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HomeMy WebLinkAboutHANKS LT 2C-1Hank Lot 2C #011-121-80 .. Municipality of Anchorage .r Development Services Department °^ Building Safety Omsion On -Site Water and Wastewater Program. 4700 S. Bragaw St. P.O. Box 196650 Anchorage. AK 9951"650 Page of www.cl.anchorage.al.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: S W D'S 0 0 U h3 PID Number. 011-12-1-80 N,ma C Lt= NN SC H U I -TES Wastewater System: ❑ New Upgrade tea`, DD P"U 2 ABSORPTION FIELD Peon. NMnD.r a eweemc 0 DO" 7f«xn 0 Sn.ro. Tf*1 0 81d 0 MouN 0 Dew. LEGAL DESCRIPTION eo1 Tar Dope, am ttt" greet. 6�ea- La.n '' /I /^� Bide W= t� ('T/""1N S 5 rp Dom h OP• ba W" can ayhr g•.a.: F Dm.a O.M b«rab pp.. T°wn".D Pa," a.awe r FA added teat arOn,i Ff Lrpe, fl. Well:❑ New [I Upgrade F"i *ttrx LAnw«aa», M,renceM e.n ne, CV,n"cehon (PMele. A B. Ct Y Dpn Ca,ed r¢ Tar ab,apeal we Ft. 1pe Me~. Ft i. Fl FP DneKDa. D~.. Suuc Wrer L*. . V41~ Data trfeced Y*d 5«a COW4 HnN AD Dmwd DPM Ft, P. TANK SEPARATION DISTANCES Q'Septic ❑Holding ❑S.T.E.P. ❑other. 7o From Septic Tank Absorption Field LNt Station Holding Tank Pubrorprtate Sawer Line M«"' 4W. ANC N `rAt4k< cap" 1 rJvlkr w.d i o � Mat". STE i= I— Muiro.ra e"p«fmw, Ong N O LIFT STATION La Lm Sao. Me. Dr ron ~ 1-7 'r""P«r'r..fK 'wnp ar r.««. "Vh.a«r«m et h h h CO" Dm N O Tnp MYe a MaNl eNaM'al h,peabre vertu rld by Pe. a*, BENCH MARK OLD IA NIV-S c 0SNED La De aa CH vus AN U 21 L D A,w"ed 3oTi ot�4 31 100.0DFL ON I i E �Eggineer's St��:p. r'='� ¢' Inspections by: - performed a y_ Y Dates: 1 /-0 5 +«�f4..9�11a! Y ....a....ee • •� F 2nd Development Services Department A royal� ��•• tobh:',$)BrtYaBt$`� Reviewed and approved by: Date: Z 6— OS?'r�y 4'•5�ei. tt� (x«. rood'dr'fYL�M'��er'LOP An: ar.94D8 I I Lor u I I I I 1500 CAL SEPTIC TANK I I I III I I I I Ss M . c�irr Asrfor x AD 26.5II II :r• eo 573 I I INSTALLED OW CIL SM SUM TANK I I I I I I UAQLYtZOPtO I I kill, � .............j....�49th.......I- ....... ,�- .............:i ... .... ................... .� .. i III TOB SPURnAND �FC� SO 0 50 Im 150 200 250 300 SCALfi I' = 100 FT BFACH /GRA. St COMR or INOm 80170M Saw ASSLWfO wATWN !00010 rT ' 103 If 15TH. AVENUE H GUI GG" JJAIVK,5' b1DI I SEPTIC TEA/ ASBU/LT I ANCH. AK. 99501 GLENN SCHULTfS DAM APRIL 1, 1005 (907) 279-3916 7951 JODPHUR STREET SHUT' 1/3 GR/D: 2222 PERMIT #SW050063 PID k 011-121-80 HANK002CIS I + MUNiCIPALITYOFANCHORAGE Development Services Department Onsite Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number. SW050063 Legal Description: HANKS LT 2C Design Engineer. 0007 Tobben Spurktand, PE Owner Name: Glenn Schultes Owner Address: 7951 JODPHUR STREET ANCHORAGE. AK 99502-3926 Date Issued: Mar 31, 2005 Expiration Date: Mar 31, 2006 Parcel ID: 011-121.80 Site Address: 007950 JODHPUR ST Lot Size: 100533 SO. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit Is for the construction of. ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ private Well ❑ Water Storage All construction must be in accordance with: I. The attached approved design. 2. All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. INSTALLATION OF NEW 1500 GALLON SEPTIC TANK MUST MEET ANCHORAGE MUNICIPAL CODE 15.65.050 (SEPTIC TANKS) 815.65.150 (INSPECTIONS OF ONSITE DISPOSAL SYSTEM INSTALLATIONS) Received By: Date: 3"sI o j Issued By. N f { r-' 1 /11 Date: ? t o Municipality of Anchorage Development Services Department " '0" L 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 ON-SITE SEWERNVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. of I – 12 I –s?o Permit Number SW Propertyowner(s)_ Day phone Mailing address .r- Zip Code _L20-1— Site `14201Site address -19S1 Ter1 p1' Zip Code 9950 ) Legal description (Lot, Block & Sub'd.) _ g-. ,s Lo} -2r Legal description (Section, Township & Range) Lot Size loop S3 S Acres/ R9D THIS APPLICATION IS FOR: Number of Bedrooms S Sewer Only ❑ Well Only El and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi El Pool ❑ Water Softening Unit ElTherapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature Permit/Rush Fees: owner or authorized agent) Date of Payment: 3 Receipt Number. (Rev. 09/04) Waiver Fees: Date of Payment: Receipt Number. bm� Envitohmental Consulting and Design SI IfTIC SYSTEM DESIGN LOT 2C BANK S/D CLENNSCHULTES Municipality of Anchorage March 31, 2005 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Dragaw Street Anchorage, Alaska 99519-6650 We are submitting an application to replace the existing septic tanks servingthis property. During an HAA inspection the septic tanks were exposed and it was observed that they were seriously damaged by contusion. The installation of a 1500 gallon septic tank will not affect the adjoining lots. All Municipal separation distances can be complied with. an 1ror&tt d tz::39 _ 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net Yours truly, d5; , Tobben Spurkland P.E. an 1ror&tt d tz::39 _ 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net I I LOT 1c I III III I I I I I I LOT x I I i! RnVa LxLS W SEPTIC TANKS I WN 15W CAL TAW I I oo/ I I — -- — — --- -- — --- — — — — — — -- I I lnwxreLovtn I I OF AN I I .�p��........ •�## I I I i_..�•..... - TOBBE SPURKLMD r = I I I �.�f'•. N . CE -2223 ' • � I I I I I so 0 so 1w 150 av 250 m SCALD r = 100 a 203 W 1511,H. AVENUE Lul 4t, HA/Y!I blU SEPTIC SYSTEM D£S/CN ANCH. AK. 99501 CLOW SCHULT£S DATE- MARCH 18, 1005 907 279-3916 7951 JODPHUR STR££T SHEET'' 1/3 GRID: 2222 PERMIT #SW050XXX P1D # 011-121-80 HANK002C1.DWG J � 9 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH'& ENVIRONMENTAL PROTECTION i ENVIRONMENTAL ENGINEERING DIV,ISI.ON 825 L Street -Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT' NAME � � J - PHONE ❑ NEW UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATIONry� D ® SJ L" - NO. OF BEDROOMS V DISTANCE TO: e y� ,'. Ito Absorption area Dwelling - PERMIT Y a G W�- Manufacturer r j� MateL jG No, of compartments rn Li . apacity.n gallons -� � � � � IF HOMEMADE:. . Inside length Width Liquid depth Z Well -DISTANCE T0: Dwelling PERMIT NO. fManufacturer Material Liquid capacity in gallons O -i= W -. DISTANCE TO: Well i 12� Foundation Nearest I t lie ye ._ PER LL Z. F z w No. of lines- - Length of eac line. %i Totallength of lines v Trend - i - h oL inches Distance between lines H CG Top of tile to finish grade / Material beneath tile er inches Total effective absorption area 600 Lu Length _ Width - Depth. PERMIT NO. - Qa F Wd Type of crib. Crib diameter Crib depth Total effective absorption area W y DISTANCE TO: WeII - Building foundation' - Nearest lot line - _J Class Depth Driller _ Distance to lot line PERMIT NO. W - DISTANCE TO: Building foundation Sewer iifie -Septic tank Absorption areas) OTHER. 'PIPE MATERIALS t- L SOI L:TESTRATING Io© Ly INSTALLER ..... ...REMARKS A./ ♦. - r - -6e, 42 4 � b_ y APPROVED - - DATE.. LEGAL - 72.013 (Rev. 3/78) Adm Alk I i DEPARTMENT .iN[.,, ENVIR NiEALTH r QNMEP-4T 825 �L` STREET., ANCHORAGE., AK". 99501 po 264--4720 C# P-4 T _T !Ll".. l=_ R-1 EFEFR. RJ F:-' C"Do r ­_u IF -1 0-D E:...' F" E:-.. F-" r"I 1 T" PERMIT r.m. < 790645 f:IPPLICANT T. SFN-`LAN[) 8155 CRANBERRY LOCATION LINK LEGAL LOT 2C HANK SUB OT SIZE 100000 SQUARE FEET TYPE OF SOIL. ABSORPTION SYSTEM IS: TRENCH NA,'­4INUM NUMBER OF BEDROOMS = `+ SOIL RATING F'T/BP)= :100 'THE RE,.-.!UIRED SIZE OF THE SOIL ABSORPTION -SYSTEM IS: I C -a == :JL Efo L_ EE P-4 K -.-i 7"t-1 -- x a_ 13 F--" f -I "...a FEE I— N EF JF="_r,, 1-4 = 4 THE LENGTH DIMENSION IS THE LENGTH +.'IN FEET) OF THE: TRENCH OR DRAINFIELD. 'THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN 'THE SURFACE OF 'THE'. GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE rlIhlItlUtfl DEPTH OF' GRAVEL BETWEEN THE ouTF-f-a I... PIPE AND THE BOTTOM OF THE EX(.*f"lVATION IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE' INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO 74-115 PROPERTY FIND THEE NUMBER OF RESIDENCES THAT *THE WELL WILL SERVE. _.....I....._.: _.. _r 0.4 RD < ;;z7-" > 10«:.«0 F"F=: C:" I T _J V-1 f--"# lF`-;i! EF; F;4 F---- 0: A U I E.'AC KFI LL. ING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY T11IS DEPARTMENT WIL.L. BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY C)N­SITE SEWAGE DISPOSAL. SYSTEM IS 1.00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WEL.L.. OTHER REQUIREMENT'S MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE 'TO INSURE PROPER INSTALLATION. f="L=lRJ­f 1 -F E-:."4 F=" 1 ::3: -L.., .1-. I CERTIFY THAT I All FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SENER'S AND [%If::*L hf: SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL... INSTALL. THE. SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEklER sy,_sTEM MAY REQUIF:*.'E ENLARGEMENT 'IF THE RESIDENCE 15 REMODELED TO I NC MORE THAN 5 BEDROOMS. SIGNED:--- T LKJN APPLICA T ISSUED BY '.'4. E", ..H4—sLin.....Q �.r.n-,. �� �"' `� SOILS LOG t MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION /� PERCOLATION TEST Pouch 6850; Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: 1/ iL Poo,I GG J DATE PERFORMED: LEGAL DESCRIPTION: Lci I N K s/D DEPTH 1"{11SLOPE _ SITE PLAN 1 (FEET) 1• I V) C. SA.11 CA FFM,, -H 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SQA ty S.JQ SC'✓Vl/�� WAS GROUND WATERO L ENCOUNTERED? O _. ZI 1 P —' O__. s'tOwf 4441*-- IF YES, AT WHAT — E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop v C 10 f 1 1110 .� a 2.o so 10 10 1 100 16 ,S y 140 10 1 (11 1% 610 to 15 10 0 10 1 3 PERCOLATION RATE' (minutes/inch) T EST RUN BETWEENn �L FT AND (� FT • to 10 11 I;T7 PERFORMED BY: 1 30 NA&4A94AIff 6. CERTIFIED 11BY: DATE: 1 &.72-008 (7/76)s) tt X40 edv o L i.C/" G Gd/Gb'� ✓1 P l 11, J111.,.. ra' GER ANCHORAGE AREA BOUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME MAILING ADDRESS pp�/ PHONNEQ,4/J�! LOCATION LEGAL DESCRIPTION7T1.%kA .FIS ! Z�7-1 ESTE ( SEPTIC TANK: DISTANCE j NUMBER OF FROM WELL /d MANUFACTURER MATERIAL COMPARTMENTS INSIDE LENGTH ,� INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY I���_GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH, LENGTH/, DEPTH LINING MATERIAL CRIB SIZE: DIAMETER_DEPTH - DISTANCE FROM: WELL TOTAL EFFECTIVE x�--^^772�__ BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) s�SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE TANK -,SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: ` PIPE MATERIAL: "j LOT SLOPE: REMARKS: REMAR DIAGRAM OF SYSTEM +>-a M -W DRILLING, Inc. P. 0. Box 4-1224 • 1310C International Airport Road (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner Dr. hanks Use of Well Dom Location (address of: Township, Range, Section, if known; or distance main road 2 Size of casing 6 Depth of Hole 280 feet Cased to 278 feet Static water levet 240 ft. (abillivet) (below) land surface. Finish of well (check one) open end ( X ); Screen ( ); Perforated Describe screen or perforation None for hours with 100% t, f Well pumping test at '' gallons per-�) (minute) .�- of drawdown from static level: Date of completion 16 Jun 74 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 —To Surface Organics —ATO 8 8 TO J0 _ATO 52 52TO 135 -135—To 1`Q _; 50 TO 200 200 TO245 2�—TO 2,90 25D_TO 278 TO TO TO TO TO Stity Sand Silty Gravel: small 2 Pr r1 it r' Sandy Gravel: silty 71993 1 —CUSTOMER GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 8330 "C" STREET .ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT—/�@�5,• MAILING ADDRESS PHONE lZ r�/`y/I� INSTALLATION LOCATION � LEGAL DESCRIPTION ,;�N h�.re .S.'¢c ! ^ • OZ-/s/'I �" C�4Y� - "`O� INSTALLATION OF; SEPTIC TANK "SEEPAGE PIT DRAIN FIELD __� OTHER TYPE AND SIZE OF FACILITY TO BE SERVED A&w,-r� 0"'dal P FINANCED THROUGHTO BE INSTALLED BY -SOIL TEST RESULTS LJ(l// 1 NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION. BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ` TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK S-, — SEEPAGE AREA SIZE FOUNDATION TO SEEPAGE PIT (L DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTICTANK. S5 . SEEPAGE PIT _ . DRAIN FIELD TO NEAREST LOT LINE./ WELL T�i��O SEPTIC TANK/ ` SEEPAGE PIT DRA tj FIELD !J2� ♦ ALSO .CONSIDER AREA WELLS. WATER MAIN TO SEPTIC//TALK"� , SEEPAGE PIT l DRAIN FIELD o - %�� 7 SEPTIC TANK, -ZGpw , SEEPAGE PIT �. DRAIN FIELD l00 TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO. CRIB CROSSING GAP OF. EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST. IRON SIPHON PIPES ON. SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL. BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGN We - 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH DESCRIBED SYSTEM IS IN ACCORDANCE. WITH SAID CODE. DATE 7y APPLICANT'S SIGNATURE FD Na" EO -016 0 DIAGRAM OF SYSTEM 28.68 AND THAT THE ABOVE �„--.�� •-.—�+--.i.....- .- hi�rNM"mf•�+r�r+,_... r .w;h.vMllira•i±h�•irm .>�`�a xi <i.eyri�mm•MYMMHi+r-n.•Iry ...r ri. _ ... 4 �ons�zue¢ione�� -fa� "One test is worth a thousand opinions" 5020 TUDOR ROAD. ANCHORAGE, -ALASKA 99507 O T[L[►NON[ 333.8472 Performed For Goerge Hood Glacier Exc. Date Performed 5-30-74 Legal Descrintion: Lot h` Idivi"sion This Form Renorts Soils Log yes Percolation Test Depth Feet Soil Characteristics i I Organic & Silt Overburden — 2 3 Fine Brown Silty Sand SM 4 a 5 6 --' Fine; Brown Sand, slightly silty & moist 7 - SW+ 130 9 10 Bottom of Test Hole minus 15 ft. Was Ground Water Encountered? no If Yes, At what Denth? Reading Date Gross, Time %P/ 0 0 Net Tim e Depth to H2O Net Dron' Percolation Rate Minute Prnnosed Installation: Seenaae Pit Yes Drain Field _ Denth of Inlet Denth To bottom Of Pit Or Trench C,nMpAENTs: _130 sq. ft. drainage area required .per bedroom below No bedrock or water tableL ft below ended-intenage -pit. Jim Mack Data Certified By: Const. Test Lab T_es,t rP:errfrned 8Y -- nano. T-�0-74 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 Parcell.D. Olt— HAA #_ Q5C(5} Expiration Date: 7—Z.& -C)_6_ .. & -pS 1. GENERAL INFORMATION Complete legal description Ly' D 0 Ll A� Location (site address or directions) _ 7 q 5 I '1 Ob-pN J iZS i a th 918502 Current Property owner(s) G LE N NI S C N o LT ES Day phone h 1— 1785 Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone 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 Individual Water Storage ❑ Individual Holding tank El Class Well El Community On-site 11Public 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 requestto homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties new water sample results. (Certificates may be reiss new by a private or Class C well and may be reissued with ued 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 ction,hand State e on-site water codsupply and/or wastewater disposal system is(are) in compliance with all applicableMunicipal and regulations in effect at the time of installation. Name of Firm $pu�yL_At4D t-`-NC-rIf�)CE2tNf7 Phone' a��5''-'qr� Address 0 _' \Y./ 14 3 Engineer's Printed Name 1 0 0 '�) = a H° Date • C: nor' 5. DSD SIGNATURE Approved for r bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: " (�(/ f p -c Original Certificate Date: 14- )-6-or (Rev 01,02) Municipality of Anchorage y; Development Services Department Building Safety Division •"' On -Site Water & Wastewater Program s 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci-anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LO j AZe MANIC 5 Parcel lD: O_ Li - A. WELL DATA � Well type 1� If A. B. or C provide PWSID # rVA Well Log (Y/N) Date completed'/4-17Y Sanitary seal (Y/N) Wires properly protected (Y/N) __y_Total depth .�/�L) ft. Cased to �R�ft. Casing height (above ground) LZ in. FROM WELL LOG AT INSPECTION Date of test Static water level adv ft. v��� ft. Well production !, g.p.m. 7 g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate OS m /I. 9 Other bacteria Iq C> colonies/100 ml. Arsenic: N_[) mg./I. Date of sample: 3�2 L/p 5 Collected b : I.Ae-� Y SPURKIANb B. SEPTIC/HOLDING TANK DATA Tank Type/Material 5.�,?�-,'r S4re Date installed _-/- O 5 Tank size -LI-0-0 gal, Number of Compartments Foundation cleanout (YIN)Depression over tank (Y/N) hl High water alarm (Y/N) Date of pumping NSA Pumper _ N �q C. ABSORPTION FIELD DATA Date installed 1 �I r 3 l7 q Soil rating (g.p.d./ftp or ft2/bdrm ) —0— System type TrL tE N C Ff Length �O ft. Width 2 ft. Gravel below pipe ft. Total depth _ ft. Eff. absorption area6n0 ft2 Monitoring tube _� Depression over field 6 Date of adequacy test _26 3 IO 5 Results (Pass/Fail) q, For - bedrooms Fluid depth in absorption field before test � in. Water added al.'*56r N r� y ��g New depth =in. Elapsed Time: ��, Final fluid depth a6 z -in. Absorption rate >= 760 9-p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N 0 If yes, give date tl� D. LIFT STATION Date installed Size in gallons "Pump on' level at "Pump off level at Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot lob Absorption field on lot 11.5- -Public sewer main N /A Sewer /septic service line q5 Manhole/Access (YIN) High water alarm level m. Meets alarm & circ requirements? On adjacent lots On adjacent lots Public sewer manholelcleanout I-1 A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: I Building foundation /7 Property line a -15—r Absorption field Water main N/,A Water service line a + Surface water Welts on adjacent lots 7 /110 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: property line y'b Building foundation 30 Water main N/A Water Service line �3b 4 Surface water ~1A Driveway, parkinglvehicle storage g Curtain drain N_ ') Wells on adjacent lots /cam 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 this date. p Engineer's Printed Name / o bh t» S p u rk- L t cC Date HAA Fee 5 U3a !V Waiver Fee $ _ Date of Payment y� CS Date of Payment Receipt Number % 1 Receipt Number (Rev. 12101) i 'k O v I o o ' J J � — N 000 '00'W 165.0' — � I � I I �€ I I f L� N I o " la < � z 19 ,� x 1� N / / \ �4. I\ ��o � � �.; •.:. •�•R. .�43NS a I 1 Y r Iy .a•za I � it 0 08 J s 00•07'00•E 165. ' JOHDPUR ROAD 9 0, Municipality of Anchorage Development Services Department i Building Safety Division Onsite 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 Parcel l.D. 611— l I- 1. GENERAL INFORMATION Complete legal description HAA ft 06 C7 V Z,0 Expiration Date: /9- / 7-0_'L L-oll a C u A'(y\G s kb Location (site address or directions) 71'-:� 1 ) m D3�'t-4 V 7 Current Property owner(s) �' �'reS5 Day phone Mailing address % Q r) I J n D P t4 v iZ Lending agency Day phone Mailing address Real Estate Agent 1 1 LIA P-14,41 R-014" Day phone 976-91&4— Mailing 76-976+4_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 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 shovm below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this applicaton, 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 I e bli-e Address 6 9-3 Engineer's Printed Name 5. DSD SIGNATURE Approved for Jr bedrooms. Disapproved. Conditional approval for Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory By. (Rw 0,M) X Phone_ A79—SUL- Date 1512,_Z vZ bedrooms, with the following stipulations: df �FANC ���: • ON-SITE •• '�G)= WATERAN[3 WASTEWATER PROGRAM 0, N\ Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 6i —17 -ate. r_.. . Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 www.a.anchorage.ek.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: tvT 9-e- 14A.NIC op A. -WELL DATA Well type '�t �j% If A. B, or C provide PWSID 0 �4 Date completed rib 7Y Sanitary seal (YM) Total depth J92 -ft Cased to _gQft. Parcel ID: m 1 1-1-,/-a D Well Log (Y/N) Y Wires properly protected (YIN) Casing height (above ground) I n. FROM WELL LOG AT INSPECTION Data of test *011 71:/o h 2 Static water level 2q O ft. a 3 % ft. Well production g.p.m. S 9 - p.m -WATER SAMPLE RESULTS: Coliformcolonies/100 mi. Nitrate N t0 . mgA. Other bacteria =_)L colonies/100 ml. Arsenic: _" mg./I. Date of sample: i I- Collected by: TSPvtWdtu40 B. SEPTIC/HOLDING TANK DATA Tank Type/Material I' Date installed -%3bl/ f tr14119y Tank size f-Sjgjq gal. Number of Compartments 110 Cleanouts (Y/N) y Foundation cleanout (Y/N) O �y Depression over tank (Y/N) ,h_ High water alarm (Y/N) r 1 Date of pumping '1#1410 2- Pumper Ad►ti&4_ teSS pea - C. ABSORPTION FIELD DATA 11 Date installedtl 1 Soil rating (g.p.d./fe or fe/bdrm) � System type 1-c. KaG Length 100 ft. Width Total depth 1 -3 ft. Eff. absorption area JL00 flz ft Gravel below pipe 5 ft. / Monitoring tube Depression over field - 11 -Date of adequacy test 7/7!010 Z Results (Pass/Fail) ? For S-_ bedrooms Fluid depth in absorption field before test 6k in. Water added7b0 gal. New depth oI in. Elapsed Time: � Final fluid depth _JeQ in. 1 Absorption rate >= 750 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) r`f n If yes, give date F7eIoµr tNw eo4 4 rif2J Yt0 t7 (.�:,* Id4"dpw rn.r Ig43 D. LIFT STATION Date installed Size in gallon Manhole/Ac ess (Y 'Pump on' level at _, in. 'Pump level at —in. High water ata level at in. Datum C es tested Meets at & circuit requirements9 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot (C]. On adjacent lots 1 lo -w Absorption field on lot i 130 On adjacent lots *)p 1&-0 Public sewer main t4/A, Public sewer manholetcleanout Sewer /septic service line )p 0V Holding tank "A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 1 M6 / 11.0 Property line _i Vi ,� Absorption field Water main H& Water service line 4;- f Surface water Wells on adjacent lots ? lop SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: V/A Nlv Property line 10 4- Building foundation 1; 'li` Water main N /A Water Service line i m 4 Surface water t-110 - Driveway, parking/vehide storage Curtain drain d Wells on adjacent lots 9/s0 F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal recofds that the above systems are in conformance with MOA HAA guidelines in effect on this date.. Engineer's Printed Name /,&kvkPCrt �pv /1G�.waC ' t c.. Date &1t 1.140 It a. HAA Fee $ 3%J ` Waiver Fee $ Date of Payment &�Ri�otc Date of Payment Receipt Number jyb 0 % Receipt Number (Rev. 12101) ._ /w7G-14-02 FRI 03:00 PM TIM-AND•-ANh'-RITTAL O c _ PA%:9072437346 PAGE .2 it ✓oJhpt• /jv N0'n7'00"w IKT.Co' • yg ��~ j♦u i � v j9TJ J x p O 11 �EYTQ� J b IF O 4 i M _ PA%:9072437346 PAGE .2 it ✓oJhpt• /jv N0'n7'00"w IKT.Co' 1 •, r �r�G���as q$' S, a PRO NiL Z r � BBBBBBCG ��Hr �1'i 1 5185 ��4 1 R 8tsf No W fl 0 n j: i:f o' S • j I � v j9TJ J x ..� _i I i M LT I i 1 •, r �r�G���as q$' S, a PRO NiL Z r � BBBBBBCG ��Hr �1'i 1 5185 ��4 1 R 8tsf No W fl 0 n j: i:f o' S CTaE Environmental Services Inc. CP&E ReLq 1024676001 All DatestTimes are Alaska Standard Time Client Name Tobben Spurkland P.E. Printed Date/Time 08/07/2002 16:17 Project Name/# 7951 Jodphur Collected Date/rime 07/26/2002 0:00 Client Sample ID 7951 Jodphur Received Date/Time 07/26/2002 16:00 1llatrix Drinking Water ' Technical Direc Stephe C. ,de Ordered By PWSID 0 Released By Sample Remarks: EP 300.0 - Nitrate detected in CB at the 0.2 mg/L PQL level. PQL raised due to hold times but it remains below action level. Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init Metals Department Arsenic 0.00500 0.00200 mg/L EPA 200.9 (<0.05) 08/07/02 1MP Waters Department Nitratc-N 1.23 . 0.500 m8/L EPA 300.0 (<10) 07/27/02 JDT Microbiology Laboratory Total Coliform 0 col/100mL SM189222B (<1) 07/26/02 KAP 0 M1 4 : MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# olI - laa-%0 HAA# ��)q-0) 1. GENERAL INFORMATION Complete legal description Lo •1 V_ L PA N V S 'sib Location (site address or directions) Property owner Mailing address Day phone Aq3- Lending agency 4 Day phone Mailing address Agent r-� � Day phone 3 gy— 5 Ale Address _ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well 11 Community well Public water NOTE: If community well system, provide written confirmation from State. ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 of this Health Authority Approval application 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 ovbk e ij 9ay V, le, f Phone Uq _3 q Lb Address Engineer's signature Date 1/1-1 %9 3 6. DHHS SIGNATURE Approved -fort S bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: By: � Date '7- 7-9�,l 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 renistered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto 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. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST an Legal Description: 7" C— Parcel I.D. U l — / ;Z /-- F6 A. Well Data Well type If A, B, r C, attach ADEC letter: ADEC water system number/i4 Log present (Y/N) Date completed % Driller w U Total depth -7 _Cased to Casing height i X02 Sanitary seal (Y/N)y Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION O �� Date of test 6 �llo'7K &Il q 193 y�q° Static water level Well flow g.p.m s Pump levell 7 O 2 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 1016 ; On adjacent lots Absorption field on lot ; On -adjacent lots 7 / 0r1t Public sewer main N �.4 Public sewer manhole/cleanout pp N�i4 Sewer service line Z / D Petroleum tank NO rte! WATER SAMPLE RESULTS: Coliform Nitrate ®o q5 Other bacteria Date of sample: & 11 q 1 Q 3 Collected by: 7Te S B. SEPTIC/HOLDING TANK DATA Date installed �3�y 171 Tank size 1.250 `f 6" Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) N Depression (Y/N) High water alarm (Y/N) t4%ice Alarm tested (Yt/N) // Q Date of pumping Pumper A� t t t f tm raa(L o Ub o a� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 10_%r1X0 On adjacent lots '> 10-0 Foundation 17 To property line > 10 Absorption field Water main/service line >5D Surface water/drainageyt CONTINUED ON BACK PAGE 72-026 (3/93)* Front C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" Level at Cycles tested Surface water Date installed 11` %S1 19 Soil rating (GPD/Ft2) 1.5 System 1 type w► 'Hcrt Length ({4 Width A LI ( Gravel thickness � / Total depth 1 ?i Total absorption area L " Cleanout present (Y/N) Depression over field (Y/N) r� Date of adequacy test ty 14 3 Results (pass/fail) for b� Bedrooms Water level in absorption field before test After test 10 5 Peroxide treatment (past 12 months) (Y/N) t4 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot j / 3o On adjacent lots > 1 " Property line i l 0 To building foundation 5 5 w I o existing or abandoned system on lot > /0 N On adjacent lots > 50 Cutbank b we- Water main/service line > 50 Surface water A 0 14 _R_Driveway, parking/Vehicle storage area > 5-0 ,, Curtain drain IV t) w 2 E. ENGINEER'S CERTIFICATION l certify that l have checked, Signa Engin Date verified, or conformed to all MOA and HAA guidelines in effect brL(liac this inspection. AVI� ��°rQ.e CF •a.ae s0a y >l S ��1 HAA Fee $ 17V , e121 C Date of Payment Zo —Z�=� \ Receipt Number F-9 M3- C �/ 7c,;� ) 72.026 (3193)• Back v:::::::,. �'i;ua.. S .::. a .`6:: ;. .::.:. a r. ®d YV' L To' en Spu Y!dural e"^ _4r Ie ji ." CE -21-25 ae ?_aR FESS10�,� Waiver Fee $ Date of Payment Receipt Number Tobben Spurkland P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 Evelyn Givins/ Mary Reardon Marston Real. testate 2404 I -lest iuorthern Lights Anchorage, Alaska 99503 ADj: U A C Y TL"'T LOT 20, HANK DUBDIVISION Owner. .14r. Robert Riggs MoD. OCT. 29.1979 Building. �:nlitt level, partial basement* 5 bedrooms, built in 1975 Water. On site well Sewer System 1250 gal6 tank with crib of unknown sizes and construction• Z'tw YS NOT ri11,;-;Uf1TE A11D MUST ID, lif:.r'LIW,D The sewer system was inspected and - ted on Oct, 25, 19'79. Inspection revealed subsidence gf the hound above the crib. The 4—inch vent pipe was broken. Floating sludge blankets were observed in both tank and crib. When pumped a residual layer of sludge remained in crib and ipnk. 'These layers measured 12 and 24 inches respectively. Approximately 1500 gal of w,rste was removed from the cribs less than 1000 gal from the taan1g. On octe 26 15W gal of water was introduced into the crib in 500 gal increments. The water level was chocked after each dump. Depth of water was 12 inches before any water was introduced 22 inches after 500 gal 37 inches after 1000 gal 66 inchoo -after 1500 gal These readings indicate that a. 8 ft. x 8 ft. crib was installed, but also that the crib has colapsed. This is also indicated by the depression of the soil surfacer. The water level in the septic tank was checked at the end of the ,fill. ''rho water level was 41 inches, indicating overflow from the crib to the tank. After 8 hours the water levels were checked Crib 43 inches Tank 42 inches After 24 hours Crib 41 inches Tank 43 inches Tobben Spurkland P.E. Very little if any percolation is seen to take place. To upgrade the system to Municipal standards a new drainfield must be installed. The septic tank should be uncoverd, inspected and. cleaned. This work can be accomplished in two dayeav and shpuld be done prior to freeze-up. If I can be of any assistance please contact me. Tobben ,Spurkland October 30r 197 ilober-L-/Har n Riggs j�velyn Givers a,.ncl glary Rearden Harston Real Estate 2804 west northern sight: Boulevard Anchorage, Alaska 59503 Subject= Lot 2C Hanks Subdivisioia ,rhe engineer "s report on the sewer system indicates that it is not adequate for a five (5) bedroom single family Gi-wel l ing. Wherefore, before we may Sella an approval to the lending agency, an ;upgrade will be necessary. he upgrade will include the following (1) The septic tank will :need to be uncovered so that it can be cleaned alld pumped. A 500 gallon septic tangy: will need to be installed in tan- om with the existing 1,250 gallon tank. (2) Cave in the existing sce'Pa.ge arcs.. (3) Install a new se page trhn0h. .prior to the installation of a new tren"I, obtain a soils test and submit to this depart-ment so that a permit can be issued, which will dive you the specifications fOr the upgUNd(" If there are any further questions, please contact this office at 264-4720. sincerely, Robert C. Pratt. R. 9. Associate Specialist ':CP j1 j w