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Home My WebLink AboutHANSEN SAND LAKE LT 7B Municipality of Anchorage Page I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Name: ~ ~)N~U~ ~~. Wastewater System: D New ~Upgrade Address:go I'0 ~ ~3.~ ABSORPTION FIELD Phone: ] No. of Bedrooms: ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION so""""'.:/¢2 GP~'Sq.F'. T°ta'D"pthf~°m°i'~a'grade: Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe Fill added above original grade: Gravel length: WE LL: E New ~ U pg rede Gravel ~,:~, j'~ Number of lines: Distance between lines: Classification (Private, A,B,C): Total Depth: Ft. Cased To: Ft. Total absorption a~ SQ. Ft. ~'~Pipe material:~ ~{~ Driller'. Date Drilled: Static Water Level:Ft. Installer:~c~ ~~ / Date i~stalled:~/~ ~" ~ 0 Yield: GPM I Pump Set at: Ft. Casing Height Above Ground:Ft. TANK I SEPARATION DISTANCES ~ s~.tio ~ Ho~ing ~ S.T.E.P. To Septic Absorption Lift Holding ~ubl~c/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Material: Number of Compa~ments: Surf.~ LIFT STATION Lot Size in gallons: Manufacturer: Line ~ C) ~ ~ Foundation ~ 0 ~ ~ "Pump on' level at: I "Pump off" level at: High water alarm at: CurtainDrain.[~0 ~ ~]~ Pump Make & Model Electrical Inspections pedormed by: Remarks: ~/ST/~'6 ~'V'U~a 'U~N~ BENCH MARK Fo~Np ~'r~ No p~ FEcT~, LocationandDescription:~¢~¢, Assumed Elevation: Inspections performed by: Dates: 1st '" '""~ ........... ?' Department of H~lt~d Hu~ervices app?va,,, ~. '~''~,: ',, Reviewed and approved ' Date: ~ ,.: ..... 72-013 (1/91)MOA 25 1000 6AL SUNSET TANK , TOM 15 0 Cl']-2225 r~ I5 30 45 60 75 9'0 SCALD ! = 30 FT, T3M~ 5ARAG£ SLA3 ELEV, 100. O0 TOBBEN SPURKLAND P,E, ~03 W ]STH, AVENUE ANON. AK. 99501 LOT 7A & 73 HANSEN SAND LAKE SEC TOWN RANGE 3610 ~ 73 SEPTIC SYSTEM AS]BUILT DATE, JULY S, 1993 SHEET, 1/3 GRID, 8I£6 9IVERTER VALVE $ 3'~/ide 40' Long I0' Deep 5' Sewer Rock 5' Cover lO' MIN. GAL, TANK EXISTING TRENCH M/mo £! 140 5 £t oF' Septic Rock TDBBEN SPURKLAND P,E, 203 W15th Ave Anchorcge Ak 99501 ~ // 5' Cover / N~ SCALE LOT 7A HANSEN SAND LAKE T]£N PA TRICK ~3R9. AVE, Exist, 5round 1000 gal, septic tank TOM GARAGE FLOOR ~:'; c, SEPTIC SYSTE-~' DESIG~ D~TE, JUL ~ ~ ~993 SHEET: 3/3.~~. OR~, 8]~6 ANCHORAGE, ALASKA 99501 (907) 279-5916 TEMPORARY SANITARY SEWER EASEHENT The following described sanitary sewer easement is a temporary easement for a residential sewer line going from the residence on Lot 7B Hansen Sand Lake Addition~ to the septic system located on Lot 7A Hansen Sand Lake Addition. (File ~ 70-30! Anchorage Re-' cording District, Alaska ) described as follows: Beginning at the Northwest corner of Lot 7B, 'Thence S89-55'W along the north property line a distance of 50 feet, Thence S O-05'E, a distance of 37 feet more or less to a 4-inch foundation cleanout, to the true point Of Beginning: Thence N53W, along the center line of a 10 feet wide sanitary sewer easement~ a distance 43~ more or less to a 4-inch pipe; Thence S89-55~W~ a distance of 45 feet to the west property line of Lot 7A, said point being the end of this easement; An additional temporal sanitary easement, for the benefit of Lot 7B, is described as follows: The North 50 feet of the West 30 feet of Lot 7A, Hansen Sand lake Addition. The above described temporary sanitary easements will be automat- ically vacated when the septic system located on Lot 7A, and serving the residence on Lot 7B is no longer required. Sworn ap~ subscribe~,, before me this 9th day of July, 1993. Notary ~ ~ My Commission Expire~; May 19, 199~ 62 I i000 GAL SUNSET TANK I I I5 30 45 ~0 SCALE; 1' -- 30 FT. 7% 90 TBM' GARAGE SLAB ELEV, 100, O0 TBBBEN SPURKLAND P.E. 803 W 15TH, AVENUE ANCH. AK. 99501 LOT 7A & 7B HANSEN SANB LAKE SEC~fOWN RANGE 3610 W 73 SEPTIC SYSTEM AS~UILT I)~qTE, JULY S, 1993 SHEET, I/3 GRII), 2126 PAGE 1 OF 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 t 0,., c~ ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930159 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:DONAHUE PATRICK M & OWNER ADDRESS:3610 WEST 73RD AVE ANCHORAGE AK 99502 DATE ISSUED: 6/16/93 EXPIRATION DATE: 6/16/94 PARCEL ID:01215340 LEGAL DESCRIPTION: HANSEN SAND LAKE LT 7~ LOT SIZE: 7709 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER WILL PROVIDE COPY OF RECORDED EASEMENT BETWEEN LOT 7A AN LOT 7B. HOUSE IS ON 7B SYSTEM IS ON LOT 7A. SEPARATION BETWEEN NEW SYSTEM AND OLD SYSTEM IS APPROVED AT 10 FT. ENGINEER MUST VERIFY INTEGRITY OF EXISTING SEPTIC TANK. RECEIVED BY: ISSUED BY: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 DATE: DATE: PAGE 2 OF 2 LST 20~ W }5th. AYenoe, Stdte 206 ANCHORAGE~ ALASKA 99501 (907) 279-3916 SEPTIC SYSTEM DESIGN 7A & 7B HA i~S EI~ SAND LAKE PATRICK DONAHUE i ~.~()/i ,, 2 ::= 125 '.-.'sq ,, .f 'i: .... i::;,'oc: k :0e,obl :l. () 5.5 Nt..tfiiJ:) 8r (]'~:£,4° .-, ,~ K(.K, ..... ."-""=~ I...er~gtfi of """ .............. SYST E~lil ,:: .... ' :l.() :=: :]';7. ::' CONFIGURATION STANDARD TRENCH TOTAL LENGTH TOTAL WIDTH TOTAL DEPTH ROCK DEPTH COVER SEPTIC TANK 40 FT. 5 FT. 10 FT. 5 FT. 5 FT. i000 GAL. EXISTIN~ ABANDON EXISTING SYSTEM 'i"h(.~) instat].atic~n o.f th:i.s ~?-,epti¢: ~i~ysd:~:.~m will not !::~rever'fi: we?,!s f rom 13e :i. r'u~'i:.a]. :i. ed on the adjacer',.'~: i ¢:)t~i~. Pub:i. :i, ~::: water" and ~ew~,r" :i. ~. ~vai].al:~:Le t¢ ali. (fi:.~,w;~i,::~i:)e..d lots ir'~ the are with the ~>.'Cel::,tion of I..ot 7 ']'? ] E' r ,$? ~i J"" E~? I"i [) d 6)) V (}:':' ]. (::) p E::~ d C) r i'] ~':t '{'.] L.I t"' ~:i ].. " t.l "~ ........ r~( E / !i~, t..( J] f~ U F f 4~ E ~:'? d I' ¢~1 :i. I"l a g ('~}? courses on this or ti~e ad,jacent lots. The:, j:)rc¥:~osed sep'Li c: sys'i:.ern w:i. i i nc:,t', c:har'~g,,.:~? t:he g~q-'~eral si op,'z:, o.F th,r-.~ ,2d'"E~/:~.. Por'Jd:~. I"1~:) aiq(:~/cir C:{::rF~C~.~-.'tit'"~.~L~iCH'I Of f~:Lti"'f:C~.C:~E:' r'L.H'~C~'~:'~: ~'..KJ. ]. ]. not r'esult .From this inst'.ailat:i, on~ "t"htE, e:,x:i.!~i'~;.:~.l'i(~! t]t'-(E:,l']izh is r~.:,:F~cirte;,cJ tel have:, 8 ~:e;,et or more) o~: se;,wc~.:,r' t'"clck . ac:c:ci~'dJ.f'ig t:o AMC i5.65. ()60. iE]. ].0 , t'.lae separ'at:i, on di stai-'lc::6~ ki~i~,t'.i~e:,E, ri thE:, 0:,x i st i r'iEjl 'Ll'-E:~rich ~;~r'i,:::J thE:, l::,r'c¥:ic:,se~cl must'. I:)e twi ce the a l:erl .Fcx::rl: ut:i.t:i, ty easement~ th:i.s separation can riot bile medE:et. We ing the:, new tr'e~nc:h i0 .Feet o.f.f the:, 1 c)'l:: I :i.n~:?. I...ot corner ar'e S,'.:.:.:,pt i c: System )i}()i:,~i ',.In Lcd: 7A 8,: 7B Han~.,~r',, SAnd Lake 3 4 PU~, ¢ ~/A TEl? 1 I ~/ES T SE VEIV T Y 'WI II ~/ACA~VI I' I q[I--- 7 IIi ~! Iii ! ]4 ,5'0 0 50 100 150 £00 8b'O 300 £CALE; )" = ~00 £'T, TBt~BEN SPURKL. AND P,E, 203 W ]STH, AVENUE ANCI4. AK. 9950i L§~' 7A & 7,~ HAN$£N SAND LAI(£ SEE TDiFN RA.NOE 36}0 ~./ 73 SEP'rIc SYSTEM DESIGN DATE: hAY 2_6, 1993 SHEET, 1/3 GR[D, 2_]2.5 A/E~/ 7~E/VCH --_J II~fS TAL L .D~UBL E £'L £ANOUTS EX]ST, ]000 6AL SUNSET i I ]S 0 15 SCAL £'; CE-2225 45 ~0 ] = 30 FL 75 TO~EN SPURKLAND P.E, 203 W ]STH, AVENUE ANCH, AK, 99501 SEPTIC SY$IEH DESIGN ]]AI'E, MA'/ 26~ 1993 SHEET, I/3 GR[D, £]£6 EXIST, 1000 GAL, rANK S'Wide 40' Long 10' 9eep 5' Sewer Rock 5' Cover BI$CDNNECT£XIST. T£ENCH lO' MIN. Cleanou~5 / 5' Cover Nir'a £~ i40 ~>~.=~o<>ooo~o~ Septic Rock / ND SCALE EX[S TIN6 TRENCH /~Monit:or Ground 1000 gal. septic tank ~M ASSUMEBELE, 100.00 FT ]BBEN SPURKLAND P,E, 803 ~lSth Ave Anchorage AR 99501 L[TT 7A HAIV£EN SAND LAKE SECTIDN 6 TYSN PA[RICK DDNAHUE, 3610 W 73R~, AVE, SEPTIC SYSTEH ~ES]GN DATE, JUNE ~ 1993 SHEET, 3/3 GRIg,~IS~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST · E AL DESCR,PT,ON: 7A 1 3 -~'~ 4 5 6 7 8 9 10 11 12 13- 14- 15- 16 °~4 17 ~/4- 18- 19- 20- Township, Range, Section: WAS GROUND WATER ~ ENCOUNTERED? ~ ~ S IF YES, AT WHAT ~ ~ DEPTH? P E SITE PLAN Depth to Water AIt~r . Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ,0~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~' FT AND FT COMMENTS PERFORMED BY: ~k.. I ~"~ ¢'~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE-DATE: 72-008 (Rev. 4/85) GRE, ANCHORAGE AREA BO[f 'IGH Department of Environmental Ouality 3330 C Street Anchorage, Alaska gg503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME .Z)I~L,~-A/~' icJll"~LLa,,'~2/.. MAILING ADDRESS ..~3~--0 LOCATION J.,C). 7-~',0 ,/~-, LEGAL DESCRIPTION PHONE ~/- SEPTIC TANK: DISTANCE FROM WELl INSIDE LENGTH MANUFACTURER 2'~ "'~/"~ INSIDE WIDTH NUMBER OF MATERIAL ,/~//~L~L/~ ~ COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY /~'~GALLONS. TILE DRAIN DISTANCE FROM WELL'~' ~ FOUNDATION NUMBER OF LINES / DISTANCE BETWEEN LINES ,ABSORPTION AREA ~-~'7 ~, C7 I DEPTH: TOP OF TILE TO FINISH GRADE NEAREST LOT LINE TOTAL LENGTH /~, I OF LINES .:3 TRENCH WIDTH IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE / DEPTH OF FILTER '~' # MATERIAL BENEATH TILE /~) '~ IN. ABOVE TILE IN. WELL: TYPE :TM-'° / t,) / o ~-4A CON ST R UCT ION-~' TI"~OS~'~ BUILDING NEAREST NEAREST FOUNDATION__ LOT LINE SEWER LINE DEPTH CESSPOOl. , OTHER SOURCES APPROVED""" D'T"S APP ROVE D REMARKS S E PTJ,~- SEEPAGE,... TANK SYSTEM DISTANCE FROM: DISTANCES: ~ ~(~ INSTALLED BY: ----~'~7'/~/'J~F~F---- ~---/V',f... SEWER LINE DEPTH: PIPE MATERIAL, C?/:)~'7- -~'-,~4),'L/ ,~ LOT SLOPE: REMARKS: DATE DIAGRAM OF SYSTEM Form EQ-O32 (;RE, ER ANCHORAGE AREA BO UGH ~DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE~ ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL/SYSTE/v~-- APPLICATION AND PERMIT PERMIT NO.. NAME Of APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION ~J INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILitY TO BE SERVED FINANCED THROUGH so,L TEST RESULTS / COMPLETION DATE ANTICIPATED SEEPAGE PIT DRAIN FIELD , OTHER ~ · NOTE:~ THIS PERI,lIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 Hour NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL iNSPECTION BY THE DEPARTMENT O~ ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM I~ISTANCES, REQUIREMENTs FOUNDATION TO SEPTIC TANK ~ / TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD ~ SEPTIC TANK, '/'¢~"~ ~ · SEEPAGE ~T ALSO CONSIDER AREA WELLS. SEEPAGE PIT ., SEEPAGE PIt / ~'~ , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. DIAGRAM OF SYSTEM GRAVEL BACKFILL CONFORM TO BOROUgh REGULATIONS REGAR~STALLATION. 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 SAIOCODE. I also certify that this home will contain a maximum of three, (3)~bedrooms. I understand an upgrade would be~necessary should more bedrooms be added. August 1, 1975 R & M No. 562077 Darlene Hallback 3350 West 69th Avenue Anchorage, Alaska RE,: Test Hole and Soil Log Report for Sanitary System Lots 7A & 7B, Hanson Sand Lake Addition Subdivision Dear ~s. Ha!lback: We are subraitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This investigation was per- formed in accordance with your request of 7-30-75 and those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Greater Anchor- age Area Borough Department of Envirommental Quality. A single test hole was put down within the Lot 7A and 7B area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 25.0 feet below ground surface. The final leg prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & bl CONSULTANTS, INC. Vice President xc: GAAB T.H.-1 7-30-75 ORGAI,[iCS : '.1 SILT, TRACE SAND SA!qDt TRACE SILT Medi~am grain Bro%.~ (SP) NO WATER TABLE 0.0~ 2~01 25.0' Log represents Lots 7A & 7B Hanson Sand Lake Addition Subdivision Engineering ~ Geological'Consultants'Inc. ANCHORAGe FAI~RANKS ALASKA JuNeau Hallback Property Log of Test Hole AnchOrage, Alaska [OATE 7--31--75 IsCALE 1"=4' IDWN DY ~,'~D j.~HKD BY WED ]P~OJ. NO. 5620?7 ~1 . .L .. _, .... : N :.2 '::!.L ceR~y tna~ I nave survoyec~ ',~e following ////,L xI~>V .:Xl/V/I LA,{'/.:: //..: ...:'AZ. Anchorage Recording Precinct, Alaska, and that improvements situa(ed thereon are xvithin the property lines and do not overlap or encroach on the property lying adjacent thereto, ~ha~ no improvemenls on prop- erty lying adjacent thereto encroach on the premises in question and that there are no ':oadways, transmission lines or o~her visib]e easements o~ said property except as indicated hereon. Da~ed at Anchorage, A1as]m /72 z:d a.y o:. J/AL/ . ,.:- this. __ - , .,,__: _:__ FRiSD ¥;,rAL,&Ti,h,i ~ Engineers and Surveyors 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 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property 'owner Mailing address Lending agency Mailing address Day phone Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well NOTE: Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer 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 s~uewwoo leUO!llPPV :$uop, elndp, s 8UIMOIIO~ eH), qjlM 'suJooJpeq Jol le^oJdde leUOBipuo0 'suaooJpeq 'pe^oJddes!Cl Joj pe^oJddv ~ ~tan.LVN~lS SHHO '9 ,, t:I=EtNIIDN=I Ali NOI.LO:idSNI -10 .LN~]IN:~.L¥.LS '~ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type ~ Log present (Y/N) N I~/'~'NS~ b,I - --~-l'q L'~ Parcel I.D. Ol;Z - /5- 3 L/ O Total depth ~ ~.~ Sanitary seal (Y/N) y If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~ ~ 7,~ Driller Cased to ~ ~ Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level1 .g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main ~ /f,~O / Sewer service line ~ ~,~'(~ AT INSPECTION .; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout '~, Petroleum tank ~,0/4 ~'~ g.p.m. ~ c~ ~0 WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: ~,~_~ <"" Other bacteria Collected by: '%~ ~ B. SEPTIC/HOLDING TANK DATA Date installed ~//]~/7.~ ~'~- Tank size it (.P-(2¢_~ -- Cleanouts (Y/N) 7 Foundation cleanout (Y/N) y High water alarm (Y/N) [*'C/A, Date of pumping ~/' Pumper Compartments Depression (Y/N) Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /L~E:} To property line ! ~) Surface water/drainage On adjacent lots Absorption field Foundation q 0 --Water main/service line '~ ~'~ O 72-026 (3/93)* Front CONTINUED 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 Surface water D. ABSORPTION FIELD DATA Date installed Length Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/Ft2) /,~ ~ System type Width '~'~ ( Gravel thickness ,¢)-- ! Total depth /'¢0'"~ Cleanout present (Y/N) y Depression over field (Y/N) ~/~///--~- Results (pass/fail) ~'-'~ for ~'~///z~ After test ~',,~ t.~) If yes, give date /0 Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I 0 ~ On adjacent lots ~ / ~ Property line TO building foundation ~2 ~ To existing or abandoned system on lot On adjacent lots N 0 14 'EL Cutbank ~ 0 IR ,¢-_. Water main/service line Surface water '~ LO 1,1 ~._ Driveway, parking/vehicle storage area Curtain drain '1~ 0 i//~ E. ENGINI--ER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines;in.." ~ffe/c?~on..... the¢date of_ this inspection. HAAFee$ / 7¢~-~ Date of Payment 72-026 (3/93)* Back Waiver Fee,$ Date of Payment Receipt Number COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES s,~cE,9o8 REPORT of ANALYSIS Chemlab Ref.~ t93o2913-1 Client Sample ID iL7 HANSEN/$AND LAKE Matrix ~WATER 5633 B STREET ANCHORAGE, AK 99518 TEL: (907) 562-2343 FAX: [907) 561-5301 Client Name :TOBBEN SPURKUAND, PoE. WORK Order :67415 Ordered By : Report Completed :06/24/93 Project Name ~ Collected :06/21/93 @ hrs~ Projects : Received :06/21/93 @ i3:45 hrso PWSID :UA ~echnical Director=STEPHEN C~ EDE R~leased By : - 2' Sample Remarks= SAfLP£J~ COLLECTED BY: UA. QC Allowable E×t, Anal Parameter Results Qual Mnits Method Limits Date Date Znit Nitrate-N 0,10 U mg/L EPA 353.2/300o0 10 06/23 LLH ~ See Special Instructions Above UA = Unavailab].e ~'~ See Sample Remarks A~ve NA = No't Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Le~s Than D = Secondary ~ilutiono GT = Greater Than Member of the SGS Group (Soci~tb G~nOrale de Surveillance) ENVIRONMENTAL SERVICES IN ALASKA, COLORADO UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY. SOUTH CAROLINA ' C_/AL ]'~'ST]NG & ENGINEERING CO, AK DIV CHEM1C4L & GEOLOGICAL LABORATORY TELEPHCNE (907) 562-2343 5633 B Street Anchorage, Alaska 995 ~ 8 Drinking Water Analysis Rep0d for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER E~"PRIVATE WATER SYSTEM f? Name j_ Phc~e No. M ailing Address C~y SAMPLE DATE: Mo. Day 7PE: [] Check Sample (for routine sample with lab ref. no. [] Special Purpose SAMPLE No. LOCATION 41 Stste Zip Code [] Treated Water '~eated Water Time Collected 1 :aa J I Collected By TO BE COMPLETED BY' LABORATORY Analysis shows this Water SAMPLE to be: //~Satisfactory [] Unsatisfactory [] Sample too long in transit;sample should not be over 30 hours old .at examination to indicate reliable results; Please send new sample via special d~livery mail. Date Rec~iYed t'~ '~ ~ Time Rece~ve,~ ~-- Z~ t~ 4_; Analytical Method: Membrane Filter * No. of colonies/100 mL ~ ~. ~of Ne. Result* ~3.2P~3 ~ ~ ~ , I-F-I I F-q-q Analyst BACTERIOLOGICAL WATER ANALYSIS Membrane Filter: Direct Count Verification: LSB BGB RECORD Coliform/100 mi READ INSTRUCTIONS BEFORE TNTC- - Fecal Coliform Confirmation COLLECTING SAMPLE Final Membrane Filter Results ~' Reported By ~. ~ Date Too Numerous To Count Time: OB = Other Bacteria ~SG! PART ONE OF TWO REMAINDER TO FOLLOW Coliform/100 mi a.m. porn. ,~r~ ~ DATI~R ECEIVED ~' INSPECTION APPOINTME~TS~ TIME TIME TIME DATE DATE ~ ~ /~ DATE INSPECTOR INSPECTOR I NSPECT~ MUNICIPALI~ OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT~IRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 EffiVI~O~ME~T~k S~IT~TIO~ DIVISIO~ Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be proce~ed. Please allow ten (10) days for processing, PHONE MAI LING ADDRESS PROPERTY RESIDENT {If different from above) PHONE 2. Y R M~I LING AD~R~ ~ ~ '~ - z~" / 4.~/~ALTOR/AGEN[ , / , p. ~ . .-'~ ~ [ PHONE STREET LOCATION 6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four [] Other__ J~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY J~ Three [] Six 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 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [~] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL ; DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: ~_/...~)O If Tank is homemade SOl LS RATING t give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line 1 WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS ~ APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79) Tobben Spurkland P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 Duane Hallback 3610 W 73rd ~veo Lnchorage, ~laska 99502 June 18, 1981 Legal Location Owner Residence Water Sewer Date of Test Test i~z, ocedure Test Result° Tank Absorption System Absorption Area Soil Rating Installation Date June 15, 1981 EWER ADEQUACY TEST Lot 7A, Hansen- Sand Lake S/D 3610 W 73rd Ave. Duane Hallback Two Storey, 3-Bedrooms, Single Family On Site Well ~Tom Minicipal Records 1000 gal. Sunset Plastic Trench, 9 feet of gravel 576 sq.£t. 150 Sept. 1975 System was inspected on June 9thoTank is located under concrete driveway and trench on west side of drive. 4~ cleanout to trench is dry, 4" sump has 8'-1" of water in it. Total depth of sump 12'-2". On June 15th water was added to the tank at a steady rate of 3.3 gal per min. A total of 462 gal was added without any rise in the water level in tank or sump. Tank was pumpes on June 16. The system accepted 462 gal of water without any sign o£ backup ia an~ part o£ the system. This system meets the municipsJ. Requrements for a three bedroom house DEPA~ql?dENi',.~'~ ~iEALll~ AND Ei'~ViiRONM[:NJAL P! OFECTiON June 2, 1.981 Duane/Dar2ene tIallback ;,u].0 West 73 Avenue · --" ~:~- Alaska 9u.~02 Subject: Lot 7Bt 'lA Hansen Sand ]Lake Subdivision Approval for the indiv:idual sewer and water facilities cannot be granted until the following items have been completed: (i.) The water analysis_report... . needs to .oe submitted to tn._~s office from the Chem Lab~ 5633 B St.: for our rev iowo ~-~ ..... 4 e+' submitted 2) The septic tank pumped with a ~ .... ,. ~ te this office~ 3) An adequacy test needs to be performed on the exising leaching area. This test will determine if[ the system is adequate according to National Standard. s~ A listing of private firms performing the -test is enclosed, This report needs to be submitted to this office from the engineer for our review, .~.z there are any furthe:r questions, .' "~ p.~ea~.~ call this office at 264-4720. S incer e 1 y, Robert C, Pratt~ R~S,, Associate Specialist RCP/lj w cc: National Bank of Alaska Pouch 7-025 99510 Connie YoshJmura % Dynamic Realty 'n West' ,.] ~. . Northe:i:n Lights lBl..vd. 99503 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received July 6, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 9:00 a.m. 7-8-76 Pratt Conv. l. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Peoples Bank and T~ust Pouch 7007, 99501 Duane~Hallback . (mrs) Phone: Phone: 344-7037 work) 3. Legal Description: Lot 7B Hanson Subdivision 4. Location: See directions Type of facility to be inspected Well Data: A. Type C~ ConstruCtion Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: E. Disposal Field: Distances: No, of bedrooms B. Depth D. Bacterial Analysis On-site system B. Installer 1. Size 2. Manufacturer 1. Absorption Area 2. Material Total length of lines A. Well to: Septic tank tOOl-t~ , Absorption area !~¢~ Nearest lot line , Other contamination .~ B. FOundation to septic tank , Absorption area C. Absorption area to nearest lot line Sewer Lines __ EQ.-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: 2. Property Owner: Duane Hallback Mailing Address: 3. Name of Buyer: CMRO__VA (mrs.) FHA Day Phone: CONV 344-7037 work Mailing Address: 4. Name of Lending Institution: Peoples Mailing Address: :Pouch 7007, 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: Day Phone: Bank and Trust 99510 Phone: Phone: Lot 7B Hanson Sub. Sand Lake Area Location: 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Single Family No. Bdrms. Public Utility. ,Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) 72-003(3/76) Page 2 of two p~ges - Re~-'~t for Approval of Individual Leljal Description Lot 7B Hanson Subdivision ~)r & Water Facilities Comments Approved Approval .Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I Certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74)