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MAY HEIGHTS LT 1
May Heights Lot 1 #014-311-08 May 06 22 10:19p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Department �o,_ Phone: 907-343-7904 On -Site Water & Wastewater Section \ ' Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number: 014_31108 Date of Issue: Legal Description MAY HEIGHTS Block Lot 1 Property Owner Name & Address: REWOUNSKI JEFFREY 50% & HOLT JENNIFER-TERRI 50 4150 E 88TH AVENUE ANCHORAGE, AK 99507 Pump Installation Date: os - 02 - 2022 65 Pump Intake Depth Below Top of Well Casing: feet RED JACKET Pump Manufacturer's Name: 8S 1 2 PumpModel: Pump Size: .50 hp 12 Pitless Adapter Burial Depth: feet CAMPBELL Pitless Adapter Manufacturer's Name: Pitiless Adapter Installer: Well Disinfected Upon Completion? XYes ❑ No Method of Disinfection: PELLETS Comments: Pump Installer Name: _ ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET Company- ANCHORAGE, AK 99518 907-243-0740 Mailing Address: City: State: Zip: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage It Development Services Department \ Building Safety Division On-site water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 995igm5o Page of www.d.anchorage.sk.us (907) 343.7900 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW O O PID Number. O -31 — O Mwa. Jet:RP_%jo1;n5kt Wastewater System: ❑ New j5upgrade 9150 S0i1, Ave ABSORPTION FIELD °na» wlb«a twaoae. )CD"OTnrwli OSnFnw Tnrwl paw OLIawM OOuw LEGAL DESCRIPTION Swnwra O. dPDrcl' TaW0ip0 n""° Pa°'°e O Bb4 La Suo6/yM�wn owth b P Pwbn e«n agntl Pwe GreNl Oepn 0«wM prpe FI. �p Ft Twnvq R«rpe Fa w FOalw wWo V.O. Growl Lwrpm I'Z Ft. U.S Fl. Well: Eyj5 [3 New ❑Upgrade of a wwwn ii F n 2. Ft. I Ft Cbnwolbn IFrlwle, A C) Taut GaPOrGnw b TaY FO.arPa«I one Pee itt~ii1 FI. n i-90 FitF•eto i krtm 3o3v t�+.. oworre 5uwcwr«L.wi Ft blWur 1, RPO kl Jeff W 0.ab IFe Io I2 O rwa Fwrro s« a �ro � Boa.. Gror.a TANK GPM FI. Ft SEPARATION DISTANCES 18 Septic ❑ Holding ❑ S.T.E.P. ❑ other. To Septic Absorption Lit Holding ublraPmwle •°a'F' y Fmm Tank Field station Tank sewer line anL GFI 17-5 w.P tooIF 100"t /V/A N14 1 15' u.i«w waw.acmweraa«w «1 a swrowa« Id t ID64 JV A/ LIFT STATION Laltale to + to t 'V A N A WI FwrWwn to'} to } A/ � N %] A 'Pwap an'Ywu 'qwb ar I.alw.«a«mH b b C~ D1— NA NIA A N /) "'l �(/ A /'t H.nP a.... r Ebancal MpatlmF Pw by R«neM BENCHMARK Lauwn N 0.r+po[en (` f (1 �� OM 51C In r SE. U4 COr rlen r, MYIaw 100 Ft "tti \\ Inspections performed by: LIM SDuAW0,%e Dates: tb 10111101 17' A 2nd to 22 0 _ qE• . .q 1 �C^•' �,,M •.S Nlr Development Services Department Approval G: 49 TH Conditional Approval Date: E•.:. , 1 0�,. Reviewed and approved by: � Date: I 9 \FSP, SSIN 1V�� WA TRACT B E 88TH AVENUE INSTALLED 4 -BEDROOM SEPTIC SYSTEM 1250 CAL SEPTIC TANK W/ PrDUP TRENCH LENGTH 66.5 rErT X MOM 2 TEL7 TOTAL DLP7H 10 TELT ROCK DEPTH 6 MT COVER 4 TEST SW/NC TIE'S l S -6X MMARKK I 3 BEAT B' � I Q INSTALLED 110W DhTIPTEq a 11 � ti 0 M I Q It: TN6 15 NOT A SURVEYED PLAT. EXISTING WCL P77C LOCATIONS TAKEN FROM ON -SIT£ WATER AND T£R OEPART4/GVT COCUMENTATION ALL LOCATIONS OWN ARE APPROX'.MATE. Well '�`P�� � ......... ��••��•. I° 49th I LOT 6 :............. I i :' ,'0 .::..:..:.::::........, LARS SPURKLAND•• .( f'•., NO. CE-1155000�, ?5 0 25 50 75 100 125 150 ••••,��'�T ��•` ALE, ' 50 FT - SPU203 WAND . AVE UE MAY HEIGHTS LOT 1 SEPTIC SYSTEM ASBUILT 203 W 15TH. AVENUE 907 ?79-J916 JEFF REWOLINSKI DATE. NOV. 1, 2007 (NCH. AK. .916 4150 EAST 88TH AVENUE SHEET • 213 GRID 2JJ5 PERMIT # SVO70283 PID M 014-311-08 MayHeight5LlD2.dwg TO EXISTING TRENCH Standard Trench. 2' Vide 66.5' Long 10' Deep 6.0' Sewer rock 4' Cover NO SCALE Monitor mr M7lf ORIoIW CROWD LUX= , Sit t Bar Tnv. ELEV LILY.= ou, NO GROUND WAnR 08SUM ELEV.= 87.7' 6.0 fl of Septic Rock Effective 1250 gol. septic tank NO SCALE BENCH MARK BOTTOM SIDING ASSUMED ELEVATION 100' 1203 W15tU Avel,tlrvttFClrvl, � I L 0 T I MAY HEIGHTS SID I I SEPTIC SYSTEM ASBIULT I 203 V15th AJEFF REWOLINSKI DATE: Nov. 1, 2007 Anchornge Ak 99501 279-3915 4150 L. 88TH AVE SHEET- 313 GRID- 3035 PERMIT / SWO7028J PARCEL ID / 014-311-08 FWAY01023.DWG O O W O J H 0 1250 gal Septic tank +2. o W v � y C G Standard Trench. 2' Vide 66.5' Long 10' Deep 6.0' Sewer rock 4' Cover NO SCALE Monitor mr M7lf ORIoIW CROWD LUX= , Sit t Bar Tnv. ELEV LILY.= ou, NO GROUND WAnR 08SUM ELEV.= 87.7' 6.0 fl of Septic Rock Effective 1250 gol. septic tank NO SCALE BENCH MARK BOTTOM SIDING ASSUMED ELEVATION 100' 1203 W15tU Avel,tlrvttFClrvl, � I L 0 T I MAY HEIGHTS SID I I SEPTIC SYSTEM ASBIULT I 203 V15th AJEFF REWOLINSKI DATE: Nov. 1, 2007 Anchornge Ak 99501 279-3915 4150 L. 88TH AVE SHEET- 313 GRID- 3035 PERMIT / SWO7028J PARCEL ID / 014-311-08 FWAY01023.DWG MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519 6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070283 Legal Description: MAY HEIGHTS LT 1 Design Engineer: 0007 SPURKLAND ENGINEERING Owner Name: JEFF REWOLINSKI Owner Address: 4150 E. 88TH AVE ANCHORAGE. AK 99516 - Date Issued: Oct 15, 2007 Expiration Date: Oct 14, 2008 Parcel ID: 014-311-08 Site Address: 004150 ABBOTT LOOP RD Lot Size: 23660 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. ❑✓ Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 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 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. Issued By: Date: 10 is, q i Municipality of Anchorage • �-� Development Services Department Building Safety Division ' On -Site Water and Wastewater Program!� 4700 Bragaw Street ''' P.O. Box 196650 Anchorage, Alaska 99519.6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. Property owner(s) Jeff Rewolinski Day phone 272.9613 Mailing address 4150 E. 86th Ave.. Mctarage, AK Zip Code 99516 Site address Same Zip Code Legal description (Sub'd., Block & Lot) May Heights Lot 1 Legal description (Township, Range & Section) Lot Size__! 2- �D�oQ Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field 0 Septic Tank F±1 Holding Tank 0 Privy 0 Private Well 0 Water Storage 0 Number of Bedrooms 4 THIS APPLICATION IS AN: Initial Upgrade ll Renewal El certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature owner or authorized agent) Permiumush Fee: Date of Payment: Receipt Number. (Rev. 11N5) Waiver Fees: Date of Payment: Receipt Number: r, Environmental Consulting and Design �L SEPTIC SYSTEM DESIGN May Heights Lot 1 Municipality of Anchorage Development Services Department October 3, 2007 On Site Water and Wastewater Program 4700 South Dragaw Street Anchorage, Alaska 99519 Subject: Well & Septic Permit 4150 East 88i6 Avenue Ladies and Gentlemen: 1 am writing to request a permit for the construction of a new septic system for the above referenced property. The Proposed system will serve a 4 -bedroom single-family residence. The lot was developed in the late '70s the original absorption field was replaced in 1986 and this field is in a state of failure. This septic tank will be abandoned per MOA code requirements. The existing drain field will be left in place and a divertcr will be installed. . System: A 1250 gallon septic tank with a deep trench absorption field. The absorption field will be 65 feet long and contain 6 feet of sewer rock. Soils: A test hole was excavated on September 13, 2007. See the attached soil logs. Ground water was monitored for through September 21, 2007. Ground water was not observed. Surface Water: There are no surface waters within 100 feet of either the proposed septic system area or the reserve site. Topography: The average topography in the area slope to the west between 3 and 100/.. Waivers: No waivers are required. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding andfor concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, 4 Lars Spurkland, P.E. Civil Engineer 203 West 15t" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net - Environmental Consulting and Design SEPTIC SYSTEM DESIGN MAY HEIGHTS LOT 1 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 October 1, 2007 We are submitting an application for the upgrade of septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). A soil log and percolation tests of the applicable test hole is also enclosed. The septic system design is based on the following : No Ground Water Encountered to a Depth of 16 Feet Soil Rating. From Testholc 05/16/05. 9.4 min/in = 0.8 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 15010.8 -187.5 sq.ft. Total area required: 187.5 x 4 - 750 sqft Bottom Rock At 10 feet Top Rock At 4 feet Rock Depth 6 feet Total Bed Length 750 /12= 62.5 feet USE 65 FEET SYSTEM CONFIGURATION 1250 GALLON SEPTIC TANK W/ DEEP TRENCH TOTAL LENGTH 65 FT TOTAL WIDTH 2 FT TOTAL DEPTH 10 IT ROCK DEPTH 6 FT COVER 4 FT(MIN) 203 Nest 15t' Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland`( gci.net PWell7tkj� I TRACT B I I I EAST I OT 6 TAT , I I �P III I I NOTE• mn a nn/ A sURvcrcO Pur. WEu t SEPTIC LOCAIlOAS TAKCN fiPgV AV -SITE WA/FR AND WASTE WATER DEPARIYEM O0CUYENTA1pN. AI! [OCATlONS SWWN ARE APPROXWATE. 50 0 SO 100 150 200 250 OW SCALD i' = 100 FT, 103 W 15TH. 4150 EAST 887*H AVENUE SV070XXX Pilo # DATE OCT. 1, 1007 SHEET • 1/3 CR/D: 2335 -- _- _-TRACT B- -_ --� f 88TH AVENUE 1NsrALc 4-8(DROom s(Pnc srsT(w 1230 CAL S(PAC TANK W/ 60' NIPntCHCN [(NCTN 63 f((T WN 2 f(fT TOTAL D(Pn/ 10 f((T ROCK DEPTH 6 f((T COM 4 M7 I I I I u I I I *,SL I SL I '- el O� i ' I q� I �Q LOT i I I I o a, I A84V� (xlSTINC TANK � ti WTALL TZOW DIVERT(,? well �?-x I III I ............. I I I •.• LOT 6 Well - ; 49th , ..............r.... ... t....y •LAR S SPURKNZ I n 0 25 50 75 100 125 150 ••!1 0' • SCAtF, I' 'URKLAND ENGINEERING 13 W 15TH. AVENUE MAY HEIGHTS LOT 1 SfPT/C SYSTEM DES/ON ICH. AK. 99501 J£ff REWOLINSKI DATE OCT. 1, ?007 07 279-3916 X150 EAST 88TH AVENUE SHffT 1/3 CR/D: ?335 WHIT k PID # ° ° -o N y ° 0 1250 gat Septic tank o e e a � v v '' o a C s Standard Trench: Sit t 6.0 Ft of Effective 2' Vide 65' Long 10' Deep 6.0' Sewer rock •�u Jf.IILL 203 WISth Ave LOT 1 MAY HEIGHTS S/D SEPTIC SYSTEM DESIGN Anchorage Ak 99501 JEFF REWOUNSKI DATE - ?79 -'+916 JISO f ARM Ivr OCT 3, 2007 SHEET i/T GRID on PARCEL ID FWAY0102J DWG Municipality of Anchorage ZE rtv s. `%\ Development Services Department �Q ✓ .''k I Building Safety DMsion _ • -� On -Site Water and Wastewater Program ; G7.49TH `�j . '•• + 4700 South Bragaw St. P.O. Box 198650 Anchorage, AK 9951943650 of Www dWww anr�jp, III, us ol . (_=. '!✓`TJ (907)343.7904 L" K* K*✓ Soils Log - Percolation Test ('r A 1 F Performed For: JZtt Ft�JDI'H,i k; ...... I Legal Description: _,.....Date uyg{,}S L, to i' 1 Date Performed: Township, Range, Section: Depth Silt,.) La+n (P1l) 10- .Jz1 j SIItI 11- Dense N:f� 12- 13 - WAS GROUND WATER ENCOUNTERED? 4/0 8 IF YES. AT WH4T DEPTH? L Depth Oo Water Albr 0 Monitoring? P E Come: % 21 0 t4 Reading Date Gross Time Net Tune Depth to Water Net Drop 15 9 /3 0 INS PM 0 16- q " 17. I i': 55 Pot 10 /t(o' b 2'05 PM zo �: I5/t ln" 1 t/rGall 18- 7 6 /t3 2-115 PM )o >~:, l0'!EIt f 2/14 t 19- 8 Ifo 'Z•25 20-r 17181, t, PM 40 e 6116f 3/(r" 2135 PM 7�8" ►'/ '' if. tt 2t1S PM Co nin f'l16't COMMENTS BA Soi�S(� LATI PERCOLATION 0N RATE of. I (..All& li) TESTRUNBETWEEN—.FT AND w FERC HOLE DIAMETER (p FT PERFORMED BY: L'tAS S ✓ILIr,,,A I PERFORMED IN ACCORDANS µ„Tv CERTIFY THAT THIS TEST WAS iH ALL STATE AND MUNICIPAL IDELI E IN EFFECT ON THIS DATE. DATE: E if AS Jeffrey Rewolinski and Jennifer -Terri Holt 4150 East 88th Avenue Anchorage, AK 99507 Lot 1 May Heights We the homeowners will be onsite and performing the labor required to install a septic system, per the design of Lars Spurkland with Spurkland Engineering. We will be borrowing a backhoe from our neighbor Pat Crabb. Jennifer has been working with construction equipment, has acquired the knowledge of plumping materials and installation, and has worked side-by-side with plumbers as a Mechanical Pipe Insulator for the past 7 years. I also have several years experience working with and installing plumbing material both at work and home and have the general knowledge of installing a septic system having witnessed the installation of a wastewater system at my parent's residence. Jennifer -Terri Holt Consulfin Environmental g and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: May Heights Lot 1 Date: October 3, 2007 General: 1. The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached MOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will Inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the project includes the procurement and installation of a 4 -bedroom on- site wastewater disposal system at the location depicted on the attached site plan drawings. The scope of the work also includes the installation of a new 1250 gallon septic tank, a drainfield comprised of 1 trenches,2-feet wide x 65 -feet long, 10 feet deep, with 6 feet of septic rock below the distribution piping. The location of the drain field is shown on the attached site plan drawings. The total depth of the field will be 10 feet below the existing ground surface. All components of the proposed septic system must be constructed a minimum of 100 feet from any surface water or water wells in the area. A minimum of 4 feet of earthen cover is required over the septic tank and a minimum of two feet of cover is required over the drain field. In addition to the required earthen cover, 2 -inch thick, 40 psi, direct bury board foam shall be installed directly over all installed piping. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of ball material. The property owner is also responsible for vegetation of all areas disturbed by septic system Installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners Installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 7. The contractor shall ensure that ALL materials being used are In compliance with the most current guidelines established by the Municipality of Anchorage. Refer to 203 West 15ib Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCgei.net �C Environmental Consulting and Design .A "Standards and Specifications for Component Parts and Materials Used in the Construction of On-site Wastewater Disposal Systems , Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. Septic Tank Installation: 1. A new septic tank, of the size specified in the design drawings, shall be procured from a qualified manufacture/supplier If the existing septic tank is found to be defective. Construction shall include two 4" diameter cleanouts for pumping access. 2. The burial rating of the tank shall be adequate for the actual burial depth encountered. 3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 4. All standpipes on the tank shall extend a minimum of 121nches above the final grade. S. Tanks installed with less than 4 feet of cover shall be insulated. 6. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval is obtained from the engineer. 7. The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be sufficiently compacted to prevent future settlement of the soil. 8. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings. 9. A cleanout shall be installed 1 to 4 feet from the foundation. 10. Post tank cleanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. 12. The tank backfill shall be graded sufficlently to ensure positive drainage away from the tank. 13. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and Inspections must be obtained where required by the MOA. 15. The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from any residential water well, 150' from any class'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. 16. The contractor shall remove or abandon the existing tank in compliance with the Uniform Plumbing Code. Drainfield Construction: 1. The drain field shall be excavated to the dimensions outlined in the design drawings. If any discrepancies are noted, contact the engineer immediately for clarification. 2. The drain field shall be installed parallel to slope contours. 203 West 151h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCagci.net ~ e Environmental Consulting and Design 3. The bottom of the drain field shall be within 2" of level. If the sidewalls or bottom of the excavation become smeared, they must be raked or scarified prior to the placement of filter sand or drain rock. 4. The drain field must be a minimum of 5 feet from the test hole excavation. S. Distribution pipe is to be installed level with perforations facing downward, atop a level bed of drain field rock. Septic rock shall then be placed atop the distribution piping to provide a minimum of 2" of cover, level across the entire width and length of the trench, above the piping. 6. A silt barrier must be installed at between the final drain rock and the native soil backfill. The silt barrier shall cover the entire drain rock surface. 7. Monitor tubes must be 4" in diameter, installed in the locations depicted on the design drawings, and extend a minimum of 12" above final grade. The portion of the monitoring tube below the septic rock must be perforated and the portion above the drain rock shall be solid. 8. Backfill over the final gravel layer must not be less than 2 feet. Insulation must be installed when the ball depth is less than 3 feet. 9. Drain field back fill shall be mounded to prevent depressions from forming due to subsequent settlement of backfill material. 10. The contractor shall verify that the drain field is a minimum of 100 feet from any residential water well, 150' from any dans'C well and 200 feet from any community Inspections: water wells. Additional separation distances must also be maintained. 1. A minimum of two inspections are required by the Municipality of Anchorage. These inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. 2. The first inspection must be conducted after the excavation of the drain field and before the placement of any gravel. The septic tank may be set in place, but may not be backfilled. 3. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any backfill. 4. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use in preparing the record drawings. S. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 West 15" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCa gci.nct MUNICIPALITY OF ANCHORAGE_ DElt _ATMENT OF HEALTH AND HUMAN SERB. - ES Environttjental Health Division 825 "L" Street, Anchorag, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name l0 I"rIGLL�IP DISTANCES TO FROM SEPTIC TANK ABSORPTION FIELD WELL Address / Phone ls Permit No. �N,,fms u/ks WELL /p p .t x4 LOT LINE LEGAL DESCRIPTION Lot Block// ilt Subdivision + ' _ / FOUNDATION Township, Range, Section AS -BUILT DIAGRAM driveway, water bodies, (Show location of well, etc.) septic system. property lines, foundation, TANKS ❑ SEPTIC ❑ HOLDING Manwacturer Capacity in gallons ri •� Material of Com No. partments r TYPE OF SYSTEM ''TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from / original grade FT Total depth from original grade FT FT `� o, FII addetl above ongrade FT Gravel depth beneath pipe pip_gmal 9 FT t 7� r .r/' S 1 d k, Greccl lenlh_ �j FT Gravel width / �•� FT Total absorption area ✓l 9'Z�—Si SQ FT Distance between lines W14 FT �� Number of Ii nes Sod rating r/ SO FT Pipe material If L -gr •- t, -:i7-9 .%ur,4 •- b�U34 Installer s,111147- deW5 7- Date Installed % ll✓ WELLS PRIVATE ❑ OTHER (Identify) •r Classihcahon (A, B,C) Total Depth dTasedC to FT Insb liel Date Installed. 1 REMARKS: opodho /0%R�i1 'r -1W . wSe &k 15'r1W& sere r', 10*1AfA1 0911511A40- aj Scale: •TS ENGINEER'S SEAL Inspections Performed by. / Date: inspection was performed according to all Date. — I ' "� r_ certil/y that this Municipal and Stale guidelines in effect on this date: Health Department Approval: �'v �� `__ '�li L 72-013 (3/85) evlLli-d ll: lt'i €_ 1 I -`t Ill Ar4CHURIABE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 1. STREET, ANCHORAGE, AY 995(-11 164-4710 OSI—S I E SEWER PER11I l PERMIT NO: 960185 DATE ISSUED; 86720196 ax� e API'L1CAMf; DAVID HILLER ADORES G' 4154 E88 AVE ANCHORAGE, AK 99507 CONTACT PHUIJL: 549-5(-89 LEGAL i}ESCRIP; SUBDIVISION: MAY HTS. LOT; I BLOCK: N/A SECTION; 9 1ONNSHiP: 12N RANGE; 31 LOT SIZE: .5A (80.,F1. OR ACRES)) IMAX BEDROOMS; Listed below are Lhe options available to you in designing your septic system. Choose the option that best fits your site. ;* GRAVEL LENGTH ; 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) TANK MUST HAVE AT LEAST T110 COMPARTIIENIS 1 1..ertif, that; 1. f am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchoraq_e (MDA) and the State of Alaska. 2. I will install the system in accordance with all HOA codes and regulations, and in compliance with the design criteria of this permit. 1 will adhere to all VGA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerailn system on this or any adjacent or nearby lot, 4. 1 understand that this permit is valid for a maximun of 3 bedrooms and any eniargeoient will require an additional permit. ]P A I.Irr STATIGN 13 IIdSTALI.ED [11 AN AREA COVERED BY VOA BUILDING CODES, THEN (1) AH ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-DUILT5 1101 BE APPROVED M1IHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL IJORK 111161 BE DOME BY A LICENSED ELECTRICIAN, SIGNED �� �� �` l DATE; APPLICANT: DAVID MILLER; ISSUED BY DATE; 1 l7lFw Z;;t�5 GY Seeo;,VlC ; 4e ley z l RE1'4C1-1 BED We DRATld DEPTH T8 PIPE 11LTTOII (FT.) 4.0 5.0 4.0 GRAVEL DEPTH (FT.) 9.0 0.5 3.5 TOTAL DEPTH 1Ff.) 13.0 5.5 7.5 GRAVEL WIDTH (FT.) 2.5 24.0 5.0 GRAVEL LENGTH IFT.) 46,0 410.0 89.0 dlOfe GRAVEL VOLUTE (CU.YDS.) 40.5 4019 66.0 TANK SITE (GALS) 11000.0 to 15000.0 1,000.0 * SOIL RATING (3Q,Ff./BR) 175 242 275 ;* GRAVEL LENGTH ; 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) TANK MUST HAVE AT LEAST T110 COMPARTIIENIS 1 1..ertif, that; 1. f am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchoraq_e (MDA) and the State of Alaska. 2. I will install the system in accordance with all HOA codes and regulations, and in compliance with the design criteria of this permit. 1 will adhere to all VGA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerailn system on this or any adjacent or nearby lot, 4. 1 understand that this permit is valid for a maximun of 3 bedrooms and any eniargeoient will require an additional permit. ]P A I.Irr STATIGN 13 IIdSTALI.ED [11 AN AREA COVERED BY VOA BUILDING CODES, THEN (1) AH ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-DUILT5 1101 BE APPROVED M1IHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL IJORK 111161 BE DOME BY A LICENSED ELECTRICIAN, SIGNED �� �� �` l DATE; APPLICANT: DAVID MILLER; ISSUED BY DATE; 1 l7lFw Z;;t�5 GY Seeo;,VlC ; 4e ley z [ENGINEER'S o Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST A PERFORMED FOR: DATE PERFORMED: (!J'7 '4"' LEGAL DESCRIPTION:/—d7—/ %ze ol� 19AI /,l Ts" Township, Range, Section: SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS L WAS GROUND WATER �� ENCOUNTERED? Z) IF YES, AT WHAT L DEPTH? O P E Oeplh to Water After Monitoring? kI0 gate: Reading Date Gross Time Net Time Depth to Water Net Drop a s .43'7 0) 70 sF3 /6, bl .o 3 Q s , (J ff / 0 /o AI 10re o�, �7= % <i PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETW EN FT AND �%1� FT PERFORMED BY:CS 2�51_— dG� If. i'JIcAI lam --CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) ALASKA ENVIRONM°NTAL CONTROL SERVIC. INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 DD !� i SHEET NO. OF CALCULATED BY DATE CHECKED BY SCALE / DATE I. nor A" MUNICIPALITY OF ANCHORAGF He -h and Environmental Prot. ion Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LING CONST. MAILING ADDRESS _/!a5 v`AN 6 PHONE 33 7- 6 310 LOCATION ��DTrLoDP RD LEGAL DESCRIPTION _1 1 1104Y A47-$, S/P SEPTIC TANK: DISTANCE i FROM WELL �CI� } _ MANUFACTURER CtREEQ MATERIAL ,STEEL NUMBER OF COMPARTMENTS 2 - INSIDE LENGTH__ INSIDE WIDTH___ LIQUID DEPTH LIQUID CAPACITY /O"O GALLONS. TILE DRAIN FIELD: TOTAL LENGTH le 11 DISTANCE FROM WELL 04P- '_FOUNDATION 3Z _NEAREST LOT LINE-__ /D ---'-OF LINE 39 1N # of Lines _- DISTANCE BETWEEN LINES � TRENCH WIDTH36 TOTAL EFFECTIVE ABSORPTION AREA _-380 SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER FT DEPTH: TOP OF TILE l -O FINISH GRADE MATERIAL BENEATH TILE— -5"V. ABOVE TILE 2- IN. SEEPAGE PIT: DIAMETER OR WIDTH _, LENGTH_, DEPTH Log Crib _Rings_ Crib Size: DIAMETER --DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_., NEAREST LOT LINE _ ABSORPTION AREA (WALL AREA) SQ. FT. Well Class: (WD • Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: PJ44ZEE� # of. Bedrooms: 3 Installer: Remarks: DATE `Y/12,/7V6 APPROVED I- I . I IT S4 r �- T -T- DATE `Y/12,/7V6 APPROVED " - x 0 . "11 WD p 11 a V40 &A � if i,-;! i III 1 ! F:: i 11, ! 1 ; k! 1 Fl! I&MARA 1131..; 0K.� " I. S A 10 F.. H A CONT. !.-11. :!' AW: I I: A (y t -111 "19 Wof AlAnIn t? M S 41 sp F I � ol 1 ()F- :,. SAIL ow lavolumn) sin or aw son, [03".. - , P: -.% rii;, i�, 1- ", 0 1! .11 :; -: : I, , it -:11 R .. TK 14 p Q 4- k -1 .. in ?Q RE Gy R- y X voo 02 071 07 l 47 Vwxi II A oil &A n h) - . (1 . F"IMMI F AF" MADRIFF HAS, pjEj: 11'1' 'T0 HAMM IMS DEASIVAIRIF DUNIM THI-� 111511j AU , PIT I cnq 1 "psmor 1 WAS W7 !:i:: fOwfumn ro ISIS FROFUTH MY RE- , 0F" FREMIMACES THAT T -FRT WELL WMA 'SERVE.. . ....... . . .. 1:1 RIO K Fit E41 wv'�! -111-,.q :ic r", I d. I L. L. :1 PA G 010 ANS, VASTErl 5411how F MAL. INSFACA1044 AM PAMORMPH, BY TATS DETYRTpuy, WILL FIT j1! III IS p"? 0 -0 X A- REI -14"o, X o"TH40 V2422 " .... RK F I. 'u, R.-. I, r+,'T J. . ", :ll I::�5 I SOILS LOG I -)yPerformed for LtAA':" <0\SAN xk,,� ate Location �5' Vicst J e-. LVV.' "r - n foci 1 5 AJ. LkM� 0 2 4 6 16 18 20 Soil Type Water. Level Remarks UJ CONSULTING GEOLOGIST BOX 476-M, STAR ROUTE A - ANCHORAGE, ALASKA 99507 - PHONE 344-7071 SOILS LOG I -)yPerformed for LtAA':" <0\SAN xk,,� ate Location �5' Vicst J e-. LVV.' "r - n foci 1 5 AJ. LkM� 0 2 4 6 16 18 20 Soil Type Water. Level Remarks Total Depth of Excavation /Material laterial at Total Depth Groundwater ( ) Not Reached Depth, if Reached (/) (5e -e- ve-wS) Classification Method �i s u a 1 Sieve Analysis Bedrock ot Reached Depth, if Reached Gary F. Player, Consulting Geologist UJ S -A e\Aj Total Depth of Excavation /Material laterial at Total Depth Groundwater ( ) Not Reached Depth, if Reached (/) (5e -e- ve-wS) Classification Method �i s u a 1 Sieve Analysis Bedrock ot Reached Depth, if Reached Gary F. Player, Consulting Geologist Depth of well ` `Cr� ft. Casing: depth `1� ft. diam. ((� �i(n... Static water ravel lV�_ it. (g § , below) land surface. DateLl-�V� ) !8 Finish of well: CEn-en screen, perforated, open -hole, other) Describe intervals and size: t Well yield tested by (pumping, ailin air) at C/20 gal/min. Ior�hours withNDft. of drawdown from static level. DRILLER'S MATERIAL LOG Depth he low land surface in feet CONSTRUCTION LOG Give (size of material, U� n� %c (� �W1ELL Drilling r f':Ej D l 1 -� USGS no. jt1� Date well completed Nearest communi t Location sketch or remarks (��e�-ror'tG1 ``IICoAl Driller!ik` nl on L 11k)l od Type of rig\ lAJll1�- I�l We I I owner ��l ll'� C(DIn ciWA Well (address & legal description) e6a"_ - / ; L4r Dl� Depth of well ` `Cr� ft. Casing: depth `1� ft. diam. ((� �i(n... Static water ravel lV�_ it. (g § , below) land surface. DateLl-�V� ) !8 Finish of well: CEn-en screen, perforated, open -hole, other) Describe intervals and size: t Well yield tested by (pumping, ailin air) at C/20 gal/min. Ior�hours withNDft. of drawdown from static level. DRILLER'S MATERIAL LOG Depth he low land surface in feet Give (size of material, description of strata penetrated color, hardness of drilling, and water content) t o 2) r wR CA) c(R o U J1 1 C Lt e 41-D to ho to �Yt`-d b«Xs) ��.�idl ` M to 111 1 � I&A Ie c "ate ` c h ccs 1 c °� td cl'_`i to oto -to- t to to to iz a to to to �Mcip —to to to `�r' to to a �f i to to to CMunicipality of Anchorage Development Services Department r" Building Safety Division s On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 014-311-08 HAA# C)LI ®QJ'�' 1. GENERAL INFORMATION Expiration Date: I / — 2 G — O Complete legal description k -j5 _-VtT Lcop W606. Location (site address or directions) 4150-E-88itr-k� * ANCHORAGE. AK 99507 Current Property owner(s) DAVID MILLER Day phone 349-5789 Mailing address Lending agency Mailing address 4150 E. 88th AVENUE * ANCHORAGE AK 99507 Day phone Real Estate Agent LARRY LINDSTAM W/ DYNAMIC PROPERTIES Day phone Mailing address 3111 C STREET * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: 261-7600 TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name ,JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for �? bedrooms. Disapproved. Phone 337-6179 Iii r Date Conditional approval for bedrooms, with the fllowing stipulations: Attachments: HAA Checklist f/ Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other By: �� &l �jp c/ Original Certificate Date: 8 (Rev. 12101) WATER AND : R' iWASTEWATER PROGRAM /NNT SE�1e municipality OT Ancnora, e Development ServII_c.As.,,Departm6ht' Building'Safety Division On -Site Water& Wastewater WINDOW " Was a Cycles tested_ rru Man o(, � c IP in. High water alarm level at in. 9 : )LDiNG`7 � t Jn p4 line Meets alarm & circuit requirements? sewer 1 r Receipt Number - �r p onsan d * 9. ..................... are in this date 'w ..; :..arn Q eff y. s, at s ESS pp C 795 odd r. r nd Prof uaelof� a� Receipt Number - July 27, 2004 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System for May Heights, Lot 1. To whom it may concern: We request that your department issue a 5 -foot lot line waiver from the east property line to the existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic ystems. If you have any questions, please contact us at 337-6179. Thank you for your assistaice. P.E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com Municipality of Anchorage �� -"' P.O. Box 196650 • Anchoragc Kaska 99519-66,50 • Tcle phone (907) ,343-8301 • raa (907).343-W20047001 r iy w Stre, t • An hor gc, Alaska 99507 wmv.mtmi.org Mayor Mark Begich Building Safety Division 26 August 2004 Gayness Engineering Group, Ltd. 3701 E. Tudor Road Suite 101 Anchorage, AK 99507 Subject: Waiver Request for May Heights Lot 01 Waiver Request #WR040059 Parcel ID #014-311-08 Dear Mr. Garness Your request for a waiver of the required 10 feet from the Absorption Field to the Property Line is approved. The approved separation distance is 5 feet. This waiver approval applies to the existing Absorption Field to Property Line separations only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Je f Poet Engineering Tech On -Site Water & Wastewater Program Community, Security, Prosperity 07-14-04 02:59PM FROM-CT&E ESI, SGS ENV SERVICES SG9- SGS RK# 1043947001 Client Name Garness Engineering Group, Ltd. Project Name/# 4150 F. 88th/Lot 1, May Hts Client Sample 1D 4150 E. 88th/Lot 1, May Hts Matrix Drinking Water Sample Remarks: 9075615301 T-066 P.02/03 F-178 Laboratory Analysis Report All Dates/Times are Alaska Standard Time Printed Date/Time 07/13/2004 11:19 Collected DatelTime 07/07/2004 9:40 Received Date/time 07/08/2004 7:54 Technical Director/fie en C. Ede ..:. ....;Allowable Prep Analysis ppm. Results PQL Units Method Container ID Limits Date Date Inn Waters Department Nitral 3.27 Microbiology Laboratory Total Coliform 0 0.100 mg/L EPA 300.0 E (<=10) colliOOmL SM209222a A (<=1) 07/08/04 33$ 07/08/04 DKC Laporatory Owision 206 West Potter Drive, Anchorage AK 99518-1665 1)907) 5G2 2343 119671561, 5301 www sgserivironmentaLcom "' " Merrill or the SGS GraplSociucO Ghnerele do ShceOilnm+e) `t O LTJ O O ZvI O r - O N EAST 88TH AVENUE IN b J7 DJ UU" W 14u.ui i I 3 � c 4 tR .. s'ED ...._ SINGLE FAMILY FRAME HOUSE N 89?59'59"W 140.00' GI m, ✓) lA! E3 F_ Q ED �7 ED a t}9TH 9 .................. SHANE A. HOLT 0 �sn LS -6914 �P SJ AS -BUILT SURVEY ( NO CORNERS SET THIS DATE } 1"=30' I HERESY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWINC DESCRIBED PROPERTY, LOT 1, MAY HEIGHTS SUB. EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS. AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL kI'H?N THE�PROPERTY�L?NES FND NO VI51DLe' STRUCTURES OR FENCEUNES. ENCROACHMENTS EXIST OTHER THAN NOTED. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PIAT, ARE NOT SHOWN HEREON.(UNLESS INDIC klW,CD AT ANCHORAGE, ALASKA THIS --:9TH-- NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LIN ADAY OF --JULY ------- 2004_ . -10,.T LAND SURVEYING Wn, FB 113-54 OR LOCATE STRUCTURES. TEL. 345-5513 ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW. CONDITIONS. .y o DECK i S K S 3 � I 2 i 1 N 89?59'59"W 140.00' GI m, ✓) lA! E3 F_ Q ED �7 ED a t}9TH 9 .................. SHANE A. HOLT 0 �sn LS -6914 �P SJ AS -BUILT SURVEY ( NO CORNERS SET THIS DATE } 1"=30' I HERESY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWINC DESCRIBED PROPERTY, LOT 1, MAY HEIGHTS SUB. EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS. AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL kI'H?N THE�PROPERTY�L?NES FND NO VI51DLe' STRUCTURES OR FENCEUNES. ENCROACHMENTS EXIST OTHER THAN NOTED. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PIAT, ARE NOT SHOWN HEREON.(UNLESS INDIC klW,CD AT ANCHORAGE, ALASKA THIS --:9TH-- NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LIN ADAY OF --JULY ------- 2004_ . -10,.T LAND SURVEYING Wn, FB 113-54 OR LOCATE STRUCTURES. TEL. 345-5513 ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW. CONDITIONS. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L 1 AA/4V ifF_iGty7' (l2/l P"SW -S66.`/ Location (address or directions) 1-rll alb e 8 e'l Ayj:_ (b) Applicant Name /V)1,1-r::A Telephone: Home'Sl�q p�sBusiness X41"100& Applicant Address �♦� Q F R8 �a 11yE &/Vi5 ' /+�I�/, / 7�g®7 (c) Applicant is (check one): Lending Institution El ; Owner/builderR'; Buyer ® ; Other ® (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family g Multi -Family 0 Other Number of Bedrooms 3. WATER SUPPLY Individual Well 19 CommunityEl Public Telephone Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. I ` 4. SEWAGE DISPOSAL OnsiteA Public 0 Community 13 Holding Tank 11 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) 5. ENGINEERING FIRM PROVIDi}vG INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 1.1 As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date Telephone 1�i61/6) Engineer's Seal a °Z� OF A4"` Q DHEP APPROVAL Approved for L��! bedrooms b� Date Approved Disapproved Conditional Terms of Conditional Approval i 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 72-025 (11/84) fv1UNICIPPALITY OF ANCHORArii DEPT, OF FIEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONiVtENTAL P OTU N HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST -FEBRUARY 1984 �`••��=' ��� 264-4720 Legal Description: L/ mh 2I�%r�,(EAv1i ll) -r12_ Al R, 3io A. WELL DATA Well Classification N(I%#tE If A, B, C, D.E.C. Approved (Y/N) A11A Well Log Present&N) Date Completed y%13/7g Yield S. zQ !6 PM Total Depth 71 Cased to � Depth of Grouting A/ Static Water Level 6q,8" ` Pump Set At 70 Casing Height Above Ground — 2-a % Sanitary Seal on Casing (VIN) Electrical Wiring in Conduit &N) Depression Around Wellhead (Ye Separation Distances from Well: To Septic/Holding Tank on Lot 105 �+ ; On Adjoining Lots t 00 To Nearest Edge of Absorption Field on Lot i2� ; On Adjoining Lots /00" To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot N Water Sample Collected by -� FFE 01'fCNuCA ; Date Water Sample Test Results SAUsFAcrokY Comments .* PF/'�WFLL FLOrU ?'aG5r �&'6���6 B. SEPTIC/HOLDING TANK DATA Date Installed .�lZ� Size %Od0 No. of Compartments Z Standpipes &N) Air -tight Caps 9/N) Foundation Cleanou &N) Depression over Tank (Y1 Date Last Pumped Pumping/Maintenance Contract on File (Y/N) A/�x� ; for &M Holding Tank High -Water Alarm (Y/N) N1 1A Temporary Holding Tank Permit (Y/N) A Separation Distances from Septic/Holding Tank: To Water -Supply Well 1051`4' To Building Foundation, 20' t i To Property Line Z© r4 To Disposal Field -35 To Water Main/Service Line NAA To Stream, Pond, Lake, or Major Drainage Course �d� �-1— Comments 72-026(11/84) 1-1 mfiv HE16Hrs C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 71�5_ Type of System Design T6 Date Installed _�%!f 16ro Length of Field yro i Width of Field Depth of Field 13 Gravel Bed Thickness 9' Square Feet of Absorption Area 9 28 Standpipes Present ON) Depression over Field (Y/9 Date of Last Adequacy Test 41A Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply 126 Pp Y Well To Property Line 1 To Building Foundation s8 To Existing or Abandoned System on i Lot On Adjoining Lots _ %S 't To Water Main/Service Line��A To Cutbank (if present) W -A To Stream/Pond/Lake/or Major Drainage Course i� t017 To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access ) "Pump On" Level at "Pump f" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I h qcdrrifle , or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ✓ Date �% T Company C �A C. MOA No. 916 �OZ� Receipt No. 400 i -at)) 1 Date of Payment —g -26-1(p Amount: $ �t,�' t�R••��'ngin ••,�St� FrrACWOC-NT.s 1 wA541. ,oG �� .. o # 2, WATER 3NO19M Page 2 of 2 �•r..•••••• •• . . • 0:3 PUMQrnL16 REcF"Pr e 72-026 (11/84)-2261 0q 5l TE PGoqA/ ��� ,_••***go*. 60464 ALASKA b iOlnOnMenTAL COnTnOL SCi)jUS, InC. 6ngineerinq & enuironmentol Studies 8/28/86 DAVE MILLER SELLER-- DAVE MILLER t150 EAST 88TII 4150 EAST 88TH ANCHORAGE ALASKA ANCHORAGE ALASKA 99507 99507 I:EGAT,:MAY HFTGHTS BLOCK 0 LOT 1 FLOW TEST ON WELL WELL FLOW DATE --8/26/86 A FLOW TEST WAS PERFORMED ON THE WELL. 988 GALLONS OF WATER WAS PUMPED AT A RATE OF 8.216 GPM OVER A DURATION OF 2 HOURS. THE DRAWDOWN WAS .2 ' WITH A RECOVERY TIME OF 1 MINUTES AND THE STATIC WATER LEVEL WAS 64.8 FEET. TIIE WELL TS ADEQUATE FOR THIS 3 BEDROOM HOME. 0 A44%4 • . .VN �e�e aeoe slseseeeeeese seem 4 e m e C. REID, JR. � �® CE - 2251 / ® 1 ••a e•e• �,Ar •e sees eoe t'�tl� 1200 Wes[ 33rd Auenue, Suite B • Anchoroge, Alaska 99503 • (907) 561-5040 DIOANI ss311409ad:) ALASKA ENVIRONMENTAL /J CONTROL SERVIC INC. 1 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 jDB L! MAY ft SHEET NO. -J OF /J CALCULATED BY DATE d CHECKED BY DATE r //� SCALE D