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ALDER PARK LT 2
PERMIT ND R.F'F:'L I CANT LOC:AT I ON LEGAL. C~ I'-l--':-: I TE 800447 ', I-,']'LI I'-,1 I C: I F' F~ L I 1'-'m" [:,EF'FIRTMENT r HEFILTH FIND ENVIRONMENTAL ~;:.'--"5 "'L STREET., FtI'-,ICHORAGE, AK. 264-4720 5EI..JEF-: IJ F' m3 F2 R r:, i 42~.11 W. 84TH R',,,'E. LOMAX, KENNETH 4':'.1t WEST :--:4TH.., FIVE. LOT 2 ALDER PARK SUB .t , >,,., F'EF-:£.I T T t .~ ,' 4- _, LOT SIZE '1.'i: ]: ]: 0 SQUAF.:E FEET 'TYPE C,F S,-,IL. AB's;C,F.'PTI_-,N S"r'STEM IS' TF.:EN~.~4.---~OZ'~'¢°~r /~-/'249/¢~ ~..~ MRXIMLIM .NL~MBER nF BEE:,ROCffIS = 4 ~"'-~ SOIL F.:RTZNG ,'S9 FT,."E;F:)= 120 'THE REQLIIRED SIZE OF THE SOIL flE:SOF.:PTION SYSTEM IS' [::,E F' T H == -1£.~ LEr-~I3TH= 12 '.3 F-: R *..." E L [:,EF'TH= TFIE LENGTH DIMENSION IS THE LENGTH ,.';IN FEET) OF THE TRENCH OR DRfllNFIELD. ]"HE DEPTH OF R 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 MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCRYATION (IN FEET;..'. F:E,;!LI I F.:E[:. SEF'T I C: TRr-JF::.' S I ZE= 5 ~--':"~ £-, GRLLC,~-I'----; F'EF:MI T RF'F'LIf':flNT HAS THE F.:ESPONSIBILI TY TO INFORM THIS DEF'RRTMENT [:,URING THE IN':';TALLRTION INSF'ECTIONS OF ANY WELLS R[:,JRCENT TO THIS PROPERT"r' AN[:' THE NUMBER r~F RESIDENCES THAT THE WELL WILL SEF.'.'v'E. 'T'I.--I,-, ,:: 2 ::, f I'-,I'_-~F'EC: T T 6,1'--I$ RF-:E F.:EI_--_.,I_! T P-.Er:, BAF:KFILLING OF ANY '-' "-:, .r :,TEM WITHOUT FINAL INSPECTTON AND RPPRO'v'RL BY THIS DEPRF.:TMENT WILL BE ':;UE:JECT Tn PROSECUTION. MINIMUM DISTANCE BETI4EEN fl WELL AND tiNY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRI',,,'ATE WELL OR 2L50 TO 200 FEET FROM A PUBLIC WELL DEPEN[:,ING UPON THE TYPE OF PUBLIC WELL. MINIMUM [.',ISTFINCE FROM R PRI'v'RTE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY RPF'LY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE R',,,'AILABLE TO INSURE PROPER INSTALLATION. F'EF-:r-11 T E::-::F' I F-:E:-_q [:,EF:EF.1E:EF-: 7_~::L.. -1 L=,. :--:~.Z1 ! C:ERTIFY THAT 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH 8Y THE MUNIr:IPRLITY OF ANCHORAGE. 2' I WILL INSTALL THE SYSTEM IN Ar:F:OR[:,ANC:E WITH THE CE[:,ES ]:: I UN[:,ERSTRND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RES I[:,ENC:~.~ REMO[:,ELE[:, TO INIE:LU[:,E MORE THRN 4 BEDROOMS. .... ............. ISSUE[' ~" '~<'¢. 1-~ TE Y4.. --] ........ _ _ =~- ~ G~'"~TER ANCHORAGE AREA BOROI'~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N? 309 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ADDRESS LEGAL DESCRIPTION SEPTIC TANK: --'~,~,;~ ~" -- NUMBER OF DISTANCE FROM WELL /~"-~r~'-c~-'~-'~~ATERIAL ~r.;~-.~_ COMPARTMENTS LIQUID CAPACITY _/"~2 ~'i'~/2 GALLONS. INSIDE LENGTH ~--~IT',JSIDE WIDTH LIQUID DEPTH _~------- SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER /"~ OR WIDTH /~ / LENGTH /'~ /, DEPTH DISTANCE FROM WELL_~~-~''''-~-/'~ '~ , BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~.~' ~ ~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL , ATI ~ NEAREST LOT LINE NUMBER OF LINES ,/"'"'""~- D STANCE BETWEEN LINES 'x~ TRENCH WIDTH DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH , OF LINES IN. ABOVE TILE WELL: ~- ;''''~' ~'"~2J2~/"~ (.~/~"~ DISTANCE FROM TYPE ,,,,~ z,f~,, ~ ~ ~ DEPTH , BUILDING FOUNDATION. ~NEAREST . S~F~TIC . SE~r. PAGE LOT LINE SEWER LINE ~, TANK ~,~"~STEM ~ATER SAMPLE ~SpooL , NEAREST OTHER ~.- -~,~- SO URC ES __ DIAGRAM OF SYSTEM DISTANCES: DATE APPROVED ~ HEALTH AUTHORITY GAA B-H D-2 GREATE 327 Eagle St. ANCHORAGE AREA %ROUGH HEALTH DEPARTMENT Anchorage, Alaska 9950~j~. 279-2511 Case No. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT RESIDENCE ADDRESS LEGAL DESCRIPTION MAILIN6 ADDRESS . PHONE NO LOCATION OF INSTALLATION APPLICATION TO INSTALL: SEPTIC TANK ,~ , SEEPAGE PIT )\' ,DRAIN FIELD ,0THER TO SERVE THE FOLLOWING FACILITY .-'~Z-,~zX~ KY~'~.~-~Y'~. ¢~;'~c/~/~,4 P" ' C 0 LA '' 0 N ' ES ' a E S U Lgr~';: ~:' 'r ANT' ~' P~TE0 DATE 0F CO~PLET'ON /'~f BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ~¢~'~'/-' , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED : HEALTH AUTHORITY OR LICENSED DESIGNER 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. ~,/~t b¥c~4t'/fl2/; ~7~r¢~ ~~/ ~~ , DISTANCES: .SEPTIC TANK SIZE f/"~' TYPE £~'~ ~'~ SEEPAGE AREA '""~/~'t~ ,TYPE/~.~ :(~.~ ¢'~ -'~'~/' DIAGRAM OF SYSTEM • •- _� Municipality of Anchorage rG Y °e " On-Site Water and Wastewater Program (907) 343-7904 SA CT? CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 011-131-35 Expiration Date: 3eff 181 c:2 0 1 g 1. GENERAL INFORMATION Complete legal description ALDER PARK LOT 2 Location (site address) 4911 W 84TH AVENUE,ANCHORAGE,AK 99502 Current Property owner(s) BENJERMIN &ELIZABETH ANDREWS Day phone Mailing address 4911 W 84TH AVENUE,ANCHORAGE, AK 99502 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ❑ Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class C Well ® Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: ZCrl c '�� ;/� • - Date: / Y-16 COSA to be released to the engineer,unless 7/le/' requested by the engineer. COSA Fee $ 52-40 Waiver Fee $ Date of Payment (p-(2''(8 Date of Payment Receipt Number 0igkeole Receipt Number COSA# 812(01 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 ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 6/11/18 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function . satisfactory for current or future occupants or can ArcTerra guarantee that no unseen \ encroachments,deficiencies or discrepancies exist. OF A *ef-s * i9TH � # AL 6. DSD SIGNATURE 1-- �•� JSystem#1 Approved for 3 bedrooms. ` 1. O KENNETH M. Alf System#2 Approved for bedrooms. 5, 7rrs�,/"\ Disapproved. \ P•• s31oo`' Conditional approval for bedrooms, with the following stipulations: ON-SITE WATER AND WASTEWATER a �� PROGRAM ' Op�'�A/7-c'p\I\C�c rr By: 0, rPA atrucjfi T vn ea I and Original Certificate Date: d(,(/')2 1E ,2018` The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: • COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.10-12.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: ALDER PARK LOT 2 Parcel ID: 011.131.35 A. WELL DATA Well type PRVT-COMMUNITY If A, B, or C provide PWSID#217453 Well Log (Y/N) Y 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 NEG colonies/100 mL Nitrate 0.1 mg/L Arsenic: 54 ug/L Date of sample: 4/23/2018 Collected by: KAPELARI-well manager/owner B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 1999 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping 4/2612018 Pumper Isaacs C. ABSORPTION FIELD DATA Date installed 1999 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 System type SHALLOW TRENCH Length 51 ft. Width 5.5 ft. Gravel below pipe 3 ft. Total depth 7.5+ft. (Measured 6/1/18) Eff. absorption area 440 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/23/18 Results(Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 1 min. Final fluid depth 0 in. Absorption rate >= 450+g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access(Y/N) "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: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. -4P-. )� OF A4,47\ Engineer's Printed Name KENNETH M.DUFFUS kg'-' Date 6/11118 49Th • v COSA canary sheet 2-6-15.doc . KEN117.3r / t \ Pte•ESS (0'‘' N116,.`1111,f MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • r907-343-7904 On-Site Water and Wastewater Section \ / Fax: 343-7997 www.muni.org/onsite OSC181264 Arsenic Advisory Certificate of On-Site Systems Approval # Subdivision: Alder Park, Lot 2 A water sample revealed an arsenic concentration of 54 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O. Box 196650 *Anchorage,Alaska 99519-6650 *www.muni.org OS Aleut Analytical,LLC 3710 Woodland Dr.Suite 900 Anchorage,AK 99517 6 Phone:907-258-2155 � Fax:907-258-6634 ARS Aleut Analytical Frank and Janet Kapelari Report Date: 5/11/2018 Attn: Frank Kapelari Receipt Date: 4/23/2018 4915 W.85th Ave Sample Date: 4/23/2018 Anchorage,AK 99502 Sample Time: 1:30:00PM 907-248-1389 Collected By: JK Fax:907-243-0498 Flag Definitions: Client Sample ID: 4915W84thKitchenSink MRL:--Method Reporting Limit MCL Maximum Contaminant Limit Sampling Location: 4915W84thKitehenSink B Present also in Method Blank Client Project: Well-Safe I II Exceeds Regulatory Limit Sample Matrix: Drinking Water M Matrix Interference J- Estimated Value D--=Sample Dilution Required **— RL higher than MCL;target not detected TNC:..Too Numerous to Count-result rejected CF Confluent Growth-result rejected TCNG Turbid Culture No Growth-rejected Lab#: A1804338-01A Analysis MethodDiI Prep Analysis Parameter Result Units Flags MRL MCL FactorDate Date Analyst 9223E-PA(Aqueous)-Coliforms in DW Test was conducted by:ARS Aleut Analytical.LLC E.Coli Absent Present/Absent NA 1 4/23/2018 4.23/18 16:56 JR Total Coliform Absent Present/Absent NA. 1 4/23/2018 4/23/18 16:56 JR Lab#: A1804338-01B Analysis Method DII Prep Analysis Parameter Result Units Flags MRL MCL Factor Date Date Analyst 4500-NO3E(Aqueous)-Nitrate+Nitrite pres Test was conducted by:ARS Aleut Analvtical,LLC pH on receipt: <2 Nitrate-Nitrite as Nitrogen <MRL mg/L 0.10 1 5/1/2018 5/1/18 15:42 AAS/CS/. Lab#: A1804338-0IC Sample Comment: 200.8=Arsenic only Please preserve at sub-lab Page 3 of 4 OS Aleut Analytical,LLC 3710 Woodland Dr.Suite 900 Anchorage,AK 99517 Phone:907-258-2155 Fax:907-258-6634 ARS Aleut Analytical Frank and Janet Kapelari Report Date: 5/11/2018 Attn: Frank Kapelari Receipt Date: 4;23/2018 4915 W. 85th Ave Sample Date: 4/23/2018 Anchorage,AK 99502 Sample Time: 1:30:00PM 907-248-1389 Collected By: JK Fax:907-243-0498 Client Sample ID: 4915W84thKitchenSink Flag Definitions: MRI.—Method Reporting Limit MC,I. Maximum Contaminant Limit Sampling Location: 4915W84thKitchenSink B Present also in Method Blank Client Project: Well-Safe I 11—Exceeds Regulatory Limit Sample Matrix: Drinking Water M Matrix Interference J Estimated Value D'Sample Dilution Required **— RL higher than MCL;target not detected TNC—Too Numerous to Count-result rejected CF-Confluent Growth-result rejected TCNG Turbid Culture No Growth-rejected Lab.4: A1804338-01C Sample Comment: 200.8,.,Arsenic only Please preserve at sub-lab Analysis Method Dil Prep Analysis Parameter Result Units Flags MRL MCL Factor Date Date Analyst 200.8(Aqueous)-200.8 Well Safe 1 Test was conducted by: TestAmerica-Irvine Arsenic 54 ugil. 1.0 1 5/7/2018 5/8/18 1:37 BIH Page 4 of 4 .}i 5 (0 9 Municipality of Anchorage �* On-Site Water and Wastewater Program • (907) 343-7904 Page of Pot 1 d (40/1 / 1S ON-SITE WASTEWATER INSPECTION REPORT RecQLpI- >* 0i5-12-1- &I1 —I 31 -35- Permit Number: OSP181115 PID Number: 8523 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple(SF and/or D) Project: ❑ New ® Upgrade Name: ABSORPTION FIELD - EXISTING Benjermin & Elizabeth Andrews Address ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound 4911 W 84th Ave., Anchorage, AK 99502 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 7.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4.5 Ft. 3 Ft. ALDER PARK 2 Fill added above original grade Gravel length Township Range Section Varies 0 -0.7 Ft. 51 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5.5 Ft. -- -- Ft. Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches To Septic Absorption From Tank Field Tank Line 440 Ft2 1 -- Ft. Well 100+ 100'+ 200'+ NA 25'+ TANK ® Septic ❑S.T.E.P. 0 Holding ❑ Other Manufacturer Capacity Surface Water 100'+ 100'+ 100'+ NA Anchorage Tank 1000 Gal. Material Number of compartments Lot Line 5'+ 10'+ 5'+ NA Steel 2 NA LIFT STATION Foundation 10'+ 10'+ 5'+ NA Manufacturer Capacity Gal. Curtain Drain NA *501+ NA NA Remarks *None known. Documentation of Pump on level at Pump off level at High water alarm at exisiting system installed in 1999 w/out in. in. in. permit. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer Owner drainfield Drainfield CO/MT 3034 Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft Inspection lit 5/31/2018 2nd 6/1/2018 Location and description 31d 4th Side of Gas Meter COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engin Conditional Approval: Date j��`��' ( ` ,.S4• --1 *14 TH ` , * , T' . 1� P J G� ,�Pr'�O 7116 G4, / _. - -� / �!3-1 q \ 11 - # Adei Date E''?ol.f to*N'''' i ilit a6( y 1t eer's Stamp Inspection Report_9-1-12.doc AS-3UILT SYSTEN DETAILS/SITE PLA\ Permit ❑SP181115 ALDER PARK LOT 2 PID# 051-721-23 N89.59'00"W 130.11' (130.00' R) x x x x-x-x-x x-x-x-x-x-x--18 10' UTILITY ESMT x x APPROX. LOC. WATERLINE z04 '�all LOT 2 x CO x I Z MT O z 18.1' Y 0 O EXISTING 51'/ 15.0' I O O TRENCH 5.5'W 2 O W/ 3' ED p, COVERED o -CHICKEN x (3- 0.) o PATIO o COOP I O O MT O - 9.0' 17.7' CO EXISTING D CO 1250-GAL- S.T. C • CO WALL c DECK 11111Iilfl -P A FCO I II B PAVED -P v 36.0' 1.8' ()1 NSBM 22.6' J NJ EXISTING N 0 3-BR HOUSE b 16.0' 22.6' _ 21.7' 7 I _I I t A-C=25.0' SCALE! 1' = 30' N B-C=24.0' 3,3 Q 7.A-D=31.0' 95.86 95.3VA N B-D=30.0' 15 A-E=34.0' i i i <_z ei B-E=38.5' MJ2 FINAL GRADE _ 94.85 ORIGINAL GRADE 95.55 A-F=35.0 x - -- _ VARIES CC z B-F-3 9.0' u FILTER FABRIC A INNILATIDN �- 13, A-G=61.0' 0s' • B-G=60.5' 1SEPTICL --_:,.,_,.< 673_.$) ,35 90,35 A-H=66.0' `t TANK SEWER ROCK 3' 1.2 87.35 NO GRNB.VTR. B-H=86.5' 90.75 090.53 87.35 Al" . I SmLS BAT o (81.35) Ba a AO. likSCALE' I 51 SCALE' NTS LI Ar �� OF • 4 PREPARED FOR: CTE D /<, 'ef- BENJERMIN & ELIZABETH ANDREWS ti �R R�� ''5"- & s o ��- `� 4911 W 84TH AVE. ,..4'4Q''6 ° �����\� ' • TH �� ANCHORAGE, AK 99502 *r`� ;� '/,: ---9�7-748-1049 Alli t \cl?1:3 -11:t / KENNETH 110r r / FIELD BOOKS COMPUTED: 2 f'Ei]..11'11 X o I r CE-711 �� / BOUNDARY:N/A DRAWN: BMW 11iiiral 11 1 ////`8�"r�~* / STAKING: N/A/ CHECKED: KMD %. `�� 1/ �"i' Py`S�' I ASBUILT: SLS DATE 6/9/18 '� 'ti��... 60/ E \ FESSIO� Algr DWG. FILE: GRID: ,, AV� t SW2224 9�'tF �� �yG o� \`,`_ ACAD FILE: JOB No.: 18-157 'si!-FRSUI.TING 8.�6L9 .� FILE AK. 99577 LOT 7 Sei 4I�l N89'59'00"W 130.11' (130.00' R) \N, �.4) —x—x—x—x—x—x—x—x—x—x—x—x—x-1* 10' UTILITY ESMT x I— x \ I x E x x7 xi Z •SEPTIC p z VENT 18.1' Y O p �tYP) 15.0' I p O p coLOT 2 Z COVERED o —CHICKEN x O Q) o PATIO q COOP O I O x O 9.0' 17.7' .. ,.°- 4 i• LOT 3 LOT 1 • WALL i -i- DECK yIII�IIII CONC PAVED J 36.0' oI 1.8' ^61 N CANT [ 22.6' EXISTING N '` 0. HOUSE b 16.0' 22.6' 21.7' 93 0 20.0' o PAVED 1 CONC DEW A N --0 N89'57'00"E 130.11' (130.00' R) 0---- v —x—x—x—x—x—x.= - - WEST 84TH AVE CA U* ANCHORAGE RECORDING DISTRICT,ALASKA AS-BUILT OF: Q =5/8"REBAR ALDER PARK SUBDIVISION LOT 2 PLAT 67-140 0012V‘` x. SURVEY CERTIFICATE:I,John L.Schuller,Have conducted a i oF A��` 'y� LANDRv. physical survey of this property as shown on this drawing and that the /// ��;.••'' ` '••.:4s�' 1 �C�.�tiO Sh��f� improvements situated hereon are within the property lines and no A. ••• 1 • ' enchroachments exist other than noted.Under no circumstance should / '7:' 49TH ,\ % , $40 r o any information on this drawing be used for construction of fences, , * ' * I` �a 06. 4-1t" � ' structures,improvements,or for establishing boundary lines. , / , 1. 'r' t'' EXCLUSION NOTES:It is the owners responsibility to determine vo . , a •.J HN L. SCHULLER.• o/ • ¢ the existence of any easements,covenants,or restrictions which ,�; LS-10408 ��� • r do not appear on the recorded subdivision plat. wa e, / �-+•-•^"' • WORK ORDER NUMBER: Dire scut a-+,,,, °e ...c,,§- 1831 Talkeetna Street JUNE 15, 2018 1"=30' 1Wcy,o• �a_� Anchorage, Alaska 99508 18-028 ""BY:afoc BY:GRID NUMBOt BDDK/PADE: XVP'°fession6 L°� (907) 227-1455 office JLS SW2224 180150 \V‘•'•�� (907) 274-4992 fax 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. # ~r,~\\ _ ~ ~\ _ .%.~:D HAA # GENERAL INFORMATION Complete legal description LoT' Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone ~Z z/5- ~/0 77 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 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 Address ~-~'. ~--~,~ Da te Engineer's signature - DHHS SIGNATURE ~ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: ~' Date //- / ~'- '~'/ 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 engineeCs work. 72-025 (Rev, 1191) Back MOA#21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L~ {- 2. Parcel I.D. A. WELL DATA Well type Log present (Y/N) If A, B, or C, attach ADEC letter. Date completed ADEC water system number Driller Total depth Cased to Casing height Sanitary seal (Y/N) Date of test Static water level Welt flow FROM WELL LOG Wires properly protected (Y/N) AT INSPECTION ,,, ,~,,,-- ......... ANCHOEAGE FNVIRONMENTAL SERVICES DIVISION t~0v 0 8 1991 g.p.m. RECEIVED g.p.m. Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ; On adjacent lots Absorption field on lot Public sewer main ; On adjacent lots Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed f°~t~"lo; ~., J~#O Tank size 10~e.~ -t-~-u-o Compartments Cleanouts (Y/N) /~' Foundation cleanout (Y/N) ~'~ Depression (Y/N) High water alarm (Y/N) I~//,~- Alarm tested (Y/N) Date of pumping ~ -~/RI Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line J {~ '{- On adjacent lots I00 ~' E~-5 Foundation J J..~ Absorption field ~ ~ Water main/se~ice line '~/~ Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manhole/Access (Y/N) "pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length 7~.~.,~,_/,, Total absorption area Depression over field (Y/N) Results (pass/fail) ~ ~, % Peroxide treatment (past 12 months) (Y/N) Soil rating 1 7..0 System type Total depth ,/ Gravel thickness Cleanouts present (Y/N) Date of adequacy test for If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain 17' On adjacent lots ~?'8 ¢~ c./e~.~ Propertyline ~' / O Cutbank To existing or abandoned system on lot Water main/service line Driveway, parking/vehicle storage area i0 -.f' E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on .the 'date of this inspection. Signature '~, ~ Engineer's Name ~ ~[,,~'~ ~---~0¢~~ HAA Fee $ ,/.~.,=d'., ~_ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number 205 WEST 15YH. AUENUE SUITE 206 ANCHDRAGE~ ALASKA 99502-3904 (907) 279-3916 LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM ADEQUACY TEST L_ot 2 Alder Park 49].1 W84th, Ave. Marvin Brownell Single Family~ C1 ass A 4 Bedrooms SEPTIC SYSTEM: FROM MUNICIPAL_ RECORDS: 4 Bedroc)m System TANK: Stack Steel 10()0 + 50C) ga]. tank~ ABSORPTION SYSTEM: Crib and Trench ABSORPTION AREA: 360 + 144 = 504 Sq, Ft. SOl)m-- RATING: ].20 I NSTAI...LA'F I ON DATE: 197(} ~ 980 DATE OF LAST PUMPING: Isaacs ~i),/23 ? 9 ]. DATE OF TEST 1012919]. TEST PROCEDURE: System was inspected and measured,, 1OOO gal tank was ,~ound with 3 ~eet o~ cover and with a lmiqUid level o'F 48 inches. 500 ~a]. ~ank had 3 ~eet o~ cover and a !~.quid depth o~ 37 inches. Log crib could not be locat, ed. No trench clean out, 'Trer~ch sump was 9,5 ~t, deep with 5 inches o~ water, 500 ga!lc)ns o.F clean water was added tcJ the trench while the ~,~ater levels in the rani.:: and the sump were monitored, The water level :i.n the tank did not change., whi].e the level in the sump rose 9 :i. nches,,During the next 3C, minutes the water ].evel in the sump dropped back to 5 inches~ indic:at:Lon that the 5('.)(:) gallons ha.,::l 1 e.F t 'l::he system,, TEST RESULT: Th:i.s system meet. s the code requirements o~ the, · Health and Soci. al Services Department o-F the Municipality o~ Anchorage. NOTE The operational l:i.~e o~ all sept~.c syst. ems depends on the :l. oc:al soil c(~nditions~ groundwater leve].s that may -Fluctuate clurJ, n~; the year,~ and the water usage o~ the ~amil. y be:i. ng served by the system,, These conditions are outside the control ,::).f the e)va].uatc)r c)-f this Sel:)t.'J.c system, We can t. herefctre not gJ. ve any e:stimat~:, c:)~: how !on~ this system will ~unction satis~ac:tc) ry .For- DEPT. OF ENVIRONMENTAL ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 November 15, 1991 WALTER J. HICKEL, GOVERNOR 563-6775 Mr. Tobben Spurkland, P.E. 6751 West Dimond Blvd. Anchorage, Alaska 99502-3904 Subject: Lot 2, Alder Park Subdivision, Anchorage, Alaska, Waiver Request, ADEC Project Numbers 9221-WA-013 and 9221-DW-O24; Review Dear Mr. Spurkland: In response to your November 8 and 14, 1991 submittals which included a request for a waiver for the separation distances between a Class A Public Water System Source Well and the wastewater disposal system on Lot 2, Alder Park Subdivision and supporting documentation for the waiver. I have completed my review of the submitted information and this office's files on the project. As we have discussed, I have to agree with you that the existing wastewater disposal system was installed during a time period in which the regulations allowed septic tanks to be installed as close as 80 to a Semi-public Class A Public Water System Source Well. During that same period, soil absorption systems were allowed as closed as 120 feet to semi-public Class A Public Water System Source Wells. Based on the information submitted to this office, the existing septic tank and soil absorption system were operating as required on the day of the testing. As a result of the satisfactory test results and the fact that lesser separation distances were allowed at the time of installation (1970 and 1980), it is apparent that waivers under 18 AAC 72.032 and 18 AAC 80.030 for the existing separation distances are not required at this time. Thus, the Department has no objection to the location of the septic tank and soil absorption system. This is based on the recent test results and the regulations in place during 1970 and 1980. I must emphasize that this letter does not constitute a waiver of exiting Wastewater Disposal and Drinking Water Regulations. The existing septic tank should be tested for leaks every three years. If either the septic tank leaks, the soil absorption system fails an adequacy test or both, the complete wastewater disposal system will need to be upgraded to meet existing separation distances. In regards to the existing public water system, it appears that the Department was incorrect when the water system was classified as a Class C Public Water System on May 13, 1985. Based on the information supplied to this office, I must reclassify this water Tobben Spu~land 2 November 15, 1991 system as a Class A Public Water System as noted in your submittal. The Public Water System Identification Number assigned to this water system is 217453. With the recent documentation that you submitted on November 15, 1991 verifying that a water sample was submitted to Chemical & Geological laboratory to be analyzed for Inorganic Chemical Contaminants and the previously submitted analytical results for Total Coliform Bacteria and Nitrate (as nitrogen), this public water system is in compliance with the provisions of 18 AAC 80.200, State Drinking Water Regulations. Please inform your client that for the existing Public Water System to remain in compliance with the State Drinking Water Regulations routine sampling as outlined in the regulations (copy enclosed) will need to be completed. Thank you for your coordination with this Department. If you have any questions, please do not hesitate to contact me. Keven K. Kleweno Environmental Engineer KKK/cf cc: John Smith, DHHS 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 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) [.O~ 0-. At_.ocrzp^ra~.~:% .~t~CTuO~ I0; Tow',~.~,r~ lO_lq; Location (address or directions) (b) Applicant Name ~'"l~,aV ~)bp~'v./kl~l _l_ Telephone: Home _f~-L'[~-L(O 7'7 Business Applicant. Address q a Il ~".,/- ~ L.(+A; .AN c,~ o ~/. t-': q ~ (c) Applicant is (check one): Lending Institution [] ' Owner/builder/~; Buyer [] · Other [] (explain); (d) Lending Institution CIIZ%T ~k'~.,~TlOl~J.~' Address .q ~]TI.'(C- ~or31; (e) Real Estate Company and Agent Address Telephone Telephone (f) Mail the HAA to the following address: ~-2 L -iE..A % ¢'. (2 AL t TYPE OF RESIDENCE Single-Family~ Multi-Family._ [] Number ol Bedrooms Other 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. 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. 72-025 ( I 1,84l Page 1 of 2 5. EHGINEERING 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. '"~'OIL.~ ~ ~-A !~ ~ ~~ Date 86 DHEP APPROVAL Approved for 't~c"~" ~'2 bedrooms by Approved /~ Disapproved Terms of Conditional Approval ~'/'~ Date =z~ _/ ~. _~-(,,, Conditional CAUTION The Muncipality 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 in order 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. Page 2 of 2 MUNICIPALITY OF ANCHOt~AGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST- FEBRUARY 1984 264-4720 MAR 0 $1986 Legal Description: {_~(~__ T~ WELL DATA Well Classification Well Log Present (Y/N) Total Depth q~OO /' Cased to Static Water Level O._ ~ 0 ' Casing Height Above Ground __ Electrical Wiring in Conduit (Y/N) "'(' Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line N,/,A, Cleanout/Manhole Water Sample Collected by If A, B, C, D.E.C. Approved (Y/N) Date Completed ~(.~ ~ lot "~ O Yield ~ O O ~ Depth of Grouting ~/~ Pump Set At _O..~J O ' Sanitary Seal on Casing (Y/N) Y Depression Around Wellhead (Y/N) · On Adjoining Lots · On Adjoining Lots To Nearest Public Sewer Water Sample Test Results !%//A To Nearest Sewer Service Line on Lot O~ ~- ' ·Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) "~ Air-tight Caps (Y/N) Depression over Tank (Y/N) N Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~.~ (~ / Size ~ No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped · for Temporary Holding Tank Permit (Y/N) N//A, To Building Foundation To Property Line To Water Main/Service Line Course tO"+ To Disposal Field [. O / To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026( 11,84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed f~c_'1' ~.'")O('tgt'["~ ~ SEP [~40(Tf~ENC-..IR)Length of Field Pc[ [~ / Width of Field ¢)~'~ ( L.[ / / - Gravel Bed Thickness Square Feet of Absorption Area SO L~ Standpipes Present (Y/N) Depression over Field (Y/N) ~"-~ Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot Ix[ /A To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course Type of System Design To Driveway, Parking Area, or Vehicle Storage Area / ! To Property Line To Existing or Abandoned System on ' On Adjoining Lots .~ 0 z.f. To Cutbank (if present) N ,./,~, Comments D. LIFT STATION J~//A-% Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that 4 h, av.e checked, v.e, Kdi,e2:l, or,conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ..~/--~_//~~/¢_~)_,~__~J.//~__ ,.- --~"/ Date Co m pany ~/~YE~ T ~)(//¢&-E~'~ M O A NO. Receipt No. '5'q ~ ~ ~ ~ Date of Payment 5 Amount: $ ~ b -- Page 2 of 2 72-026 (11,84) DEPT. OF ENVIRON MENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA qg501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-?_533 MUNIcIPALITy OF DEPT ANCH© ~'t"IIAL PROTECTION RECEIVED To Whom it May Concern: According to records on file in this office the Water Regulations Water System is in compliance with the State Drinking Sincerely, ANCli0RAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 AhlCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR 274-2533 Mr-. Ted Hawley Arctic Engineers 1506 West 36th Avenue Anci]orage, Alaska 99503 May i3, 1985 D~PT OF H~A cNVIRON,V~,-~, L~H & '.~ "*'~-, ~.ec, RECEIVED SUBJECT: Class "C" Well, Alder- Park Subdivision, Lots 1-7 Anchorage 852FA-187 ' Dear. Sir.: The Department has reviewed the Engineer As-built plans for. the subject project. Final approval is hereby given for' the water, system. The Certificate to Operate is attached for. the water- system. Any future expansion of the subject project will require additional approval from this office. The separation distances fall under-the old semi-public water, system regulations. Si ncerely, SWE/dd ENCLOSURE: ' S'teve-~Hg, p. ~ Environmental neet MUNICff ' OF ,ANCHORAGE - ' DEF,. OF 2 MUNICIPALITY OF ANCHORAGE ( i i~. ~i/--[~,.r~Lj ,:~ .~~..~~ DEP~M~N, O~LTH & ENV' RONMENTAL PROTECTION ~' .... ~25'~eet- Anchorage, Alaska 99501 - ~ [ ~' ~ C R[¢ J AL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE Kenneth C. & Sheila Lomax 243-45 ~AI LIN~ ADD~ES$ 4°11 W. 84th Avenue, Anchorage, AK q95~2 P~OPE~YY ~ESIDENT (If ~ifferen~ from ~bove) PHONE S~ ~S 8~ove 2. BUYER PHONE Harvin & Daniele Brownwell none ~AILINQ ADD~ESS P.O. Box 37~2, Soldotna~ RK 9°560 3. ~DI~I~SYIYUYIO~ [ PHONE ~HE LO~AS & ~=m~=m~: ~O. 1274-VF'~1 ~AILINQ ADD~ESS 444~ Business Park Blvd., Anchorage, AK 995~3 ~. ~ALTO~/A~Z ~HONE Paul Monet, C-21, Heritage Homes 27~--!333 ~AILIN~ ADD~ESS 207 E. Northern Lights Blvd., AncBorage, AK 9~503 5. LEGAL DESCRIPTION Lot 2~ Alder Park s/d STREET LOCATION 4011 E~. 84th Avenue, Anchorage, AK 995n2 TYPE OF RESIDENCE NUMBER OF BEDROOMS ~[~ One [] Four [] SINGLE FAMILY ~ ~-'Two [] Five [] MULTIPLE FAMILY [~ ~T-Three [] Six [] Other WATER SUPPLY' I-X1 / INDIVIDUAL* [5~ COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE [~ PUBLIC UTILITY Connection Verified E~]Septic Tank or [] Holding Tank Size: /0~~'~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line [] ONE [~ THREE [] FIVE [] TWO [] FOUR . [] SlX [] OTHER PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED I (.; INSTALLER SOILS RATING MANUFACTURER MATERIAL Septic/Holding Tank ~ -- IAbsorption Area lSewer Line INearest Lot Line 5. COMMENTS DATE E~,-~ ~Z~PP R OV E D FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must~accompany certificate) [] D,S^PPROVED ¢! BY (Title) "' ~ \.dc. LEGAL DESCRIPTION 72-010 (Rev. 3/78) RE2 REID ENVIRONMENTAL ENGINEERING 5RA BOX 1584R ANCHORAGE, ALASKA 99507 (907) 344-! 205 MUNICIPALITY OF ANCHORAGE DEPT. OF il ;:L'F,i & ENVIRONMENTAL i ,; £, i LCTION JUL 3 1 !980 RECEIVED Municipality Anchorage 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR July 22, 1980 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Kenneth C./Sheila Lomax 4911 West 84th Avenue Anchorage, Alaska 99502 Subject: Lot 2 Alder Park Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: The septic tank pumped with a receipt submitted to this department. An adequacy test be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associat~ Specialist RCP/ljw cc: Lomas and Nettleton Company 4449 Business Park Boulevard 99503 Paul Monet % Century 21, Heritage Homes 207 East Northern Lights Boulevard 99503 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. MAILING AD~RES~ PROPERTY RESIDENT (If differen~ from obove) PHONE 2. BUYER ~' PHONE MAILING~ AD~RESS,, ,~ ~.~ , M~I~ING~DO~SS MAIEIN~ ~DD~SS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) , HIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1, TYPE OF RESIDENCE .~~SI NG LE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL /~ COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM )~DIVI DUAL/ON -SITE BLIC UTILITY .~sennection Verified pticTankor [] Holding Tank ~ize."w./¢~m~:~) If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Fq ONE ~ THREE [] FIVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING MANUFACTURER MATERIAL [] OTHER Septic/Holding Tank IAbsorption Area ISewer Line [ Nearest Lot Line DATE APPROVED FOR BEDROOMS coNDITIONAL APPROVAL (letter must accompany certificate) DISAPPROVED I BY (Title) ,,~ . I /- ~""~'/t"~ I--,' ('~¢" LEGAL.~SCRIPTION 72-010 (Rev. 3/78) ~--%~,. '~NICIPALITY OF ANCHORAGE ,,!"~~,',~ .~ ' DEPARTMEN, ,~," HEALTH AND ENVIRONMENT~,- ,'ROTECTION [,~%~2t/ - ' 825 L Street, Anchoraa~.. Alaska 99501 '~- ~'~"~-~'"" ~ '7:~ )., 'x L t-- 264-4720 '~~ , ~w~ ~:~ ~-' .,,~ .... ''~( ~q'~' ~a 0~' ~ ~¥~q~ April 11, 1978 #1: Time ,~;.~,3z,/ #2: Time __~.~', 1;~.[. ,C~- #3: REQUES FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: National Bank of Alaska % Sherrie Stephens Mailing Address: Pouch 7-025 99510 Phone: 276-113~ 2. Property Owner: Douglas R/Cherie L. Anderson Phone: 243-4739 Mailing Address: 4911 West 84th Avenue 99502 3. Legal Description: Lot 2 Alder Park Subdivision 4911 West 84th Avenue 4: Single Family Residence: Number of Bedrooms: Four Multiple Family Residence: ( ) Number of Bedrooms: Well System: Permit # Individual well ( ) Community/Public System k~ Depth of Well Well Log on File ( ) Construction Bacterial Analysis e Sewage Disposal System: Permit # Septic Tank Size Absorption Area On-site System I©00 Public Utility ( ) Installer Manufacturer _~ 5~L Soils Rate Material Distances: Well to Septic Tank ~.~.¥11,~- W~ Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Page Two - Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 2 Alder Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date: Disapproved: Date: Department W©rksheet: ~ .,dNICIPALITY OF ANCHORAGE .~Q~ i Dep~rtment of Health and Environmental Protection ~f" · ~ 825 L Street, Anchorage, Alaska 99501 ~ 264-4720 '~'~'~-~'~uest for Approval of Individual Sewer and Water Facilities Property Owner: Mailing Address: Douglas R. Anderson & Cherie L. Anderson 4911 West 84th, Anchorage, Ak. 99502 Phone: 243-4739 Name of Buyer: Mailing Address: Kenneth C. Loma× and Sheila K. Lomax 4632 East 3rd, Anchorage, Alaska Phone: 333~1973 Lending i~,shitution: National Bank of Alaska Mailing Address: Pouch 7025, Anchorage, Ak. 99510 Phone: 276-I ] 32 Realtor/Agent: Mailing Address: NA NA Phone: NA Legal Description: Street Location: Lot 2~ Alder Park $/D 4911 West 84th, Anchorage, Alaska 99502 Single Family Residence: (X) Number of Bedrooms: 4 Multiple Family Residence: ( ) Number of Bedrooms: o Water Supply: *Individual Well ( ) If Individual Well, well depth If Community System, name of system Public/Community System (X) tlnknown 8. Sewage Disposal System: *~Dn-site System (X) Public System ( ) If On-site System, date of installation: Unknown *NOTE: 3/77 A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy .test is required by this department· ~4UNICIPA~ITY O~ ANCHORA~5 A fee of $25.00 must accompany each relatiVe,TEXTCo%Ceasing can be initiated. 1978 RECEIVED April 24, Do~9~las Anderson 4911 ~{.~.st 84th Avenue Anchorag~, Alaska 99%02 Lot 2 Alder Park Subdivision ~efor~ this de~)artment mm}. apurove your r~quest for and water facilitie:~, a percolation test must be perfo~ed. See handout, ~ragra}i~h ~. If ~he percol~%~ion t~st fails to pass the adequacy test, ~n u!~rad~ of the system will b~ naef~ed. A permafit must be Issue(i before any consaruc%ion can he,fin. office at 2~4-4720. Sincer(~t¥, If there are ~u~y £urther questions, f)lea[~e con%act this Robert C. Pratt, Sanitarian RCP/ljh ~[ationaI Dank of Alaska Pouch 7-025 99510 May 18, 197~q Legal : Lot 2, Alder Park Address: 4911 ~est 84th We are aware that the above residence which we are purchasin~':~ ~s ~ a~equate s~ic s'~stem for a three bedroom unit, i~e are willing to accept it as a three bedroom and are aware it is not a~proved for a four bedroom residence. September 17, 1974 £1mer ¥. dohnson 4915 aest 84th Avenue Anchorage, Alaska 99502 SUBJECT: Semi-public well serving Lots 2-5 of Alder Park Subdivision Dear Xr. Johnson: The well located on your property is presently in a pit. According to State Law, pit wells are not approved. This meaas the well will have to be upgraded. The well casing must be brought above ground level 12'° and the pit must be filled with impervious soil sloping awaw frem the well. The upgrade must be completed 30 days from receipt of this letter or legal action may follow. If you have any questions, please feel free to contact me at 274-4561. Si ncerely, Robert C. Pratt, Environmental Control Officer III RCP/ko Certified ;(o. 740367