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Home My WebLink AboutAMANDA PLACE LT 4Amanda Plac Lo1- 4 #015-501-34 Municipality of Anchorage Development Services Department ~_','~ ~'~',o Building Safety Division ;'~ On-Site Water & Wastewater Program, 4700 Bragaw St. · i~ ~l:~l~'~ P.O. Box 196650 Anchorage, AK 99519-6650 ~ www.ci.anchorage.ak.us (907) 343-7904 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Perm;t Number:. SW090180 PID Number:. 015-501-34 N°me:CONNIE SCHLEE Wastewater System: [:] New I Upgrade 10600 BIRCH RD * ANCHORAGE, AK, 99516 ABSORPTION FIELD Phone: No. Of Bedrooms: (907) 505-670-8156 3 lDeep Trench r'lShclllol Trench Deed OMound mother 0.45 ~,o/s~. ~L SEE DWG. - 4 AMANDA PLACE: SEE DWG. r~ 7.10+ - - - SEE DWG. rL 2 © 40' (80' TOTAL) WELL: [3 New r'3 Upgrode 2.5 rL 2I 14+ rL r~ WILCO CONTRACTORS 4-26/2009 SEPARATION DISTANCES ,s.,~ a,o,~.~ a~.T.[.P. T~nk Field Stotion TQnk S.., L~. GREER 1000 Wer~ 100'+ 100'+ - - 25'+ STEEL 2 ;urface Water 100'+ 100'+ -- - -- LIFT STATION ~or~s: BENCH MARK OLD TANK WAS FILLED WITH GRAVEL AND TOP OF GROUND LEVEL SLAB IN FRONT OF ABANDONED IN PLACE. BASEMENT SLIDING DOOR. 3rd 9/26/2009 "~ Development Services Department Approval ,.~//~ i'i' ...... R~viewed and approved by AS BUILT DRAWING SW090180 - 015-501 FCO 30.9 43.65 ~.11 P~CEL ID ~: 015-~1-34 C01 20.69 45.80 54.02 OBL1 15.03 44.25 64.11 ~ DB~ 14.65 44.23 65.36 ~ FD 14.77 44.50 66.51 ~ ~ C02 16.28 46.02 66.12 ~ C03 13.70 43.60 66.96 ~ / ~ 49.46 62.56 -- ~ / C~ 56.22 71.38 -- ~ / ~5 63.08 58.96 - / I ~6 75.06 85.17 - / C07 85.09 81.29 - / I ~ 85.67 82.70 - I I I I r INCORR[~ ON DESIGN ~ ......... I ~c~ [ SHOWN CORRE~Y. : ~ ,.',.; .. :. .... - .'-:;; '7~'- '. T.': -:~ ~'-*"~':'.: ;.y.'""::~-: ~ ~~.'"' :. ..'" "':~. ~.' ';' "'....,~. .... ,.': ' '1' 3 BEDR~M r '. ' ...... ' ', / / C~4 ~~ ~ "*"* '7'. ;- ~', ~ / L.~ 1~ ~ON ~OLD T~K W~ ~ ~ BED TO BE ~ED ~ S ~ RESE~ S~ X : GAIJNESS SEPTIC SYSTEM ASBUILT ORAWmO PERMffNUMBER: AS BUILT DRA~/~NG PARCEL ID NUMBER: SW090180 - 015-501 -:54 FINN. GR~D£ - 101.92 ~'1 / ST2 TOP OF TANK --~ ~- TOP OF' TANK AT INLET - 97.$7 ~~ AT OUTI.ET - 97,$7 1000 GALLON iNVERT Or eUNO SEPTIC TANK ~-INVERT OF' BUNG AT INLET - 97.09 AT OUTI. ET - 96.81 I,owE. ,,E.c. ~R.~I I v""ER '"c"o" <~""ERN)I 'O.IC, F1N~L~ ORADT: ;4~7~41+-'~ ~l~i~ /-ORIGINAL CRADE: - 95.B7 ,.,, FI. G. .gf ,,,, .--- 1111 r/-,NBU ,Ti°. ________ ' ' r f iNSULATION ~J~ ~F'ILT[R FABRIC , .... ilium i ~BC"ROU OF 1REN(H . 87,02 RELATIV~ ELEVATION OF BOTTOM - ~RL'~TN~ ELEVATION OF' BOTTOM OF' TESTHOL[ _. · , .~ Sm,PREPAREDF.. ~,~ .o*o. ~,~ to~ · ~c~,4~., w~ le~o~ · ~,.~,~ (~-~ · ~*x (to/~t34-3~# · ~*~]~,Tr.: ~..~FOR: ""*" "! ..... '~'~:) N S~'ILTA NTS I PHONE & GENERALNuMBER:CONTRACTORSi ........ PAGE NUMBER: ~, Ii: :; :~.',~[1: ~ ' ": .... I I CONNIE SCHLEE 505-670-8156 :5 OF :5 ~v0/~...:., ~C~:_7.~,....~....<~.~./ LEGAL DESCRIPTION: DRAWN BY: AMANDA PLACE LOT 4 PNB PROFILE ASBUILT DRAWING 9/:50/09 MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (gO7) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 16, 2009 Expiration Date: Sep 16, 2010 Permit Number: SW090180 Legal Description: AMANDA PLACE LT 4 Design Engineer: 0855 GARNESS ENGINEERING GROUF Owner Name: CONNIE SCHLEE Owner Address: 10600 BIRCH RD ANCHORAGE, A 99567- Parcel ID: 015-501-34 Site Address: 10600 BIRCH RD Lot Size: 47842 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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: 1. 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. Received By;.-~-~,. ' ~ ~~--~:~' Date: Municipality of Anchorage Development Services Department Building Safety Division On-Sile Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.a nchorage.a k.us (907) 343-7904 ON-SITE SEWER/WELL PERHIT ~,PPLICATION FOR ~, SINGLE FAMILY DWELLING Property owner(s) CONNIE SCHLEE Day phone 505-670-815§ Mailing address 10600 BIRCH ROAD *ANCHORA~[, AK Site address Zip Code Legal description (Sub'd, Block & Lot ) AMANDA PLACE LOT 4 Legal description (Township, Section & Range) Lot Size ~ ~.. ~'1 ~- Sq. Ft. H/^ Humber of Bedrooms THIS APPLICATION IS FOR ( [] all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy ~ Private Well Water Storage [] THIS APPLICATION IS AN: Initial ~ Upgrade ,~ Renewal 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. GARNESS ENGINEERING GROUPf Ltd. Waiver Fees: Date of Payment: Receipt Number:. GARNESS ENGINEERING GROUP, Ltd. ,. ::-:~ ~ .~- :CONSULTANTS&GENERALCONTRACTORS.~:~....~?~=..~._-~:~_~ September 3, 2009 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 9951%6650 (907) 343-7904 Ref: Proposed Septic Upgrade for Amanda Place; Lot 4, To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be upgraded. We are proposing to install a 1000 gallon septic tank and a deep trench type drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: I. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPIIY: As can be seen on the attached design drawing the average topography below the drain field is approximately 10-15%. If you have any questions, please contact us at 337-6179. Sinceri~/~~ l , esS,Pre ii t We are unaware ofany adverse impacts this installation would have on adjacent wells or septic systems. Thank you for your assistance. NOTE: Attached is a site plan drawing, a design drawing, one soil log. which are all part of the design package for tfiis scptic system. (Contact G.E.(7. Ltd. for 7page construction specification letter.) 3701 E. Tudor Road, Suite I01 * Anchorage, AK 9950%1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com x I P~RC~. ,o !: ~T~. \\ BIRCH NOra ~A~S. LOT 3 / / xq , / / ~ I / / ~ // / BIRCH NO~ E~A~S. I _ I ~oz 4 SPRING FOR~. LOT 1. BL~K 2 I SE~D ~ PUBUC ~ WATER ~D A PR~A~ T~=.. caw. sz~o. ~C ~x~ I I HO~ ~ / % ~RO~SED S[~C ~u 2 / ....... ' ' LOT 1. BL~K 1 ,/ ~~ ' I S E~D, PUB~ I '" ...... '~" ~ . I LO~ '2 ~ , O, ~ ~ --// '. .~ t-:~:;~ ~ - -~ .... ~1/' ~- ~/ ~~ ' ~1 -~---~ ./~ ~ ~ r '. LOT 2. 8L~K ~ ~ I I ~ / S~E' / ~ r~, X ~ I / ~ · , , ~OT~ ', ~*"~. ', I ', ~ / / ~, I I I~ CONNI SCHLEE 505-670-8156 10~ ~ ,~ ~.U~/~G~n*~/ ~'j wo. : SITE P~N 8/20/2009 NUMBER Or O~ROCUS: ,1 IP~CEC mo !: 0,5-50,-~41 GALLONS PER DAY (GPD): 450 PERCOLATION RATF.~S: ~0 PROPOSED APPUCATION RATE: 0.45 MINIMUM DRAINFIELD SQ.FT.: 1000 NOTE: THE CONTRACTOR RAI F I ' \ SHALL HAVE THE WEST LOT -- ~uc<IuuM DEPI~: 10' ~ UNE, AND ALL WELL RADII FLAGGED BY A REGISTERED ~rN~TH: 2e38'-76' \ LAND SURVEYOR PRIOR TO M.OJL APPROVED SAND FILTER: N/A ~ CONSTRUCTION. EFTECTTV[: 7' REDUCTION F~CTOR: N/A ACTUN. SQ.FT.: 1064 \ / / GEG, Ltd. HA~ A 7 pAGF SPECIFICATION ~ / LETTER THAT pERTAINS TO ~-IIS DESIGN. ~ TO OBTAIN A COPY OF THE LETTER ~ / CONTACT OEG. BY PROCEEDING FORWARD ~.,~/ PROPERTY OWNER AGREE THAT THEY N;REE TO ACCEPT THE TERMS NeD / CONDmON$ OUTLINED. '~,j,~ ~ sP~rrr~R ~ ~ :.'-~....,..-, ::.. \ .... ~ · ...:..*, ~ EX~-'T]NG BED TO BE USED AS A RESERVED SITE S GAI1NESS ENGINEEIIING GI1OUP, Ltd PR[PARED FOR: IRHONE NUMBER' I PAGE NUMBER' I[.~'.-- f/.~'x/. ........ L ......... .!~ CONNIE SCHLEE I 505-67~)-8156 2 OF 5' [ ~-~?o ;..dj [~;y~.9_q~[ess.: DESIGN GARNES$ ENGINEERING GROUP, Ltd. ................... CONSULTAN?$ & GENERAL CONTRACTORS ...... ,,o,~.~,o,.~,.~,,,~,~,,,.,~,,~,.~~4 ~,...~ ................ ISOIL LOG - PERCO~TION TESTI <,~.~o~,cs i TEST HOLE ~1 UPPER BENCHI ~INII~II ~ GP ~ HL ~ II ~ II u II ~ -H ~ - '~ ~g 7 DEPTH TO x IIHIIIlU ~"'~ ~/~ ~;f ~ ~:'~.. .... 94~111111 , ~.~..,~..U ~ ~ :~.~ ..... IIHIIIIII ' ~ I I ,o4HIIIIII ~ ~ ~ ~ ~ ~'~'~ IINIIIIII c~ TO UL , JJgJJJJJJ DATE READING CLOCK NET TIME WATER LEVELI NET DROP '~IHIIIIII ~-,-o~ , ~=~ - , , - I1~111111 ~ ~ ~o '~dl~llllll ~ ~=~ ' - ~ - II DIIII II ~ ~:5~ ao '11~111111 ~ ~ - .' - ~sJ~llllll , 6 4:~s ~o ' , 19~ J PERCOLATION RATE 7.5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) I I TEST RUN BETWEEN 2 FT, ~D ~ FT, SOILS LOGGED BY: ROB ~MPBELL PERCOLATION TEST PERFORMED BY: PIERCE BL~ COMMENTS: PERFORMED BY GLO, Ltd. I, JEFFR~ A. GARNESS, CERTI~ T~T THIS WAS P~RFpRMED IN ACCORDANCE WITH ALL STATE AND MUNICIP~ GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO GROUNDWATER DATE DRY 9-1-09 O.F LEGAL DESCRIPTION: AMANDA P~CE LOT 4 ~ ~Jef~ iA. Go'ess¥ DEPTH ~ , (f~e~OROANiCS jTEST HOLE ~1 LOWER BENCH' SOIL C~SSIFICATIONS ~/' GM CL ~ ~ ~ro~ou GC OL .om~ % . SW ~ MH ~ .... SP 'CH SM OH GROUNDWATE~ DATE DRY 9-1-09 / ~ .,~ .o ~/1~111111 DATE READING CLOCK NET TINE WATER LEVEL NET DROP TINE (HINUTES) READING (INCHES) 12 9-1-09 1 2:57 - 6- _ 2 5:27 50 5" 1 15 3 5:27 - 6- _ 4 5:57 50 5' 1 ' 14 5 3:57 - 6- _ 6 4:27 50 5' 1 ' 15 16 17 18 19 . PERCOLATION RATE 50 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5.5 FT. AND 6.5 -FT. 20 ~ A FO~ HOUR PRESO~ WAS PERFORHED: ~ YES ~ NO. SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORHED BY: PIERCE COHHENTS: WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ,~~ MUNICIPALITY OF ANCHORAGE ~ S ' 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 IP"ONE MAILING ADD~ESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS ] l Absorption area~ Dwellin~~~ PERMIT NO, ~ Z Manufacturer Ma~er~ No, of compartments Li~._ capacity~in gallons IF HOMEMADE: Inside length Width Liquid depth ~ ~ ~ DISTANCE TO: Well __ Dwelling PERMIT NO. ~ -- ~ Manufacturer Material Liquid capacity in gallons ~ ~el,~ ~ fiounr ~earest lot line ~ ~ DISTANCE TO: ~ No. oflines Length of each line ~ Total lengthoflCnes Trenchwidth~ Distance between lines ~ ~ ~ Top of t~le t~h grade. Material beneath tile Total effectiveabsorption area Length ~ Width * Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) ~ L id r INSTALLER -- REMA~S r 72-013 (Rev, 3/78) PERMIT NO. [:'EF'FIF::'.TMEI'iT OFHEFILTH F-IN[:' ENVIRONMEI']TF"IL PF.'OTECTIOI",I 825 "'1_"' STF'.EET.: FINC:HOF:FtGE., FIK. 99:SEk:L 264-4728 E L. [ .... t~ f-.I rz:, c, ~"-.! ..... :=_'; I 'T E_' E; E I.,4 i F: F' E ~: fi ][ 'T' 810652: ) FIPPL t CRt',IT LOCRT 10I'4 L. EGRL TOM STEI,4FIRT OMFIL. LE¥ & BIRCH RD. LOT 4 FIMFI14DR PLLFICE SUB 8420 WILLOWR CIR LOT SIZE ~]:--8684 66000 SQLIRRE FEET TYPE OF SOIL. RBSORPTION S'¢STEM IS: TRENCH ,"" II SOIL RRTING ,'=,6. FT,.."E:F.'.)= HH,:.:,IM..M NUME:ER OF E:EDROOMS = ~ ?-~-~,,¢ t THE REI]:!UIRED SIZE OF THE SOIL. RBSORF'TION S'-r'STEM IS: [:, E F' T H = ."_=: L E I'-~ ~7.~ T H == ~ t3 E: R THE LENG]'H DIMENSION IS THE LENGTH (IN FEET::' OF THE 'TRENCH OR DRRINFIELD. 'THE DEPTH OF t'4 TRENCH OR PIT IS THE DISTRNCE E:ETI.4EEN THE SURFFICE OF THE GROUND RND ]'HE BOTTOM OF THE EXCFIVRTION ,:i IN FEET). ]'HERE IS NO SET I.,.IIDTH FOR TRENCHES. 'THE GRR',,,'EL DEPTH IS THE MINIMUM DEPTH OF GRFIVEL BETWEEN THE OUTFFILL PIPE FIND THE BOTTOM OF 'THE EXCR',,,'RTION (IN FEET). E;: E ¢..-., ! ~ ][ E: E [:, ,__. E F' 'T' ][ C: 'T R !'-,! I-::: '=' I ~ E = ~4~!'f~-Z-~ ~_=~ l] F-~ L. L. C, I'-,! ,__. PERMIT RPPLICRNT HFIS THE RESPONSIBILIT9 TO INFORM THIS DEPRR]'MENT DURING THE INSTRLLF4TION INSF'ECTIONS OF F~N9 WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT 'THE HELL WILL SEF. WE. ............ TII..-IIC~ ( 2 ::, .~ I"-]_f. SF'EC:T' I C~!"-.1'-2; RF-.:E F,.:E~:':!LJ I BRC:KFILLING OF'-' FIN¥ S'¢STEM WITHOUT FINRL INSPECTION FIN[:.:, RPPRO',,,'FIL BY THIS DEPFtRTMENT WILL BE SUBJECT 'rE: PROSECUTION. MINIMUM DISTRNCE BETWEEN FI WELL RND ANY ON-SITE SEWAGE DISPOSFIL S'¢STEM IS ::1.00 FEET FOR FI PR IVFITE FIEL. L OR :1.50 TO 200 FEET FROM FI PLIBLIC 1,4EL. L DEF'EN[:,ING UPON ]"HE T'~'PE OF PUBLIC WELL. MII.~IMUM DIS]'RNCE FROM R PRIVR]'E 1.4ELL TO FI PRI',,,'FI"f'E SEklER LINE IS 25 FEET RND TCI FI COMMUt.,IIT'¢ SEWER LINE IS ?5 FEET, 14EI.~I.. LOGS FIRE REG~UtRED RND MUST BE F.:ETURNED ]'0 THE DEPFIRTMENT 1,4ITHIN 2:0 DR'CS OF THE WELL COMPLETION. OTHER REQUIREMENTS MR'¢ RPPL'T'. SPECIFICFITIONS FIN[:, CONSTRUCTION DIFIGRFIMS FIRE FI',,,'FIIL. FIBLE 'TO INSURE PROPER INSTFILLFtTI014. I CER]'IF¥ THF4T ±: I FIM FFIMILIFIR WITH ]'HE RE~]~UIREMENTS FOR ON-SITE SEFIERS FIND WELLS FIS SE]' FORTH BY THE MUNICIPRLIT'¢ OF FINCHORRGE. ':2.: I WILL INSTFILL THE S'¢STEM IN RCCOR[:,RNCE WITH THE CODES. 3: I LINDERSTFIN[:, THRT THE ON-SITE SEI4ER SYSTEM MR'¢ REG!UIRE ENLHRJEMENT IF' 'f'HE RESIDENCE IS REMODELED 'TO INCLUDE MORE 'I'HRN ]: BEDROOMS. TO{f 8-1~ 14fLLOI, IR C[R LOt' ~ [~ Contrac,...g Engineers & Associates 212 East International Airport Rd, Suite 204 ANCHORAGE, ALASKA 99502 (907) 278-3773 SOILS LOG- PERCOLATION TEST ~_J SOl LS LOG PERCOLATION TEST DATE PERFORMED: '--~""--/~ -~:~ ! LEGAL DESCRIPTION: 1 2 3 4 5 6 7 .8 9 SLOPE SITE PLAN 10 11 12 ,13 14 15 16 17 18 19 2O OF ,~ I~, Jokela ,'~ NO. WAS GROUND WATER ENCOUNTER ED? IF YES, AT WHAT DEPTH7 . Reading Date Gross Net Depth to Net 'Fime Time Water Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT AND ~ FT COMMENTS PERMIT NO. [:,EF'FIRTHENT OF HE:FILTH FIND EN',,,'IRONMENTF~L PROTECTION 825 "'L'" S'FF.:EET., FtNCHOF..'FtGE., FtK. 264-4?20 ,:: 8]:~_.-~692 ::, FIF'PLICFINT ]". STEWFtRT C:01,',I'=-]TRUCTION 2735 E. TLI[:,OR R[:,. LOCFtT 101'4 [..EGRL. LOT 4 FIt'"IFINDFI PLFICE S,,'[:, LOT L:;IZE 562 -.'2:279 478,4-;2 SL.':!LIFIRE FEET MINIMUM DtSTRNCE BETWEE1,',I A I.,.IELL Rt",l[.', RNY ON-SITE SEWRGE DtSPOSFIL $"r'STEM 1'5 ::L~-Z'~O FEET FOR Ft PRI',,,'FITE WELL OR '158 TO 20¢'~ FEET FROM FI PUBLIC WELL [}EF'EI",IDING UPON THE T"r'PE OF' PUBLIC WELL. MINIMUH [:'ISTFII",tCE FROH FI PRIVFtTE WELL TO FI PRI","FITE ::]EWER LII",tE I':'; 25 FEET FI1,',t[) TO FI COHMUNIT"¢ '-:,EWER LINE I2; 75 FEET. WELL LOGS FIRE RE6!UIRE[:, FIN[:' MLIST BE RETURNED TO THE [:'EF'FIRTHENT WITHIN 2:8 DFI"r'L:; OF' THE WELL COMPLETION. OTHER RE6!UiREI"IE1,',IT'.'5 HFI"r' FIPPL"r'. SPECIFICFI'TIONS RND CONSTRUCTION [:'IFIGRFIMS FIRE FI',,,'FIILFIBLE TO IN2]URE PROPER IN'.STFILLFITION. I CERTIFY THFIT :[.: i FIN FFIHILIRR WITH 'THE REQUIREMENTS FOR ON-Lc,ITE SEWERS RND WELL'_c, FIS SE]' FORTH 8'¢ THE MUNICIPFILIT'¢ OF FINCHORFIGE. 2: I WILL iN'_:;TFiLL THE 'E,'¢STEM IN FICCOR[:,FINCE WITH THE CO[:,ES. FIF'F'LICRNT T. '_-]TEWFIF,:T C;ONL-]TRLICTION V4. 0 I'l~ well is producing¢i, ,i~'gf~lons INVOICE MOON DRILLING ' SR BOX 668, BOGARD RD, TELEPHONE 745-4071 //V Lot J'~ BIk ....... SubA~-/4J/VDA WELL LOG j I il CA$1N FORMATION CASIN FORMATION __ leer. INVOICE NO. YOUR P. ~. CASIN FORMATION PLEASE.PAY FROM. THIS INVOICE per foot ,Anch~r~e, ,~)( 99519-6650 Pump Installation Log 5~/eI1 Drilling Permit D~te of Issue: parcel Identification Number:__ Pump Size //~ hp pifless .~dapter Bm-ia/Deptk: ! ~ feet Pittess Adapter IVLo~uf~ctarer: a Yame: pitless _,&dapt~r Installer: The pump irmtaLlcr sha[t provide a pump hna~il,~tion l~g'to thc DS]D ,mtkin 30 days of pump instail~ion~. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPRO'~AL OF ON-SITE SEWER AND WATER FACILI-rY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, tp~nst~p, range) Location (address or directions) · (b) Applicant Name ~¢2.: Telephone: Home Applicant Address _~{~- ._ //~ __ ~u~ ~.~/~ ..... (c) Applicant i~- (check one): Lending Institution D' Owner/builder D' Buyer (d) Lending Institution Telephone (e) (t) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family--[~/" Multi-Family [] Number of Bedrooms '~"' Other WATER SUPPLY Individual Well I~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of E~v~ronmentai Conservation attesting to the legality and status. Page 1 of 2 SEWAGE DISPOSAL Onsite [~Public [] Community [] Holding Tank I-I Note: If community well system, must have written confirmation from the State Department of E~vironmental Conservation attesting to the legality and status, 72.,r~,~$ ~; ~, ,~ 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 thai rn¥ Authority Approval shows that the on-site water supply and/or wastewater disposal system ~s safe, for the number of bedrooms and type of structure indicated herein. I further verify that based from the Municipality of Anchorage files and from my investigation and inspect~on, the on-s~e wastewater disposal system is in compliance with all Municipal and State codes, ordinances, the date of this inspection. N me of Telephone o Approved ___~. ~ ..... Disapprove~J~ _ C~:~d~tional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) iss~,es t-le~ Approval certificates based solely upon the representations given in paragraph 5 above by an indepeede~t engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes acr¢ll the~ institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not condo1 analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors e~r professional engineer's work. Page 2 of 2 72-02,5 (11/84) OF ANCHr, RA_,' PROTECTION RECEIVED A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: z';/- y Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Well Classification /,*'/z~//l~///''''~/' If A, B, O, D.E.C. Approved (Y/N) Well Log Present (Y/N) /'~'--4 "~Date Completed Total Depth /J~..('/ ~ Cased to //-~'/ / ~ Static Water Level ~,~x~,,-~,~,,~ ~-"~' //? / To Septic/HOlding Tank on Lot ,.5, /~ o To'Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /V/'4/' Cleanout/Man hole Depth of Grouting /'~ Pump Set At ¢,~,c/~-,~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Water Sample Collected by Water Sample Test Results Comments ,,~ ~' / o o ~ ,-'"', On Adjoining Lots · On Adjoining Lots To Nearest Public Sewer ~ ,,-7'~- ,.~ ~/¢ /,/',~ To Nearest Sewer Service Line on Lot ~'/~/',~ ,/~,~.-'/,f .~'7- 'Date _-,¢~./'Z-_~ J''''~--'''~ ,? SEPTIC/HOLDING TANK DATA Date Installed ~,/~'~/~'/~'~Size ,/~"-~'~ ~ ~'; ''~ . No. of Compartments Standpipes (Y/N) /~'~'-'~ Air-tight/Caps (Y/N) /-~.~ Foundation Cleanqut_..~,,/_..--(Y/N) Depression over Tank (Y/N) /~'~ Date Last Pumped ~~'-~/ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~> · o ~ ,' To~ Property Line ."~ ¢Q ~' / Temporary Holding Tank Permit (Y/N) To Building Foundation To_Disposal Field Z- o ~' ~td~f To Stream, Pond, Lake, or Major Drainage ~ Comme~-~ Page 1 Of. 2~ 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ,//,~'~ Date Installed '~/'Z- ~Z~/~/ ~ Width of Field ~-~ / ~ Square Feet of Absorption Area Depression over Field (Y/N) Type of System Design Length of Field --~'- ' Depth of Field . ..~?'¢ ~ Gravel Bed Thickness /¢- '/ Standpipes Present (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test =T..zz_.~/..¢/4~ (.¢~,/.¢, ~ /, Separation Distance from Absorption Field: / To Water-Supply Well .,~ / o o'~ f To Property Line To Building Foundation ~"_...,2 / -.~ To Existing or Abandoned System on Lot "~)/ ~ ~-/b ,/.~ ;On~djoining Lots ~ ,f' To Water Main/Service Line '-~/-"// e¢- .<'/ o -- To Cutbank (if present) ,~' To Stream/Pond/Lake/or Major Drainage Course ,,'I/' To Driveway, Parki.ng Area, or Vehicle Storage Area ~ ~,7'-/¢¢~-- ,.%, ~,/~. ~¢~' Comments -'~ ~¢.,_¢_,,..,~ /.//~., ,,¢ D. LIFT STATION /~~ 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 I have c.~e~.ked, vp,~fied, or Signed ..._...~. /r Company Receipt No. Date of Payment Amount: $ L ,Ca conformed to all MOA an/d HA/,& guidelines in Date MOA No. Page 2 of 2 72-026 (11/84) effect on the date of this inspection. 4_-... ; 'g iSATE RECEIVED INSPECTION APPOI NTM ENTS T~.ME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR ~, ,M,~,,o^, ,~,, ,~,~ , ,, ,%: :~,2 ' ~' DEPT. OF HFALT~I & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street-Anchorage, Alaska 99501 ~,~ ..~ ~UV ENVl RONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED 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 c~cp~-~ d~c?~ ~~.~ ~F-t~° MAILING ADDRESS ,PROPERTY RESIDENTial(If different~from above) ( ~"S = ~ ~ ~rZ/~ ) PHONE 2. BUYER ~ PHON'~ MAILING ADDRESS 3. LENDING INSTITUTION PHONE [~AI LING ADDRESS 4. REALTOR/AGENT I PHONE ~ MAILING ADDRESS ~7"~- C-d ~ ~ ~ ~ 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [~ One [] Four [] Two [] Five E~ Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] 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.) YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) APPLIC..NT FILLS OUT UPPER HAL. ONLY ~ FSpe, ~'Ow~,er 7" ~.~j-,C: ~.~ ~..~ C'~ '~ ~ ~w'.~.'~ .... /.'~C, Phone Buyer .-~r .~(;.~` ~ .~ Address Zip Code Lending Institution ~; ) .)' /¢.4 ~',;*.-.-/ ¢_.¢.~/( m'¢ ~'~( ~¢¢M ~ ~ Phone Realty Co. & Acnt /'~?),x,~ .~/~ '~ (' ,;. ~. cr'~ ~ o//(¢Z / Phone Legal Description Street Looati~ Type of Resi~nce } Single Family Multiple Family No, of Bedroo~ ...... ~ Other Water SupplyIndividual ~ Community . ::" ~)[z~. O E A~AGH WELL LOG. a w~l log is required for all wells drilled since June 1975. t;' ~ For~ells drilled prior to that date, give well depth (attach log if available). ~ Public Utility '% Sewer Disposal Individual ~ Year Individual Installed: , Public Utility ~ When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EAC~ RE. EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ~,'t,,~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH JUt_ 2 5 RECEIVED ( "~ APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( )DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE ~' "'_{ ~"" ~ 5 BY: ~/~//~ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72.023 (3182) July 29, 1983 T. Stawart Construction, Inc. 2735 E. Tudor Road Anchorag~, A;i 99 507 Subject: Lot 4, Amanda Subdivision Approval for the individual ~ew'er and water facilities cannot be granted ~ntll the following items have been completed: ~'~ You will need to locate the neighboring sewer system to the ~~orth so that ~easurement can be made between it and your well. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, RP30/ej/E2 Robert C. Pratt Associate gnvJ~ronmental Specialist tM 'oau~ t~6'099 M,,9t~,~O oOON