•L 1200 West 33rd Auenue, Suite 3 • Anchorage, Alaska 99503 • (907) 561-5040 / MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ® ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW ❑U)GRADE MAILING ADDRESS yt-Xl._ _ oL ClC LEGAL DESCRIPTION 4r * Lok LOCATION NO. OF BEDROOMS \` DISTANCE TO: Well I Absorption area D elling PERMIT N0. - U X 1 �" P 2 Manufacturer�T' Material No. of compartments If J Cn Liq. capacit in gallons IF HOMMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling PERMIT NO. _j0Z 2 cz I_ Manufacturer Material Liquid capacity in gallons D w= DISTANCE TO: Well 1��. Fp,, ndation Nearest lot line rL ( PERMIT N Lj`�( , 1 ( F w No. of lines LengTIj of leach Ii e . Total len th f liners Trench width �j Distance bet n ines L� { { inches ah Top of tile to finish grade L. l Material beneath tile l Total effective a sorpt`on area Length Width Depth PERMIT NO. Lu C7 Q h_ W° Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line CI Depth Driller Distance to In line PERMIT NO. _j ham. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL T'E1STTh RATIN INSTALLER !� K , . C _ �, REMARKS Cog I C a kur zi s i APPROVED DATE LEGAL Tk� 2-U13 they. 3//dj MUNICIPALITY OF AtICI� 16. -.,-GE: DEF'6RTMENT OF I-IL:AL.TH AND ENVIRONMENTAL PROTECTION 825 I_ . TF:EET: ANCHORAGE, AK 99501 PERMIT" NO: 840464 y DATE ISSUED: ADPL I CANT: : OHN M iO .E ADDRESS: BOX 4-604 CONTACT T PHiNE : E'.88-4555 LEGAL DESC:F: I P : SUBDIVISION: RE.ED LOT: E. BLOCK: P•1AN SECTION: 9 TOWN'E'.HIP: 15N RANGE: :1.1'.I LOT SIZE: 16625 (SQ. FT, OR AC:RE--.') LISTED BELOW ARE TETE OPTIONS AVAILABLE TO YOU Il'i DES113NING YOUR SEPTIC: SYSTEM. CHOOSE THE OPTION THAT BEST FIT' � YOUR ITE. GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS ':: NOT E::--'C.EE1.*- l ,3 75 FT. EAC:H ) TANK MUST HAVE AT LEAST TWO CaOMPAF::TI''1ENT S CERTIFY THAT: 1. 1 All FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE SE14EF"S AND 14ELLS AS SET FORTH BIT' THE MUNICIPALITY OF ANCHORAGE ''MOA) AND THE STATE OF ALASKA. 2. I I•'•IILL INSTALL THE SYSTEM IN ACCORDANCE KITH ALL MOA CODES AND REGULATIONS, AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. % I WILL AC-HEF„:E TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET SACK DISTANCES FROM At'a'7 EXISTING WELL: WASTEWATER DISPOSAL :='r':=TEI"'I OR PUBLIC SE14ERAGE SYSTEM ON THIS, OR Atd'r ADJACEt•,I`F CSF: NEARBY LCAT. 4. 1'. UNDERSTAND THAT THIS, PERMIT IS VALID FOR A MAXIMUM OF 31 BEDROOM AND ANY ENLARGEMENT 14ILL REQUIRE AN ADDI•FIONAL PERMIT. IF' A LIFT STATION :15 INSTALLED I N AN AREA COVERED BY I,IOA BUILDING CODES, THEN '':J.:' AN ELECTRICAL PERMIT AND INSPECTION YrIUST BE OBTAINED; 1::2) AS -BUILT: WILL. NOT” BE AF"PRO%JED WITHOUT AN ELECTRICAL INSPECTION REPORT; FIND '': THE ELECTRICAL WORK I'1LIS,"F BE DONE E.',' A LICENSED ELECTRIC:IAN. SIGNED/1 � C` FATE: _W A P P L I CANT : ._"OHt� F'1�� _ RE ISSUED BYDATE : DEPTH GRAVEL TO F'IF'E BOTTOM (FT. :' DEPTH (FT. 4. ( 3. 0 � F,, 0- '7. U 4. 0 4. Y 0 5 TOTAL C:'EF F'N `FT. .' 10. 0— /49 . o ` %� � VV�v ,o, "I ��' g A GRAVEL I.IIC}TH '::FT. ? u 5 , 1 2. 0 �D `�1 S 5 GRAVEL LENGTH (FT. '' p. 102. 0 :+::+: Ll 0_o J 52. 0 13RAVEL TANK' SIZE VOLUIlE ''CU. YDS. ''GALS:; W. 1.. 3 C.4.:, Gp�K.��9; , 1,000. 0 :+::+ 1,000, 0 4::+:` j,: 000. 0 .501L RATING (SQ. FT. /BR) el,07 312 40 GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS ':: NOT E::--'C.EE1.*- l ,3 75 FT. EAC:H ) TANK MUST HAVE AT LEAST TWO CaOMPAF::TI''1ENT S CERTIFY THAT: 1. 1 All FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE SE14EF"S AND 14ELLS AS SET FORTH BIT' THE MUNICIPALITY OF ANCHORAGE ''MOA) AND THE STATE OF ALASKA. 2. I I•'•IILL INSTALL THE SYSTEM IN ACCORDANCE KITH ALL MOA CODES AND REGULATIONS, AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. % I WILL AC-HEF„:E TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET SACK DISTANCES FROM At'a'7 EXISTING WELL: WASTEWATER DISPOSAL :='r':=TEI"'I OR PUBLIC SE14ERAGE SYSTEM ON THIS, OR Atd'r ADJACEt•,I`F CSF: NEARBY LCAT. 4. 1'. UNDERSTAND THAT THIS, PERMIT IS VALID FOR A MAXIMUM OF 31 BEDROOM AND ANY ENLARGEMENT 14ILL REQUIRE AN ADDI•FIONAL PERMIT. IF' A LIFT STATION :15 INSTALLED I N AN AREA COVERED BY I,IOA BUILDING CODES, THEN '':J.:' AN ELECTRICAL PERMIT AND INSPECTION YrIUST BE OBTAINED; 1::2) AS -BUILT: WILL. NOT” BE AF"PRO%JED WITHOUT AN ELECTRICAL INSPECTION REPORT; FIND '': THE ELECTRICAL WORK I'1LIS,"F BE DONE E.',' A LICENSED ELECTRIC:IAN. SIGNED/1 � C` FATE: _W A P P L I CANT : ._"OHt� F'1�� _ RE ISSUED BYDATE : L SOILS LOG MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST COMMENTS WAS GROUND WATER „ ENCOUNTERED? \0 IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 1 c` t 1 ;�J U .Mr .a3 10 (6 .iU3 2' v73 pf� 10 1 o10c? 10 079 1.c? }jo /�. 0'(L44 SE' `yet PERCOLATION RATE f1 JQ (minutes/inch) TEST RIYN BE.��.1 / BETWEEN FT AND � FT /Y .w ll n ,A— .0 / �/'tri , / N - 1 I ^,nr) .PERFORMED BY:-LAUAn CERTIFIED BY: 7 2-00 8 (6/79) DATE: 6 0 ALASKA CRUIR011CT nTAL COnTROL SCUM, IX Engincerinq & l3nuironmental Studies PERCOLATION TEST DATA SHEET CLIENT J—Dkv� Moo1�C� ADDRESS DATE 6 11L11 94 ZIP CODE LEGAL LOCATION (GJL `)LjkAl0�` I ov1 L0 --F (a TOTAL DEPTH OF HOLE Left. ZONE TESTED ./L U ft TO Sa O — ft READING # CLOCK TIME NET TIME DEPTH TO DATUM NET DROP RATE (min/in) l -LEo- so /omiv, Aq -aqo Qo 2 j 00 N rpt vl 1.0 z- qs 007 3 Ga ��`�o ( l (�Ihll� �(�"—,q ,0,7 2; -2,21 FINAL PERCOLATION RATE (min/in) PERFORMED BY 72 Lb Rato� rads 2 -�o /q" -ree tl ii t•,F• AnAorage, Alaska 99503 • (907) 2161361 ALASKA RICO MMAL COUROL SMIUS, InC. Engineerinq & 6nuironmental Studies December 21, 1984 Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 Subject: On -Site Sewage Disposal and/or Well Inspection Report During 1984, a number of septic systems have been installed and inspected, prior to the establishment of the foundation(s). AECS has contacted (or attempted to contact) the applicants concerning the installation of foundation clean-out and pipe from the foundation to the septic tank inlet. In many cases, construction will not resume till in the spring; therefore, precluding any further inspections. Since the end of the year is near, with the expiration of permits, AECS is forwarding the inspection reports without a foundation cleanouts to your office. We understand that this will not eliminate this situation; nonetheless, the reports reflect the actual inspected installation at this time. We recommend you accept these as is. The Health Authority, site evaluation for these properties can confirm the installation of the cleanout. Conditional approval, based on required installation in the spring, may be required during the interim. '��tta� If this office can be of further assistance, please contact us at 1 561-5040. tat Sincerely, J L. D. Montgomery e Supervisor, Environmental Department Approved By: MUNICIPALITY OF ANCHORAGE DEPT. OF Hr =' 7 ENVIRONMFNTAL PR,OUCTION 0EC 2 6 10..q/1 1200 West 33rd Ruenue. Suite 13 • AnchoraQe. Aloska 99503 o X9011 5615040 Municipality of Anchorage • • ,� On-Site Water and Wastewater Program o s`' 5t-c- _ (907) 343-7904 `; CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-102-07 Expiration Date: ( '-Iq-I� 1. GENERAL INFORMATION Complete legal description Reed Lot 6 Location (site address) 23026 Homestead Rd Current Property owner(s) Porter Day phone 694-4994 Mailing address Same Real Estate Agent Partners Day phone 694-4994 • 2. TYPE OF DWELLING: c ,, n ' ® Single Family (w/wo ADU) �,`' • '' ❑ Duplex N ��^ ` ❑ Multiple Dwellings (Single Family and/or Duplex) lm� 1 . ;.; •, : = Vk i,..% 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual EZ Individual Water Storage ❑ Holding Tank ❑ Community Class C Well El Community ❑ • Public Water System ® Public Sewer ❑ Received by: Date: / 30/(7 (? COSA to be released to the engineer,unless oth ise requested by the engineer. COSA Fee $ Mei Date: Date of Payment HMV/YJi 9 Date of Payment Receipt Number O23 SD Receipt Number COSA# 05C 0-/5L// 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724,Eagle River Engineer's Printed Name Steve Eng Date 11/28/2017 6. DSD SIGNATURE System #1 Approved for E bedrooms. System #2 Approved for bedrooms. V.266/47.<:; " •, Disapproved. �- _ Conditional approval for bedrooms, with the following stipulatlottsfW: `'r --`G•\ Y Of- c ON-SATE t;. WAT R AND o WASTEWATER PROGRAM �T,E i\/\ki' B . Original Certificate Date: /1- 2,-9( The Municipality of Anchorage Devlopment Services Division(DSD)Issues Certificates of On-Site Systems Approval(COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9.1-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On Site Systems Approval Checklist Legal Description: "567.46 .4 or Parcel ID: 057 /0207 A. WELL DATA Pu&le- Well type If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height(above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA / • / Tank Type/Material SE PT( C_/ .STEEL Date installed (V/r// Tank size /&OO gal. Number of Compartments Z Cleanouts (Y/N) Foundation cleanout(Y/N) Depression over tank(Y/N) Al High water alarm (Y/N) ( Al' Date of pumping �f EIA) ( Pumper C. ABSORPTION FIELD DATA bee? Date installed 744/ Soil rating (g.p.d./ft2 or ft2/bdrm) L,/D 7 . System type 7 , IC# Length VI ft. Width 3 ft. Gravel below pipe 7 ft. Total depth / 0 ft. Eff. absorption area 723Zft2 Monitoring tube y Depression over field Al Date of adequacy test /J/M// 7 Results (Pass/Fail) P / For 3 bedrooms Fluid depth in absorption field before test /5/ in. Water added 4(50 gal. New depth 213 in. Elapsed Time: ‘0 min. Final fluid depth / in. Absorption rate >= .42 TD g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) A/ If yes, give date D. LIFT STATION /J,c} Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: PV(3446" Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 4- Property line 5 "F Absorption field S 4-- Water fWater main /Q 1 Water service line /O (14- Surface water /GIG - Wells on adjacent lots /0a ABSORPTION FIELD ON LOT TO: Property line 47 Building foundation /64 f- Water main / 4' ��►` Water Service line /a 4- Surface water /00 j^F' Driveway, parking/vehicle storage /Q '1— Curtain fCurtain drain !/N>4- Wells on adjacent lots /DD /f' F. COMMENTS art G. ENGINEER'S CERTIFICATION OF elsit I certify that I have determined through field inspections and „v;+; ' �-*•.�.<<�Q , 1,1 review of Municipal records that the above systems are in a!�' ... .��••e conformance with MOA COSA guidelines in effect on this date. ptef,47-;if.lE.. LU es®D, Engineer's Printed Name Date ///7 P/l v `<. y '�w lr/� ; \OW.4 COSA yellow sheet 2-6-15.doc HOMESTEAD ROAD o GRAVEL PARKING . S 89'59'00"E 8 64' 10.3'x16.0' u� DECK � N \ GRAVEL ". ORIVEWAY o 8 0 0 x 12.8 17.6' 12.4' D ' ' ' • N 11.3'x12.2' ENCLOSED DECK u 1 STORY RESIDENCE N p • '� Z `! w/ DAYLIGHT BSMT. U) O O 21.1' cn It04' 19.4' �� 19.8' vii 23.4' A O Lot 7 '0. Lot 5 `,4 w Lot 6 ,w U11 1,166 s.f. o 0 CHAIN-LINK FENCE-_/".c•/ 26.2' ' SHED N , GREENHOUSE'' • SEPTIC PIPES ----' CHAIN-LINK FENCE M f N 89'59'00'W 83.64' Lot 8 Lot 9 Lot 10 PLOT PLAN __ AS BUILT _X SCALE 1" = 30' GRID NW 1359 Project No. 17-456/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , inc . (907) 522-6476 Phone 0000 (907) 522-4625 Fax �QQ F A`0''N Professional Land Surveyors kenOlangsurvey.com ,9 jonathanOlangsurvey.com O ..... ---°0,,S I hereby certify that I have surveyed the following described property: ��O�P �'" LOT 6, REED SUBDIVISION (PLAT P-390) * 49TH i� •*�vA Anchorage Recording District, Alaska, and that the improvements situated thereon are g , ) VA within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed VOA ETH G��LANt� o premises and that there are no roadways, transmission lines or other visible �, ffl easements on said property except as Indicated hereon. VO 's� Ll(i.P• L�� p, kr �F '••.LS-5202.••' gJp� Dated this the — -.',r-� Day of talc':.•y. 1 ..,.. , 2a"^r , at Anchorage, Alaska 0 o a ''•••"• foo 404 O SSIONAI-�,� It is the responsibility of the owner to determine the existence of any easements, `DODoo�� covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 Municipality of Anchorage Development Services Department y Y Building Safety Division On -Site Water and Wastewater Program , • , T. 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.0 s (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING/ 1l Parcel I.D. ��'��''�� HAA# & bID�I��J Expiration Date: 7 1. GENERAL INFORMATION Complete legal description Location (site address or directions) 7---20Z(- ?o CG/AILS Current Property owner(s) ''" E y %^ult-n(C-,2— Day phone Mailing address Lending agency Day phone Mailing address 1id.el fioyp -Pi2vJ_ Loaybh ne -76a-252 Real Estate Agent Mailing Address xW�J2ra for ;— ? 1� /o r Unless otherwise requested, HAA will be held by DSD pickup. 2. NUMBER OF BEDROOMS: 3. 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 ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 less than 30 days old. (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, 1 verity 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. S & S ENGINEERING Name of Firm 17034 Eagle River Loop Road No. 404 Phone E Cj I ' ?' % 7 Address age River, Alaska 99577 Engineer's Printed Name 1% ()!3/E.2i C . Co w/3.✓ Date 3�0 5. DSD SIGNATURE Approved for Disapproved. Conditional approval for Or p i ROBERT C. COWAN F CE -8801 bedrooms. bedrooms, with the following stipulations: W Additional Comments AMI) m= Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other_ By:c j ��+i !r, Original Certificate Date: �3 - 7— a 1 Municipality of Anchorage •., • �' Development Services Department Building Safety Division - SA {i♦ On-Sfte Water & Wastewater Program 4700 South Bragew St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: V4*!!>- SY Parcel ID: OS / fl - 0 7 A. WELL DATA Well type'Pul�Ur/ If A, B, or C provide PWSID # Well Log (Y/N) Date completed Total depth ft. FROM Date of test Static water level Well production WATER 06f sample: RESULTS: Sanitary seal (Y/N),�-' Wires property protected (Y/N) Cased to It. Casing height (above ground) in. AT INSPECTION It. ft. g.p.m. g.p.m. ml. Nitrate mg -A. Other bacteria colonies/100 ml. Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material ?1L/vTrL Date installed g Tank size ran gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout (WN) Yk< Depression over tank (Y/N) High water alarm (Y/N) t Date of pumping G L�1 �! I Pumper 'i s C. ABSORPTION �nFIELD DATA Date installed Soil rating (g.p.dJft2 or ft2/bdrm) System typef-f Q fr Length _ CL_ ft. Width ✓�� ft. Gravel below pipe Total depth ft. Eff. absorption area JZVft Monitoring tube Depression over field -6LO Date of adequacy test Results (Pass/Fail)For 3 bedr000ms Fluid depth in absorption field before test 11 in. Water added gal. New depth a in. Elapsed Time: d= min. Final fluid depth —0— in. Absorption rate >= li Jiro g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NO If yes, give date D. UFT STATION Date installed 'Pump on" level a in. Datum E. SEPARATION DISTANCES Size in gallons 'Pump ofr level at in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/llft station on lot Absorption Heid on lot Public sewer main Sewer /septic service line Manhole/Access (YM) High water alarm level at Meets alarm & circuit requirements? Pu�S�-tL On adjacent lots On adjacent lots Public sewer manhole/deanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 1 *l- BuUding foundation 5 1"r Properly line Absorption field I.a r I Water main / Iater service line / r Surface water �� f Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r Property line r(Pk4'AssApiar Building foundation t 'j Water main Q in. Water Service line ( 0 I Surface water f QV I+ Driveway, parkinglvehide storage l o /+- Curtain drain Wells on adjacent lots N // VV t F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field innspec6Dns and r' v review of Municipal records that the above systems are in r , conformance with MOA HAA guidelines In effect on this date. - AN "• r Engineer's Printed Name R066V- �. COw9.✓ .4 WAM01 Date 1111�1�,F� .... .»`t /01 14.��rFOiii$$t J HAA Fee $ Date of Payment YA /a I Receipt Number 0 0 8 d S, 3. (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number QSl J02 D% MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES g� �a a CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL i OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date July 15, 1988 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 6: Reed Subdivision Location (address or directions) (b) Property Owner . HUD Telephone: Home Mailing Address $VG7/ 3V (c) Lending Institution City Mortgage Telephone Mailing Address ATTENTION: Carol Nesbeth Business (d) Real Estate Company and Agent Lou Campbell/ASSOCIATED BROKERS Address 640 West: 36th Avenue, Suite One, Anchorage, Alaska 99503 Telephone JVJ-JJJJ (e) Mail the HAA to the following address: or: Check here ®, if hold for pick up. List contact person and day phone number below. S & S ENGINEERING/694-2979 17034 Eagle River Loop Road, Suite 204 Eagle River/ Alaska 99577 ordered by Lou Campbell 2. TYPE OF RESIDENCE Single -Family nc Number of Bedrooms 3. WATER SUPPLY 3 Individual Well ❑ Community a 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 O� 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 (RPV 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 inspection. Name of Firm g & C FNGIN RINE: Telephone Address 17034 Eagle River Loop ttua„ Date 6. DHHS APPROVAL ? Approved for 3 bedrooms by ate _ 1 —99 Approved 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 72-026 (Rev 81661 Back MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION MUNICIPALITY OF ANCHORAGE (MOA) U L 19$g HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 RECEIVED A. WELL DATA Well Classification Legal Description: If A, B, C, D.E.C. Approved(ON) Well Log Present (Y/N) Date Completed Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Depth of Grouting — Pump Set At Yield Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: r To Septic/Holding Tank on Lot �' On Adjoining Lots I To Nearest Edge of Absorption Field on Lot On Adjoining Lots — To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments To Nearest Public Sewer To Nearest Sewer Service Line on Lot -'2 r"Date B. SEPTIC/HOLDING TANK DATA Date Installed — Size I DflC-,� No. of Compartments VAN Standpipes (WN) 4 Air -tight Caps PN) y Foundation Cleanout MN) —� r Depression over Tank (Y/6 t_� Date Last Pumped U `�� 5 Pumping/Maintenance Contract on File (Y/N)� for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/ in+E14i4 Tank: / I To Water -Supply Well � To Building Foundation r I To Property Line G✓ 2 To Disposal Field To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course o j -- Comments Page 1 of 2 72-026 (Rev 8 86) Fronl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ��% /� Type of System Design Date Installed Length of Field Width of Field 1 Depth of Field — -2— Gravel Bed Thickness Square Feet of Absorption Area 96 Standpipes Present tVN) ♦/ Depression over Field (Yd Date of Last Adequacy Test / Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well 1STTo Property Line �\ To Building Foundation To E�cistin$ or Abandoned System on a Lot P ; On Adjoining Lots - -2�� t I To Water Main/Service Line 1 4- To Cutbank (if present) P I+ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area I S -'r- Comments D. LIFT STATION / Date Installed Size in GaTf7nr�— "Pump On" Level at High Water Alarm Level at _ Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles duan uacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MO and H A guidelines in effect on the date of this inspection. Signed s, & S ENGINEERINO Date Z Company17034 Eagle River Loop Road No. 204 U ��®®.�► yd ca 99577 — MOA No. Eag a ve , Receipt No. ®& °•� d Date of Payment Amount:$ ��.` c�.D�`-0 6 E Page 2 of 2 72-026 (Rev &861 Back ............ w R. Sh .: • Na 14574 �Q® �OFEgg10X, i 1 ;.� 111 - 11l ! 57LWE COWPER, GOVERNOR fit DEIFMl. aFIE, IVWHIASi AFLI ltjIWA[L Q,'oI`TgIEin,WA`ITHOMN ANCJ-IORAGEAJESTERN DISTRICT OFT-ICE 563--6775 3601 C STREET, SUITE 13-04 ANCHORAGE, AL.f SKA 99503 PWS Pi Mass C LJeI l To IJhorn .It May Concerns According to the record, on e in Ihis cN, the L_qt_ 9 REED SUBDIVISION Water Sy ,tern is in crn)pl iance with the State of Ala-ka Prinking Dater Regulations. �>i �,cerely, F?onald S. KIei.n F-nvironmental f=ield Officer CHEMICAL & (,-'E0L0G.1rAL LABOYRATORIES OF ALASKA, INC. �____� _. • =': ELEPHONE (907) 562-2343 =�_-- Y� 5633 11 Street w In Anchorage, Alaska 995113 nx- _. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER F1 PUBLIC WATER SYSTEM Lf).{1 ft(PI IVATE WATER SYSTEM Name S & S V4131HELRIP6 PnonoNo. ---------- E,10-34, Un-Jix lltnaw I.ca)p Pan<l kjao 2Gaj PAalllnq nMN ik veP, IArtve ca 5�a' - ----- CityState r Zip Code SAMPLE DATE: II l4T� 5 -2)]I2 -00.I Mo. Day Yonr SAMPLE TYPE: 1;9' 3nutino ❑ Check Sample (for routine ,,ain.plo with lab ref. no. —__—_—} C7 Troated Water ❑ Special purpose ❑ Untreated Water SAMPLC Tinto Collected NO. LOCATION 1 Collected By L__. --- ----- L_- -_ ----- - - -- READ INSTRUCT11ONS BEFORE COLLECTING SAMPLE }�TO SE COMPLE=TED BY LABORATORY P All al&Is shows this Water SAMPLE to be: 9 :'Itlsfactory Unsatisfactory Sample too long in transit; sample should not be over 30 hours old at examination to Indicate reliable results. Please send new samplo via special delivery mall. Date Received 9 4 i itne Received � Analytical IVIothod: Membrane Filter No. of colonies/100 nil. Lab )!of. No. 1 051.11 ` Analyst F� I__ _J C❑ _-- -.- BACTERIOLOGICAL WP.TL=-R APJALYSIS n,ECOM) n� Mernbrano Filtoi: Dhoct Count ___ _____ 0 Verification: L7Q_____-___ _____ _--_BGB_ Final Mon-brane F t; , -r Reported By/%�/ 1 � - - ' _ Date __- �� 11-. L, Time: -. �v- TNTC = Too Numborous To wv;owit OLS --- othor Bacteria F'AFZT t O z , REMA I NDEI-? 1-0 FOLLOW Coilform110Uml Collforrnl100ml a.m. p.m. C'HEMIC'AL & C'E'®, OGICAJ, :� ' -81 °WATORIE5 OF ALASKA, IfvC,. 5633 B STRLET ANCHORAGE, ALASKA 99518 TELEPHONE �)-"� (907) 502-2343��- LABORATOmes-. FEDERAL TAX ID It 92-00404!0 ANALYSIS RE?ORT F SIMPLE Client POI# : VKR91,F-- -- --dei] Client Smr,l I L(fS 6, 7, H, 9 REED S'/D PETER'S CRC?r Sample Recd : DEC 7.1 07 Ordered By : '180M FISC!2R Send Reportz To: COWIN 3 A.SS0,C 1200 INDUSTRY FLAY, BLDG B, ill AVC1101ME, AK. 995t5 Special COLLEC'T'ED 12-21-07 BY T. YISCHER Instruct: Chemlab Ref. 11: 0670 Lab :Pjfl iD: 1 Matrix: Water `r'o=.k Order No. : 9436 C'ie t Account : CORWINP Die ""port Printed, DEC 30 87 9 11:17 Release L SL Reports Qdrens 'I2 Parameter Tested Result/Units Method NITRA'i'e id 2.0 mr/' Sade ROUTINE SAMPLE Remarks: ANALYSIS COMPLE'T'ED: 12-21-07 LABORATORY SiM.RVISOR: SIEPMFMI C. GDE 1 Tests Perforined ND= None Detected PIA= Not Analyzed See Special InstructionS Above See Sample Remarks Above LT=Less Than, G'14ceater roan AIIrA+able IAlni is 10 ^ A� 1A 0 t4 l�+ E9\RIVER. PVPS�P HEALTH AUTHORITY APPROVALS August 3, 1988 ROBERT A. SHAFER CIVIL ENGINEER 694-2979 Mr. Dan Roth Municipality of Anchorage Department of Health and Human Services SEWER & WATER 825 L Street MAIN EXTENSIONS Anchorage, Alaska 99501 REFERENCE: Lot 6; Reed Subdivision SEWER & WATER Dear Dan, INSPECTION It is our opinion that the portion of the trench located under the driveway on the referenced property has sufficient burial depth to prevent it from freezing and causing subsequent adverse problems during ENGINEERING STUDIES winter operations. AND REPORTS The system was installed in December, 1984 and subsequently approved in January, 1985. The house has been occupied periodically since that time and was reapproved in December, 1987. WELL INSPECTION & FLOW TEST To the best of our knowledge there is no history of problems associated with this ystem. Sip erel /� SITE PLANS . SHAFER, P.E. ROAD DESIGN RAS''/ss SOIL TEST MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION PERCOLATION TEST AUG�Jf�(�(� HUG 3 1900 RECEIVED STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION D C� f DIVISION OF ENVIRONMENTAL HEALTH L CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date l z Ilk Ig 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) _1= OT 6 ]�L K -c-- E S u /3 , Ip Location (address or directions) (b) Applicant Name {V d Lm ID/L� 4� /L� x i Telephone: Home X61-66ta Business Applicant Address la) -7 n-�' I ' l-nnP t Ed AncJ_� ate/ g (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other (explain); r' '- (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone Telephone (f) Mail the HAA to the following address: MOVA Pe0P`QTV A4 c m T. 14f4 -n = Ed Sr�nclellc X5-1 G) P1A�1a/ll A AnC A C-7gS'!S� 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 13 3. WATER PUPPLY Individual Well ❑ Community`4 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(11,84) MUNICIPALI I OF ANCHOI;A(•r ENVIRONMENTALSMWN1pjl� ITY OF ANCHORAGE (MOA) HEALTH At IORITY APPROVAL (HAA) J �y8YHECKLIST - FEBRUARY 1984 264-4744 Legal Description.% Fa lL I< A. WELL DATA Well Classification If v� lJal (�[If A, B(�)D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot I e4 1 'w` Depth of Grouting — Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots To Nearest Edge of Absorption Field on Lot / 5 t ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Samole Tast RA.9IIIt8 To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed �� ./i� L— Size Gc ( No. of Compartments C Standpipes (Y/N) Air -tight Caps (Y/N) ty Foundation Cleanout (Y/N)_ Depression over Tank (Y/N) Ill Date Last Pumped (/ / p`7 Pumping/Maintenance Contract on File (Y/N) / for N1 2 Holding Tank High -Water Alarm (Y/N) _ A Temporary Holding Tank Permit (Y/N) _ k__— Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation i To Property Line 6-,q) To Disposal Field _I To Water Main/Service Line Course Comments To Stream, Pond, Lake, or Major Drainaqe Page 1 of 2 0-026 (Rev 8 A6) Front S E or L SK& DE PT. OF ENVIRONMENTAL CONSER"' ION APIA HOP,AGE/WESTERN DISTRICT OFFICE "601 "C" STREET, SUITE 1334 AtICHORAGE, ALASKA 99503 DATE: 12-17-87 PWS I D # : -Class-C Well Peters Creek To Whom It flay Concern: STEVE COWPER, GOVERNOR 563-6775 According to the records on file in this office, the REED SUBDIVISION Lots 6, 7, 8, f, 9 Class C Water System is in compliance with the State of Alasl<a Drinkinq Water Requlations. Sincerely, Ronald S. Klein Environmental Field Officer Per verification of Jim Hayden, ADEC, Anchorage MI.eNICIPALITy OF ANCHORAGE; DIVISION OF ENVIRONMENTAL HEALTH DEPAR'_'MEtvT Or ILIA -LTH AND ENVTRONMT',NTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE yo General Information Application Datey- (a) Legal Description (include Lot, block,,subdivision, section, township, range) Location (address or directions) Applicants Name 1�/ l 1 '(b) Telef ,i . Business Applicants � AddressAn ��r 1�- (c) Applicant Y�!s (check one) Lending institution �� Owacr/buildert Buyer �� J s Oi:her EJ (explain); (d) Lending Institution Address (e) Real Estate Co. & Agent Address Telephone (f) Mail. the HAA to the following address: s_ C 20 L'ype f-, Residence Telephone Single -Family Multi Ea:u:tly J j Other ((Ic Number of Bedrooms -3 3. Water. Supply, Individual WellCommu}zity _ f 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 II Community �__ � Holding 'Dank Note: If community well system, must have written confirmation from the State Department of Environmental. Conservation attesting to the legality and statue. [Page 1 of 21 as RnBineet ixlF; )rarnx Provi.dto 1:rz:sle i i.ou 1'e t ,, File Search Iia a and YuFo,:raai I -,;t As certified by my seal affiged hereto and as of the validation data: shown below, I verify that my investigation of this Wal th Aut:hovity Approval shows that the on-si ra water supply and/or wastewater di3pou a:l system is safe, functional and adequate for rche number of bedrooms and type of ncr.uc tore indicated herein. I further verify that, rased on the information obtained f;:om the Municipality of Anchorage free and from my investigation and inspection, the on -:site wager supply and/or wastewater disposal system is in compliance with all Hunic:ipal and State codes, ordinances, and regula- tions in effect: on the date of this inspection. a Na -me of Virri Address 100 L,1 .� is �(, °l �. i? .grit Date 6, DF3`P Approval Approved for: bedrooms Approved _`' Disapproved, Terms of Conditional Approval. SEAT,) By Conditional CAUTION TeIephone M THE MUNICIPALITY O1+ A NCEIOIII&OE DEPARTMENT OF 11 AT j U AMU nNVIRONME,'TbAL PROTECTION (DREP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TEE REeRZSI:l:tiTi ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFFSSI:ONAL ENGINEER REGISTERED IN `L`IiE STATE OF A.LASKC,. TLI73 DHEP DOES THIS AS A COURTESY TO PUKCITASERS OF DOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND SL'A'TE REQUIRE- MENTS. EMPLOYEES OF DEEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPObSIBL}E FOR ERRORS OR OMISSIONS IN THE PROFI?55IONAL ENGINCER'S WORK. (DEEP S3:XL) RR4/ej/Dl8 (Page 2 of 21 1-19-84 IIIPJAli a MUNICIPALITY OF ANCHORAGE (MOA) r - HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. WELL DATA Legal Description: t47- 6 ?&� 51101J1 T/<,—/1J i2(60 Well Classification ('�RPMJ OJ If A, B, ora D.E.C. Approve Y ) Well Log Present (Y/N) A/'i Dateleted �} Yield Total Depth �1 _ Cased to 7,pt Depthof Grouting Static Water Level ,f%�� Pump �t AtAIIA- Casing Height Above Ground Sanitary Seal on Casing (Y ) A Electrical Wiring in Conduit (Y/N) ��i} Depression Around 4b llhead Separation Distances from Well: To Septic/Holding Tank on Lot /�� `jam ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /OZ.S ; On Adjoining Lots To Nearest Public Sewer Line e ��ii To Nearest Public Sewer Cleancut/Manhole A(12 Water Sample Collected By /V Water Sample Test Results O To Nearest Sewer Service Line on Lot N� C/) ; Date Olf (2, Comments ca / /9��s ura, t- ? �. a 1�� O)Fac s""o B. SEPTIC/HOLDING TANK DATA Date Installed TUL-4 24, M4 Size 160 E7✓tL No. of Ccmpartments Standpipes Y ) Air -tight Caps Y ) Foundation Cleanout Y ) Depression over Tank (Y Date Last Pumped W A Pumping/Maintenance Contract on File (Y/N) id 1 14--; for Holding Tank High -Water Alarm (Y/N) g Temporary Holding Tank Permit (Y/N) Separation Distances frau Septic/Holding Tank: To Water -Supply Well /4r�r 0 To Building Foundation �Lo4� i To Property Line Tx U To Disposal Field b To Water Main/Service Line W-)/-) To Stream, Pond, Lake, cr Major Drainage Receipt # Date Paid:-��,.-�_; Amount: (Page 1 of 21 2-15-84 GG f & DLI, V ^tCcr -/" C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �Di Type of System Design'fN Cf� Date Installed :rad 74P / qy� Length of Field VIS, � Width of Field Jf Ir3 Depth of Field /Q Gravel Bed Thickness Square Feet of Absorption Area J1 -3Y- ti Standpipes Present 6Y ) Depression over Field (YIQ Date of Last Adequacy Test NJ�A T_T- Results of Last Adequacy Test ,J i Separation Distance from Absorption Field: To Water -Supply Will ID To Property Line ?.Sc To Building Foundation / _30"O To Existing or Abandored System on Lot 44 ; On Adjoining Lots _50 /0/ To Water Main/Service Line I X To Cutbank(if present) Al To Stream/Pond/Lake/or Major Drainage Course ad To mlDriveway,lParkiv nng Area, or Vehicle Storage Area �o �- Corents riin�v �c� D. LIFT STATION talled Size in Gales "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ng Cyc ing Adequacy Test. Meets MOA Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or oorfctrmed to all MOA HAA Guidelines in effect on the date of this in7_� tione Signed � C . G� Date�'� ;��%�LaQ .�;I ut 4�r, Company ��5 MOA No. O i'�a �EA�J�p KB1/d5/s [Page 2 of 21 OF pt'14 DDD SDDD Dead Deep p C. n..i No. 2251-C A <, 2-15-84 O. CHEMICAL & C OLOGICAL LABORATORIE 9F ALASKA, INC. Ir; .._ TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER �^•^p�l■■ 5633 B Street \h� Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: V) See h on back I.D. NO. KG's s�/-Soho Water System Name Phone No. Mailing Address City State zip Cods SAMPLE DATE: O T O R Mo. Day Year SAMPLE TYPE: (� Routine ❑ Check Sample (for routine sample with lab ref. no. s ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE Time Collected NO. LOCATION Collected By C ker-r -7 &.x o 1A_111eAJ r(?EED S�D 2 II� caafr 3 L 5 READ INSTRUCTIONS BEFORE COLLECTING SAMPLE TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: 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. special delivery mail. Date Received - 9 - .8!�s Time Received Analytical Method: ❑ Fermentation Tube R Membrane Filter Lab Ref. No. Result' Analyst I I I I � l I I -- I W -No. of colon.ov IDom] o/ No of Pos,ry pon,m M1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 190 Membrane Filter. Direct Count Verification: LT B Colfform/100m1 Final Membrane Filter Results Coilform/100ml Reported By - c Date I 10 Time: / U a.m. p.m. TNTC = Too Numerous To Count ?%L.M'jr%H GI14VIRVIVIVICI141M. CONTROL SERVIC' INC. 1200 West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 561.5040 SHEET NO. CALCULATED BY CHECKED BY— SCALE- OF— DATE V—SCALE Kof}� OF_DATE DATE % S 3G - d.S pmxTi0L1[ a ; lm Gm o Um 0!471 111111111P q-) 10 11 ht � JIM UDEPU. OT 1F1V\VUM6%rVd1ENJr0FA1L COM91E, RVIV90% ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE :JN PWS I.0.1Y BILL SHEFFIELD, GOVEI?NOn Tolephone: (907) Address: 274-2533 To Whom it May Concern: Acco rdi ng to records on f i I e i n th i s of f i ce the Q 2 _111 t IL - �C_ Water System is in compliance -with the State Drinking Water Regulations Sincerely, v