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Home My WebLink AboutILIAMNA ACRES TR 4B MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAL. TH & ENVIRONMENTAl. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/QR WELL INSPECTION REPORT . ~d'GEW [~UPGRADE LEGAL DESCRIPTION LOCATION ~'~/ Absorption area NO. OF BEDROOMS DISTANCE TO:Well -- I ,' Manufacturer ~ .~ [Liq. capa~it× in gallons I --- ,. f¢'~ ¢/(~ I IF HOMEMADE: IM~nufaeturer /-~ ~/'/9 --~--- I~ I WeU ~z /DISTANCE TO: I / No, of lines J Lenmh of each line Length Width / ~;f crib Crib diame~¢~ ~ /'~/¢~ DISTANCE TO Building foundation DwelJing ~j~// f Inside length JW dt~ Dwelling Foundation ~,~ , Total I on g~..9 f~i n.~s Material beneath tile Depth Crib depth Building foundation Driller Sewer line JNearest JOt lin.~-.'~) J Trench width J inches Z)L- OC~' II inches PE~M,TN%:~/ma ~ / No. of compartments Liquid depth PERMIT NO, Liquid capacity in gallons PERMIT NO. Distance between li)),es /"7 Total effective absorp, tion area Total effective absorption area Nearest lot line Disf, m~ce ~o Io~ lin~ I~'RMIT NO, kSept c tank J Absorption area(s) OTHER PIPE MATERIALS~ SOIL TEST RATING INSTALLER R EMAR KS ~,// ~ L.. jAPPROVED~ 7~78) DATE LEGAL 'TYPE OF :SE):[L RB:E;ORPT :[ ON :~;'~.':~"f'Ef'l ]:E;: TREI',ICH I"IRX];I"IUI"1 NI...II"IE3ER OF BE[.'."ROOi"IS := 2.-': :SO]:l... F.'.RTZI'.~G ,::SE'::! FT,"BR::,= THE REC;!U].'REE:, SIZE OF THE :.:.;OIL. RB:5ORPTtON 'E;'¢STEI"I TNE L..EI'4(~,TH bIi'flEN2;IOl'.,l IE; THE LENGTH (IN F'EET) OF THE TRENC:H OR [:,F.:FIII",IFIEL[:,. THE DEPTH OF' R TF,'.ENCH OR PIT IS THE DISTRNCE BETHEEN THE :E;URF'FICE OF:' THE: GROI..IIqD RN[:, THE E~OTTOI"I OF'" THE EXC:R',,,'FIT'ION (IN FEET). TI-.IEf;~:E Ir.'.:.; NO '::';ET .t4]:D]"H FrOR 'TRENE:HELS. THE GRR',/EL DEPTH ZS THE i'"l.'[i'.,!]:i"lLli"l DEF'TH OF GRR',,,'EL BET!.,.IEEN ']'HE OUTFF:II..t... P]:F'E FIHD TNE BOTTOP1 OF THE EXCFI',,,'RT]:ON ':::IN FEET:). I='EI:~:PI!T AF'F'L]:CFINT HR2; THE RESPONSIBILITY TO INFOF..,P1 THIS [:,EPFIR, TP1ENT .r..',UR:[NEi TNE INE;TFILL. FITION II'.,tSF'ECTIONE; OF' RN'-r' HELLS; R[)..TRCENT' TO TH:[E; PROPERTY FINE:, THE NUI'"IBEF.: OF' REE;IDENCES THRT ]"HE HELL H~.I._L SERVE. E:FIC:I.:::FILI_ING OF FINY 2;Y'::;TEM !-4ITHOLrT F'INFII_ INL=;F'EE:TION RND RPF'RO',,,'FIL E:Y DEF.'RRTfqENT I.,.I :I: Lt. BE ."SUE.,'.~ECT TO PROSECUTION. f,IINIi',IUM /DISTRiqE.'E BE'r!.4E'EN I:::1 HEL. L. laND RNY OI",I-SITE :SEP.IRGE DISPOSRL. S"r'S'TEP'I ±00 FEET F'OR R PR:[',,,'RTE [4ELL OR :'L50 TO 2e~e~ FEET F'F..'Oi"I R PUBLIC 1.4EL/.. r:,EPENF.:,ING LIF'ON "rile TYPE OF' PUBLIC I.,~!EL.L. PIlNIi',~Ui','i [::,ISTRNC:E FROI',I R PRIVRTE [4ELL.. TO la PF..'I'¢RT'E SEI4ER I_]:NE I~; 25 FEET F:II'.,ID TO R COi',~i',IUNITY SE!.,.IER LINE ]:$ 75 FEET. HEI_L. LOG:E; RRE F..'EE!U]:REE:, FiND I',IUST BE RETURNEE) TO THE [:,EF'RRTfdENT b.llTHIi'.,I :.4:0 E:,RY% OF THE HELL COf,IF.'LETION. OTHER REE!UIF..'Ei'.IENTS i'"lFl"r' FIPPLY. SPECIFICFI'rloN!; RND CONSTRUCTION I::,IRGRRi',I'E; RF.!E I:'tVRIL. RBLE TO INSURE PR. OF'ER :[NSTRLL. RTION. I CERT IF:".P THFI'r :t.: i lam F'FIMILIRF.: I.,.IITFI TFIE REtT~LIIREMEI'.,IT"E; FOR ON-~E;ITE SEI.,.IERS FIND I.,.IELt..E; AS SE]" F."ORTFI E:Y THE i',IUN I C :[ PR/~ I TY O[" RNCHOP::laGE. · 2: ]: HII...L.. INL=;TFILL TNE S"r'E;TEI"I I1'4 RC:C:OR[:,FII'.~CE !AITN THE C:O.r..',E:?;.,. 2.-':: I UNDER:..'-;TFIN[:, THRT TNE: ON-SITE ?.,EI.,.IER ~S"r'STEI"I HRY REE!UIRE ENI...RRGEi"IEIqT Fi:ELS :[ [:'ENC,~.%-.~S;,~.:Ei"IO[:,E~.ED TO :[ NCLUE:'E: i"IOF.:E THFIN .7.,:: BE:[:,ROOi'"IS;. ,, 1'HE 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE ,4IL SULLIVAN, MA YO[4 DEPAR'T MENT OF ItEAL'FII Al,iD ENVIRONMEiNTAL PHOTEC FION Decen~er 31, 1980 Ed Stevenson 3351 Amber Bay Loop Anchorage, Alaska 99502 Permit ~ 800070 Subject: ]Lot B Tract 4 Illiamna Acres Subdivision A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, LNB/ljw enc: Copy of Permit SWP/057 PERMIT NO. RPPLICFtNT Et:, STEVENSON 2~5:l. FIMBER BFIY LOOP LOC:RT I ON LEGAl_ LOT B TRRCT 4 ILLIFIMN8 8CRES.,"' LA]" ...,I,:.E TYPE OF SOIl,... FIBSORPTION S'¢STEM IS: TRENCH MFIXIMUM NUMBER OF BEDROOMS = 2 :SOIL RR"FING <SQ FT,.'BR)= THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: IPlLI~'--i I r_:: .,'[ F'RL..'[ "T-"¢ OF Fli'-.I C:H l':.~l~: R C-iE DEPFIRTMEI'.,IT OF HEFILTH FIND ENVIRONMENTFIL PROTEOTION 825 "L" STR. EET., FINCHORFtGE., RI.-'..'. 99501 264-472'0 I..-IELL Flr-4t[:, ,.-J IN---"~. I 'TF_" '_~='; EI..JIER ,:: 8000?0 ) ]:44-6625 ±08900 SQURRE FEET I[')EF'TH= 6 LEf-.II3T H = 51 [3 F-: R'..-' E L [:,EF'TH: .... THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE 'fRENCH OR DRFIINFIEL[:,. THE DEF'TH OF R TRENCH OR PIT IS THE DISTRNCE BETHEEN THE SURFRCE OF THE GROUND FIND THE BOTTOM OF THE EXCFIVFITION ,.'.tN FEET). THERE IS NO SET HIDTH FOR TRENCHES. THE GRFIVEL DEPTH IS THE MINIMUM DEPTH OF GRFtVEL BETWEEN THE OIJTFFILI_ PIPE RND THE BOTTOM OF THE ENCFtVRTION (IN FEET). PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRI..LRTIEIN INSPECTIONS OF RNY 1,4ELI,_S RDJRCENT TO THI% PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELl,. WILL '~]ERVE. TI-.-IC, ,:'.' 2 ) I I'-.ISPEE:T I L--ill'-.l_'i~. RF-:'E F.:~]u];!LI I RE:[: ......... BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION FIND FIPPROVRL BY THI:S DEPRRTMENT HILl,.. BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND ANY ON-SITE SEWFIGE DISPOSRL SYSTEM IS :1.00 FEET FOR FI PRIVRTE WELl,.. OR t50 TO 200 FEET FROM R PUBLIC.' WELL [:,EPENDING UPON THE TYPE OF PUBLIC WELl,_. MINIMUM DISTFINCE FROM FI PRIVRTE WELL TO FI PR I ',,,'RTE SEWER LINE IS ;-25 FEE'I' FIND TO R COMMIJNIT~r' SEWER LINE IS 75 FEET. WEt. L LOGS FIRE REQUIRED FIND MUST BE RETURNE[:, TO THE DEPFtRTME. NT HITHIN 20 DFtYS OF THE HELL COMPLETION. OTHER REQUIREMENTS MFt'¢ RPPLY. SPECIFICFITIONS FIND CONSTRUCTION [:,IFIGRFIMS FIRF FP/RILRBLE TO INSURE PROPER INSTOL. LRTION. I CERTIFY THRT 1: I FIM FFIMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS FIS SET FORTH BY THE MUNICIPFILIT"r' OF 8NCHORFIGE. 2: I WILL INSTFILL THE SYSTEM IN 8CCORDFINCE WITH THE CODES. 2: I UNDERSTFIND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCL.LIDE MORE THRN 2 BEDROOMS. HPPLIbHNT~ ' '-Et, ~,TE~,EN ,~ IN ACCOUNT ~ I1~ ~o.-~ I AJ~T. OF J J J' J J ~ '~, ?.) '~ J ACCOUNT I I JCASH J [ J' BA~E J('/! ' I ~ MONEY ~,~ DUE ' J -J I ORDER HOW PAID ~.. _.~ ./.~~ eK608 ', n~.r !,,¢:i' AtA. S!<A99501 December 31, 1979 Ed Stevenson 3351. Amber Bay Loop Anchorage, Alaska 99502 Permit ~ 790059 Subject: Lot B Tract 4 Illiamna Acres Subdivis_ion A pe~it issued by this department for well and/or sewer system has expired. PeA~its are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer has inspected the installation of the on-site sewer system, please have them send us the as-builts for our ~.].ea. If there are any further questions, please contact this office at 264-4720. Sincerely, LNB/Ijw eric: Copy of Permit DEPRRTr'IEr~ 825 "L" STREET,, 264-4720 PERf'IIT NO. < LOCflT I ON T~'F'E OF SOIL FIE:SORBTICIN S,~r'STEM IS: ~. F'FtL I T'T' I[IF ~i'-. HI~_IF-"~I.~_iF~ ,, OF HEALTH FIND EN\,'IRL-~NMENTaL PF,;OTECTION , aNCHORaGE ........Ri(. q':~UZ.- _,": E ~,J E F.: MR;:<Ii"IUM NUMBER: OF BEDROI_'IMS = ,~ LOT SIZE //O~dT~ S,;!LIRRE FEET SOIL F.:ATING <SQ FT,~'E:F.:',= /~..~'- THE REQUIRED SIZE OF THE iSL-IIL RBSL-IRF'TIC~N S'¢STEM IS: [>EF"TH= ¢' / I_E['-dl-iTH= ~-// -- · - , , , ~_~ -F-. ~t ... E [_ E:, i P' -F ~1 ~ THE LENGTH DIMENSION I~ THE LENGTH (IN FEET..') OF THE TRENC:H OP, r)F.:RINFIEED. THE DEPTH OF Fi TRENCH 13R PIT IS THE DISTFiNi-:E BETHEEN THE SLF.'FRCE OF THE GRFiI IND_ _ aND THE BOTTOM. 0F THE E,,,E.H~ RTI _ N"'- ' a ,"IN.. FEET's.. THERE IS NO SET WIDTH ~EIR TRENCHES. · THE GRFCv'EL DEPTH IS' TH.E MINIHIJM DEF'TH OF GRR',,'EL E:ETt,IEEN THE OLITFRLL PIPE aND THE BOTTOM OF THE ,E,'.<iZRVRTION <IN FEET>. F'ERMIT HFFLI_.MNT HaS THE R:ESF'ONSIE:ILiT,T, TO INFOF.:H THIS £:,EF'RRTMENT DI_R'ING THE INSTaLLaTION INSPECTIONS 0F aNN' HELLS R[:,JRC:Et-~T TO THIS F'ROPEF.:T'¢ aND THE I.d_It'IE:ER OF RESIDENCES THaT THE WELL WILL SERVE. T L.JmZ:l ':: 2 .':, I ~-4$F'Em_-~-T I BZmF-dLS FIRE Fd: E L.~!I_I I F;EC, E~RC:KFILL ING OF aNN' S'¢STEH' 14I THOUT FINAL INSPEC:TION aND RPPR'C',/RL B'-r' THIS [)EPRRTMENT NILI~ ' BE SLIBJECT Ti-i PF.:OSECUTION. MINIMUM DISTFIt-IC:E BETNEEN R NELL aND aNN' CtN-SITE SEWAGE [:,ISF'OSRL SN'STEM iO0 FEET FOR FI F'RIVRTE WEEL.~ Ca' ~50 TCI 200 FEET FROM R PUE:LIC NELL DEF'ENDING LIF'ON THE TN'F'E OF F'UE:LIIZ: NELL HELL LOGS RRE REQUIRED aND MI_IST E:E RETURNED TCI TIdE [:,EPRRTHENT WITHIN OF THE NELL C:C~MF'LETION. OTHER REQUIREMENTS f,lR'¢ RF'F'L~'. SF'EC:IFICRTIONS aND cor.dSTRL,i:TION DIaGRaMS RR:E R',,,'RILRBLE TO INSURE '"- '" FRUFER INSTaLLaTION. I C:EF.:T I F',r' THaT 1: I aM FRHILIFIR WITH THE REIZUIRErdENTS FOR ON-SITE SEI,IERS aND WELLS RS SET FORTH B'.r' THE MUNICIF'FtLIT'¢ OF aNCHORaGE. 2: I WILL INSTALL THE S'¢STEM IN RC:C:CIRDRt.41_-:E WITH THE CODES. . Z<: I LINDEF.:STFit.,I[) THaT THE Cit.~-'--;ITE SEI.,IEI;: S'¢S'I'EM MaY REi..-.P_IIRE ENLRF.:GEi',IENT IF THE RE%I[:,ENCE IS REMODELED Ti3 ,INCLI. IDE I"lnF.:E THaN 0 E:EDRi-OI~IS. Applicant r::IF:'PL I C F:Ii",IT LOCFIT I ON ED S TI~i:'v'EI'.,IS;ON LOT ~:]1:5:?. F:IHE:EI~.'. E:FI"r' LOOP T"r'PE OF SO :1: [... I::~E~'.:~:';I]F~:E:'F I OIq ~S"r':.:'2'FEH I :!]~: TREIqC:H f"lFl::.:::[l'"lt.r.ll'"l I'qt..li"l[!=[i;f(: OF E~E[)F;?,OOM:L:; = RED :L:; I ;;.~]:i,': Of THE :!i;O :[ L,. I:::ll:!i:'.?:;Ol~F'T I ON S'?'S:;'T'EM 1 5;: "['HE L. ENG]"H [:,IM[.:.I",IS";II::)N IFF..:; ]';"IE: I...EN(.:iTH ,::II'.,l F[~[i::T::, OF Tt..lli~ ...........t[ [:b! !1 OR [:,RF:I:fI",tF::'IF:i:I.r.D.. ]'HE I}EF::'TH Of F:I TRENCH OF~:'. P:I.'T :I::S TH[ii: I".:,I:STI::IIqCE [:}ETI.,.!EEI'.~I THE '.":i;UF~'.F:Fp:'::E OF' 'rf'HE GROt..IN[:, I::11'.,1[:, THE Bo]r']"Oi'"l OF THE: E~:',:':',CFI"/FtTIOI'"I ':: :1:1'"1 THEF:~:E I :"5 IqO SE]" P'I:[ DTFI FOF?. TRISNC:HE!S. THE!: I]i['.l'~l, [:]... [)EF:'TH I :E; 'I-'HE I"t ]: i'"t I ML.IH DEI:::'TH OF 51:]i': V[::':L Blii:TI.'.IL::EN THE OIJ"I'FF:ILL F"' FINI:) 'T'HE E:OTTOH (]iF THE I:}!:::'::CFI',,,'FIT l' O1",1 ( I I".! f:'EET ). F::'E:F~:MI'F F:IPF:'L. ICI:IIqT I"11::1':'~; ]'HE Rli'~:S;F:'ON~i;IE:II..:[T"r' "FO II'.,tF:'ORM TI*I]:~:.; [:,[:~:F:'F:IR]"MEI'.,Ff' [::,l. JRl'Ni]i THE ]:N:STF:IL.I..I::ITION ):I'.,I5;F::'[~C't":[ON:i!~; OF::' F:ff.,l'.r' I.,.l[iJLL...:i!!: i:::l[:,Jl:aCl-~]qT TO TFII~i; F:'ROI:::'!:':(F~'.'T".r' F:ff',l[:, TH[ii: I",ILIHE:ER OF:' R[.::'.:2;I[:,EI'.,IC:E'.~; THF:I'F '['I"IE I.'.IEL. I.. HILl_.. E:[::tI:]I<]:::' I Lt.. I NG OF::' Ftl",l'.d '.S"r'~;TEH I.,-!]: THI.']IJT F' I NFIL I i",I:SF'EC T ]: Cd",l FII",ID F:IF::'F::'RO'v'F:II... 1:3"r' 'T'H Z !ii; t]'EF::'FIF;?.THENT I.'.11 t...L 8E :SLIEk:fEC]' TO F'RO!SECLIT ]: ON. I'"11 N I HLIH I:::' I 5;'['FINC[:~ [:ii:ET!-,.IEEN F:I I.,.t[EL.L Rf',l[) FIN"r' ON-:E; I 'T'[i:: 5;EHFIGI:~: [:' I 5;F::'OSFII... S"r':E;"I"E:H :t::ii:; :I..0!:.~!1 f::'[~:':[!!:]' F::'CIF..' FI F:'F.'.I',/I:::I'i"[i!: I.,.IEI....L..; I.][F~'. J..~:.~O "t'O ;:i~I~iEI FEET f:'I:,?OH I::1 F'UEg.. I C I.'.IELL. DEPEN[:' I NG UF:'OI",I 'T'HE T"r'F::'E OF:' I':'LI:E','L. ): C I.,.l[ii:l.J HELL. LOGS; I::IF.:E F?.EL:.!UZREI:)I::llq[) iVly"E;]~ Eli.:: K::[F:TLIi:E'.N[~:[:, TO THE!: [:'[~:PFIF,?."I'HEI",IT HITHIN ]:O E:'l::l"r'!:~; OF:: THE: I.,.IELL COHPI...ET'[ON. O]'HEI:;i: REI]~U I F~:E]"IE:IqT:~'; Ml::t"r' laI::'F'L.'.r'. :5i:'E:C l [:' :[ CFFT' :[ ON:i:i; Fii'-,I[:, COP.,I':::i;TF:~:LICT ].' ON E:, Z FIGI:~:F::Ii"tfli; I:::l'v'f:l t L.F:IE~I....E ]"O I I'-,ISUI-;i:E I::'ROF'I:ZFE'. I I",I."S'I"f::ILLFI]" I ON. t CEF::T I F"r' 'I"PIFFT' ::L: I I:::IH FI::IM:[L.T. F II~'. ,L,.II]"H THE [;i'.[~:~.~:!t..l:[l:~:[:~:i'"l[:!:l'.,l'['~:~; F:'OR (:)N.-..~':;ITI!: :~:[ii:l,.IEi:F[:~i:; FIND I.,.IELL.S; I:::1~:~; F::'OF;i:TH [3"? THE MUI'.,I I C :[ PI::IL I ~1"~' OF: F:INC:HORF'IGE. 2: ]: t.,.1:t: 1...t~ t I",I:!.Ff'FILL 'T'HE ~i;'t'..:~TEM I I'.,t F:ICCOR[:,RNCfi:: H :!: ]"H THE. CO[:,F?S. ::!!:: Z IJf,.I[.',ERS]"FIN[:, THF:IT THE CIN-S:I:'I"F.~: ::ii;li~l.,.IE[~: '::Ji't'~;TEM MI:::I'T' RI:'.~:(~:!U]:F;i~[!i: I:~NL.I:::IRGli~:HENT :1:1::' THE RF:i:SZl}ENC:E Z~ fi?.EMODELED TCI II",ICI...IJ[)E i'"IOI"~:E THFIN 2::: S I Ciil'.,IE [:,: .......................................................................................................................................................... FIF:'F'L.. I Cf:INT El::, S"I"Ii:;:VI~::I'.,ISON · TESTING · EXPLORATION · CHEMICAL · t4ATERIALE, · INSPECTION 4040 "B" Stree~ Anchorage, Alaska 99503 October 29, 1974 W.0. #17111 279- 2581 Mr. Gary Lewis Star Route A - Box 330 T Anchorage, Alaska 99507' SUBJECT: Seepage Pit Analysis LOCATION: Lot B, Tract 4, Illiamna Acres Dear Mr. Lewis: On October 28, 1974, Larry Johnson, senior technician, of our staff, logged a test pit in the vicinity of the proposed seepage pit, located per the attached sketch. Ail soils encountered were visually classified in the field in accordance with the criteria contained on Sheets 1 through 3 fol- lowing the text. The samples from 8.0', 9.0'-10.0', 10.0'-12.0' and IS.O' were brought into the laboratory for additional visual 'review and class- ification based on the same criteria. The composite of the field and lab- oratory review is compiled in the following test pit log. Test Pit 1 '-Depth in Feet From To 0.0' 1.0' 1~0' 1.S' 1.5' 6.0' 6.0' 9.0' 9.0t 1S.O' Soil Description F-4, tan, sandy silt, damp, hard, PLy ML, large cobbles at transition F-2, brown, silty gravelly sand, damp, high density, SM NFS, brown, sa.ndy gravel with layers of F-2 silty rav~~ s.and,'(30%± of the strata), damp, h'igh density, rounded particles, 6"-, GP-GW/SM NFS/F-2, grey, silty gravelly sand with occasional cobbles, damp, high density, SM F-2, grey, silty gravelly sand with occasional cobbles, damp, high density, SM, with random layers of sandy'silt and with pockets of NFS sand to sandy gravel Mr. Gary Lewis Page 2 October 29, 1974 Test Pit 1 (continued) Bottom of Test Pit: Frost Line: Free Water Level: Sample Depth 1 8.0' 2 9.0'-10.0' 5 10.0'-12.0' 4 10.0'-12.0' 5 15.0' 15.0' None Observed None Observed Type of Sample G G G G G Renmrks: 1. 2. 3. Test pit located per attached sketch Elevation: Existing Ground Date of Exploration: October 28, 1974 4. Type of Sample, G = Grab The seepage area required per bedroom by soil type (per the Greater Anchorage Area Borough) is as follows: Soil Type (Unified Classification) ML SM SP SW GM GW ~eepage Area Required 275 ft.2/bedroom 250 ft.2/bedroom 1S0 ft.2/bedroom 125 ft.2/bedroom 225 ft.2/bedroom 85 ft.2/bedroom Soils requiring greater than 250 ft,2/bedroom are not allowed in seepage pit Mr. Gary Lewis Page 3 October 29, 1974 area calculations (per the Greater Anchorage Area Borough). The seepage area required at depth can be expressed as follows: Unified Soils Depth Classification 0.0'-1.0' ML 1.0'-1.5' SM 1:5'-6.O' GP-GW 6.0'-9.0' SM 9.0'-15.0' SM Seepage Area ~equired 275 250 134.5 250 2S0 ~nclosed are some excerpts from State and Borough ordinances which may be of value to you. For further restrictions, particularly with reference to location of the seepage pit, we call your attention to the Greater Anchorage Area Borough Ordinance 28-68. Please call if we can be of further service. Very truly yours, ALASKA TESTLAB John M. Lambe JML/vms ¢~nclosures n d 0 0 0 0 0 0 0 0 0 0 0 0 ~ ~ ~ ,-4 ~ ~ ~ ~ ~ ~ ~ ~ 0 0 0 0 0 0 0 ~0 [,~ ~,~ ~ r~ L~ r~ ~ ,~ lei < DEPARTMENT OF HEALTH& HUMAN sERViCES::' t~ll - Division of EnVironmental services.: ' ~ On-Site Services Section ' . ~ P.O. Box 196650 Anchorage, Alaska 99519-6650 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I,D.# ~\-~- IC')\-~/ HAA# ~-'~O~?k~)~.~(,~ 1.' GENERAL INFORMATION Complete legal description Illia~na Acres, Tract 4B Location.' '(§i{~'ad;dress or directions) ,~. "Prope~'owner.. D~n~is Mendel 5401 Riverton Rd., Anchorage, Day phone AK 99516 .,~.. J,,Mailing address '.:. Lend ng agency address . . .. -'?.~... L,..~-, - Agent r~., ~, ~,, ~ Day phone "Day phone 2. '~'~NUMBER OF BEDROOMS:_· 4. TYPE OF WASTEWAT~D~SPOSAL: ..... ~k-.. . , .-, ,' ,. Indw;dual:~a-s~te · . ' ~:~" . ', ,.~ ~ uommu~i~y on-site - . ' NOT~: If com~uni~ Wastewater system, provide wri~en confirmation from State ADEC a~esting to the legali~ and status of system. "': ' - 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 vedfy 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 Environmental Management, Inc. .~ Phone (907)272-9336 Address _206 E. Fireweed L,.n.~', ~. choral, AK ~03 ~ John Ear} Simpson DHHS SIGNATURE ~/ ,~,~ F~OFES$\~," ~ Approved for 7 bedrooms. "' Disapproved. Conditional approval for bedrooms, with the followir;g stipulations: ,,,'.,Additibnal (~0mments 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 p?ofessiona! engineer's work. 72-025(Rev. 1/91) Back MOA~I Municipality of Anchorage ,~ Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Illiamna Ac:~es, Tract 4B Parcel I.D. A. Well Data Well type Private Log present (Y/N) Total depth 95 ft. Cased to Sanitary seal (Y/N) Y If A, B, or C, attach ADEC letter. ADEC water system number Date completed 10-31-80 Driller Jay Wi].li~-~ms 84 ft. Casing height 28 in. FROM WELL LOG Date of test 10-31-80 Static water level 20 ft. Well flow 5 Pump level1 84 ft. SEPARATION DISTANCES FROM WELL TO: 102 ft. 113 ft. N/A Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line Wires properly protected (Y/N) ~' AT INSPECTION 4-3-95 21.75 ft. g.p.m. 1.5 84 ft. ; On adjacent lots ; On adjacent lots g.p.m. ~o~, 150+ ft. ~ 150+ ft. Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml Date of sample: ,~/14/95 Nitrate 1.43 mg/1 Other bacteria O cnlon~,~./lnn ml__ Collected by: B. SEPTIC/HOLDING TANK DATA Date installed · 7-~ 1 Tank size 1000 gal Cleanouts (y/N) .. y High water alarm (Y~N), Dateof pumping ..... 4-5-95 - , ~, Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Compartments 2 Foundation cleanout (Y/N) y Depression (Y/N) N ' N Alarm tested (Y/N) Isaacs Pum~inq Service Well(s) on lot 102 ft. On adjacent lots To property line 50+ ft. Absorption field Sudace water/drainage Non~ nhm~_rv~d 150+ ft. Foundation 31 ft. 8 ft. Water main/service line 20+ ft. 72-026 (3/93)' Front CONTIN U ED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer 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 D. ABSORPTION FIELD DATA Date installed 7/81 Length 57 ft. Width Total absorption area 770 sq; ft, Cleanout present (Y/N) Sudace water Date of adequacy test 4-3-95 Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) 135 sq ft/b~ System type Gravel thickness ~Total depth y Depression over field (Y/N) Results (pass/fail) Pass for 3 74.8 inches Aftertest 79.2 inches N If yes, give date On adjacent lots 150+ ft. Property line To existing or abandoned system on lot Cutbank N/A Water main/service line t¥~n~h 9.08 Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 113 ft. To building foundation 41 ft. On adjacent lots 120+ ft. Driveway, parking/vehicle storage area Surface water none observed Curtain drain N/A E. ENGINEER'S CERTIFICATION 2N+ ff 20+ f'h. ~n.t- f~__ Waiver Fee $ Date of Payment Receipt Number HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)' Back I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in eff_~e date of this inspection. / .... {/ / // £4;"' . .~-- _~ {,.~ .. ~ /~NGF[SS~~ ~ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Illiamna Acres, Tract 4B Parcel I.D. A. Well Data Private If A, B, or C, attach ADEC letter. ADEC water system number Date completed 10-31-80 Driller Jay Williams Cased to 84 ft. Casing height 28 in. Y Wires properly protected (Y/N) Y Well type Log present (Y/N) Total depth 85 ft. Sanitary seal (Y/N) FROM WELL LOG 10-31-80 Date of test Static water level 20 ft. Welt flow 5 Pump level1 84 ft. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line 102 ft. 113 ft. N/A N/A AT INSPECTION 4-3-95 21.75 ft. g.p.m. 1.5 g.p.m. ~ 84 ft. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout 150+ ft. 150+ ft. N/A m z Petroleum tank N/A WATER SAMPLE RESULTS: Coliform 0 Colo,;~s ~oo~,,.,4 Date of sample: 8/14/95 Nitrate /. ¥3 m~ / .( Other bacteria Collected by: ~ B. SEPTIC/HOLDING TANK DATA Date installed , 7.-81 '. Tank size 1000 cfa]_ Cleanouts (YIN) '¥ Foundation cleanout (Y/N) ¥ High wateialarm (~;/N). . "' .N · Alarm tested (Y/N) Compartments 2 Depression (Y/N) Date of pumping ' ' ~'- 5-- ~- Pumper SEPARATION DISTANCES FROM SEpTIC/HOLDING TANK TO: Well(s) on lot 102 £t. On adjacent lots To property line 50+ Ft. Absorption field Surface water/drainage None observed 150+ ft. Foundation 31 ft. 8 ft. Water main/service line 20+ ft. 72-026 (3/93)* Front CONTINUED ON BACK PAGE C, LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Date installed Length 57 ft. Total absorption area Date of adequacy test Well on lot D. ABSORPTION FIELD DATA 7-81 Width 2 770 sq ft. 4-3-95 Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Soil rating (GPD/Ft2) 12,5 ft. Gravel thickness Cleanout present (Y/N) Results (pass/fail) 86 inches Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 113 Et. On adjacent lots To building foundation 41 ft. On adjacent lots 120+ ft. Y Pass System type trench 6.75 ft. Total depth 9,0R Depression over field (Y/N) N for .3 Bedrooms After test 90.4 inches If yes, give date 150+ ft. Propertyline 2~+ ft. Surface water none observed Curtain drain N/A E. ENGINEER'S CERTIFICATION To existing or abandoned system on lot N/A Cutbank N/A Water main/service line Driveway, parking/vehicle storage area 50+ ft. 20+ ft. I certify that I have checked, verified, or conformed to all MOA and HAA guidefines /,"1 / Signature /~'///~" l- ~/// Engineer sName~X]~/~/~%~__~ ~>~ /~/ Date HAA Fee $ ~"¢2' ~ Date of Payment Receipt Number /~;'~/..~ Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back ¢~::~.,,'1R.,"~ t 0: 23 E:OHHEF.!C I RL TEST I HG CT&B Ref.~ Matrix CT&E Environmental Services lnc, Laboratory Division Laboratory Analysis Report WA'rER Client Salnple ID OUTSIDE FAUCET ILIAMNA ACRES L4E Clien~ Name ENVIRONMENTAL MGMT INC (EMI) WORK Order 17149 Ordered ~y I~ARRY Printed Date 08/17/95 ~ 13:20 hrs. Project Na%ue Coll~¢tsd Dabs 08/14/9~ ~ 12:00 hrs. ProJact~ Recsived Date 08/14/95 · 12:25 hrs. PWSID UA Technical Director ST~PH~N C, EDE Sample Re~aark~: 8~MPLE COLLECTED BY: M.M.I. QC Allowable EX~. Anal Parameter Results Qual Units Meghod Llmit~ Da~e Date Init Nl~rate-N 1.43 mg/L EPA 35~.2 10. 08/16/95 DJM See Special Inetru~Cions Above UA - Unavailable Sea Sample Remarks Above NA - Not Analyzed undetected, Reported value is th~ practical quan~l£ica~ion limit. LT - b~o~ Than Seeo~%dary dil~lon. GT - Grsater Than 200 W, ~0[~ef Ddv~, Amoh0taOs, AK 99518-1 605 --Ish (907) 552-2343 ~8x~ (907) 5~1-5301 ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN. MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA 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 Parcell. D.# .~Et--] ~ ~(~\- ,---O.\ HAA# ¥-~ ~"~(7'lZ~Ch~(¢)"] 1, GENERAL INFORMATION Complete legal description TZiamna Acres Subd±v±s±on Lot 4B Location (site address or directions) 5401 Riverton Avenue Property owner Mailing address Ed Stevenson 5401Riverton A~nue, Day phone 345-0684 Anchorage, AK 99516 Lending agency Mailing address Day phone Agent Address Phyllis Hackett Dayphone 279-2001 2600 Denali St., Suite 400, Anchorage, AK 99503 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ~ TYPE OF WATER SUPPLY: Individual well X 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 AD£C 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 d/~te of this ~nspecbo . /I NameofFirm Env±~or~ental Hanag/e~ent, Tnc. Phone 272-9336 206 E. Fi~/eweed~Lane, /J~201, Anchorage, AK 99~ Address !,! / ( '//" DHHS SIGNATURE _7~ Approved for ....5 Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, 72-025 (Rev. 1/91) Back MOA ~Y21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Iliamna Acres Lot 4B A. Well Data Parcel I.D. Well type Private Log present (Y/N) Yes Total depth 8'5 :, Feet Sanitary seal (Y/N) Yes If A, B, or C, attach ADEC letter. ADEC water system number Date completed 1982 Driller Jay Williams Cased to 84 Feet Casing height 28' ' Wires properly protected (Y/N) Yes g.p.m. FROM WELL LOG Date of test 10- 31 - 80 Static water level 20' Well flow 5 Pump level1 84 ' From MOA' records SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 102 Feet Absorption field on lot 113 Feet Public sewer main N/A Sewer service line N/A AT INSPECTION 05-18-94 19 Feet 5 84' ; On adjacent lots 150 Feet + ;On adjacent lots 150 Feet + Public sewer manhole/cleanout Petroleum tank N/A N/A WATER SAMPLE RESULTS: Coliform 0 Date of sample: 05 / 18 / 94 B. SEPTIC/HOLDING TANK DATA Date installed 08 / 82 Nitrate Tank size 1.29 rog/1 Other bacteria Collected by: Chad Helgeson 1000 Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) High water alarm (Y/N) No Date'~of pumping 05 / 13 / 94 Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot · 102 Feet On adjacent lots To property line 50 Feet + Absorption field Sudace water/drainage None Cbs erved Yes Depression (Y/N) Alarm tested (Y/N) N/A McDo~aldS No 150,:.Eeet. + Foundation 31 Feet 8 ~;. Water main/service line N/A 72-026 (3/93)' Fron~ CONTINUED ON BACK PAGE C. LIFT STATION N/A Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed July 1981 Length 57 Feet Total absorption area Date of adequacy test Soil rating (GPD/FF) 13 5 Width 2 Feet Gravel thickness 770 sq. ftCleanoutpresent(Y/N) Yes 05/18/94 Results (pass/fail) Pass System type Trench 6.75 focTt°taldepth 9.08 Feet Depression over field (Y/N) No for 3 Bedrooms Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) 91''below G.L.Aftertest 28''below G.L.. No If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot 113 Feet On adjacent lots 150 Feet + Propertyline 100 Feet To building foundation 41 Feet To existing or abandoned system on lot N/A On adjacent lots 100 Feet + Cutbank N/A Water main/service line N/A Surface water None Observed Driveway, parking/vehicle storage area 50 Feet + Curtain drain None Observed E. ENGINEER'S CERTIFICATION .. I have checked, verified or c~¢rmed to all MOA and HAA guidelines ,n effe~.~l~/~.~Cf~ ~. ,nspection. I ceN~ ~at , , ~. ~ ~ ........ ' '~ / u / // :..:" HAA Fee ~ ~"'~---F~' Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number. 72-026 (3/93)' Back F~N\"IRONMENT,-kL MANAGEMENT INCOR?OR:\TED May 25,1994 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, AK 99519-6650 RE: Well and Septic Adequacy Test for Lot 4B, Iliamna Acres Subdivision Our inspection and test of the system located at the above location indicated that it is functioning adequately to meet its intended use. However, it appears the system was installed without a foundation cleanout. A foundation clean out has since been installed inside the orawlspace within the foundation. ? Sincerely, Envi.r.~,n m ental,.M an age/m~nt , /' I , ~; I / · ;//2 /? .,' /John Simpson PE~,/ /~/ Civil Engineer There is nothing to indicate any change in the system since it was installed. It appears to have been functioning well since that time. For passing the standards for a 3- bedroom house the system is safe, functional, and adequate for this 3-bedroom house. Therefore I recommend approval of the system. 206 E. FIREWEED LANE, SUITE 201 · ,'\NCHORAGE, ,AK 99503-2703 C'ONSUUFING (9(17) 272-9336 · FAX (907) 272-4159 · TRAINING (907) 272-8852 ° FAX (907) 272-0319 NO. 846, Commercial Testing & Engineering Co. Environmental Laboratory Services ~"~J~f~e'~'~'~r~-fj~-~.~.~.~f~~j~~ LABORATORY ANALYSIS REPORT 94.2379.} OI.YI;'qII)H I"A U C I,.'T \'VA'I'RIt EN V[R ONMENTAL MGblT l~c ('EMI) 8TAN DOLLOFF ' UA WORK Ordur 78592 Prin(cd D~dc 05/22/94 (~! h5 4'9 trs. Collccled D,,~ie (}5118/94 '/.j~ 4:q0 ~. Received Dal~ o5/18/94 (~ 15:35 'l~chnical F~rector S'['EPIJ~N C. b',l)F; Released By: · '~7%d.,__ ~ ~---~;~ SAM~I E COLL,.15CTb;D BY: C'HAD it-IE~GESON ANt') WFI'N E.".i,'-;I.',D B~' F.'D STEVENSON. Qc -_ Allmv~l)le Results Omll I lJts Mcthod b its 1.29 ~ g/L EPA 353.2/300,8 l(} Ext. Anal Dale D,'uc Init 05/ 91o4 MCI.; s(JrlU;l'(° H'°' Ab° v c Ilfi~. Unuv ~atl, sAl>ovc , - = . ' ailablc ...... udcd value is thc pract.icnl qtm]tilicaiio~t I nit. ; ~.3' ' ~ NA = Nol Aaalyzcd oil iT= r~ss ~an 5~33 g Slreot, Anchorage, AK 89518-1800 ~ TBJ: ~g07) 582-2343 FSX: (g07) ~81-S301 [TAL fACILITIeS IN ~SKA COkOflAOO. ~LORIDA, /LLINOIS. MABYLANO. N~W 3EBSEy. OHIo, UTAH, W~ST VIgGINIA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTFIORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1, GE~'~ER^L It'!FOF{MA'I'ION (a) L.egrd./~¢.TDescription.../.Z.¢_ (include. ?.~">~--?---~- ~ ~' _'%-<'l°t' block, subdivision,~ .~secti°n' township,./~//-¢/N~range) Location (address or dil'~ens~ ....... Applicant Address ~'~¢/ ~~¢~ ~¢~ (c) Applicant is (check one): Lending Institution []; Owner/builder/~ Buyer []; Other [] (explain); (d) Lending Institution 4'/¢c',~ gJ"~ f'~ Telephone Address (e) Real Estate Company and Agent _ /~//'JF Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Family~['~ Multi-Family [] Number o[ Bedrooms ' ~ Other WATER SUPPLY Well'~ Community [] Public [] Individual Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE i.}ISPOSAL Onsite/~' Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGII'IEER]IqG FIRM PROVIDING INSPECTION'S, 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 t~sI~.>ction, t Name of Firm ~.~' .~,,-~'¢=- .~'~.2,/~ ~-~ ,/'~'~¢~':::;_ ~.~.~Telephone . ,"~4//~' .--~¢'(<~_.5t/ Date ____ -~ --/~' - ':¢'~ Approved for~'~'?~'-~ bedrooms by/~~44' ~'¢~,,~,~__ Date Approved ~ Disapprov6~l Condi io~r¢l. Terms of Conditional Approval 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 72-o75 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification MUNiCIPALiTY gl' DEPT. OF HEALTH & ENVIRONNtENTAL PRoI'ECTION 1986 Well Log Presen / ) Total Depth ~9 ' Cased to Static Water Level ~ / Casing Height Above Ground Electrical Wiring in Conduit~N) If A, B, C, D.E.C. Approved (Y/N) Date Completed . ,/2~ ' ~/~ ~'~--~ Yield Depth of Grouting Pump Set At Sanitary Seal on Casin~) Depression Around Wellhead ('~'~. Separation Distances from Well: / To Septic/Holding Tank on Lot _/'~? · ~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /~'¢ <TL ; On Adjoining Lots To Nearest Public Sewer Line -~ To Nearest Public Sewer Cleanout/Manhole ,--¢"'/,-~/~,/. ,_~To/ Nearest Sewer Service Line on Water Sample Collected by ./([/~"/-' '/ ,¢/~r ~,~-¢-"~-" ; Date , _~"~ Water Sample Test Results -~-~/'¢¢7~'~/'1 (..~-, Co m m e nts ~ ~ _/-/_- ~' B. SEPTIC/HOLDING TANK DATA Date Installed Standpipe ~F~'~) Air-tight Caps~J) Depression over Tank (Y~)-} Pumping/Maintenance Contract on File (Y/N) . Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: Size ,/~'~>¢~¢ No. of Compartments Foundation Cleanout (Y~ _..,.Bate Last Pumped ~ '- Temporary Holding Tank Permit (Y/N) To Building Foundation To Water-Supply Well ,/'~¢'¢~ / //"' To Property Line ~ '~'/-~ / , To Disposal Field '...~'~;¢ /~'''~-~ To Water Main/Service Line . ~ To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ . // Width of Field - ~-~' Type of System Design Length of Field Depth of Field ~d"7 Gravel Bed Thickness Standpipes Present) Date of Last Adequacy Test / Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation --~/' / Lot .-4/~/~,¢~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course / To Property Line ~:¢~ ~--' To Existing or Abandoned System on ; On Adjoining Lots ,,'"~-'¢~ /. To Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area ~-':*¢ '/'¢-~ Comments ~.~,z~ ~ ~-~-"r~%'C',CC~r~' ? ~'~ .~/?'~- .:-~-¢-'~¢¢/'¢ ~"~- ~/~"¢~'~'¢7"~ LIFT STATION ,~' Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at High Water Alarm Level at Tested for "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I h~ve checl~d, verified, or conformed to all M CA and HAA guidelines in effect on the date of this inspection. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) BESSE, EPPS & P(~i'£S 2220 EAST 88 AVENUE ANCHO~A~, AK 99507 (907) 349-6451 W~ ~LT~ Date: Subdivision: Lot: Block: Client's Na~e: Address: O~4~ / Initial Reading on Meter: MUNICIPALITY OF ANCHORAG~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 2 i t986 RECEiVI:D Production Rate: ¢.'~ GPM 24-Hour Capacity ,...X?.,.~O Gallons