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HIGHLAND TERRACE LT 3
F_ Municipality of Anchorage Page I of a DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 O Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: 050S1a07 Name: C ALANWastewater CARL.✓=NC J�'61'l-"AIr�1 Cy System: El New f�pgrade Address: 'EA('LE fZIVL loql-19 Hiatt -B-orr b2• AV. 995]7 ABSORPTION FIELD Phone: No. of Bedrooms: 3 L`1 ueep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: a- Total Depth from original grade: a r I • GPD/Sq. Ft. I Lot: Block: Subdivlsio-n�q: Depth to pipe bottom from original grade: Gravel depth beneath pipe S— flI(,HLAN O rufQ(?A"-f 'pj1 Ft. Ft. Township: _ Range: Section: �- Fill added above original grade: 1 Gravel length: q I 61- O. 5 -- 7 Ft. WELL New ❑Upgrade �Ft. Gravel width: a S r Number of lines: I Distance between lines: �<ISTIN Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ASi'w\ IP(;_>1VATE Ft. Ft. Ll1 olI SO. Ft. F010 /T_ -)303q Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. Yield: Pump Set at: Casing Height Above Ground: TANK GPM FL Ft. _ SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Litt Holding Public/Private Manufacturer: Capacity in gallons: IJ00 From Tank Field Station Tank Sewer Lines - Well 15 Qi Ib51 — 1 oZ� Y Material: ST��L Number of Compartments: E Surfac Ioo1+ Ic)ol•4- _— — — LIFT STATION Water Lot1 I Size in gallons: Manufacturer: Line a 7 I $ _ Foundation (01 -7 0 1 �- "Pump on" level at: "Pump High water alarm at: Curtain Nc�tJ KrJ t�N Pump Make &Model H rical Inspections performed by: Drain v BENCH MARK Remarks: Location and Description: t2'0Ne26TL- s7'ootf qr >"2nnir o� yv�s�. p Assumed Elevation: /00.0, ENGINEE 'S SEAL OF dL 4� S & S ENGINEERING{� Inspections performeda 034 Eagle River Loop Road, No.l0bat85: 1St 995772nd agle River, Alaska IMBERT G. COWAN �R''sryo�q CE' 880' Department of Heal �id Hu Services approval e lC t1 _ / j` C' �- Reviewed b C`' `am/ ` Date:v •'�`\�`�� t�: l Fr FCs �� and approved :' :��ar ' 72-013 (Rev. 9/91) MOA 25 Permit No. SW950186 Page 2 _ of 2 Municipality of Anchorage 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 Legal Description: LOT 3, HIGHLAND TERRACE S/D 05031207 PID No.: S 1 sTz FINAL GRA E 9'i.3' M'P1 02 95.1' NEW 93.7' 1000 EPTICGAL 3.5' ANK 82.9' 78.7' WATER FC UND 7-20-95 A B FC 13' -- 1 ' ST1 67' 69' -- ST 73' 74' -- CO 76' 76' -- N CO2 77' 78' -- 79 83'— MT1 73' 83' -- LOT 3 C04 72' 86' -- NEW 100 GAL SEPTIC TANK G V o0 Cat ST2 o E MN�k ST1 CO3I I B C^ V %1�< i 1MT1 { COM1 _ A ENGIN, FCO EXISTING YSTEM ABANDONED C014P ZTELY • .+ _ - ••I ,ROBERT C. COWAN SCALE V = 40' p • CE -9901 0"'." d --TEMP ABANDaF� ............•�� 72-013 A(Rev. 9/91) MOi 25 \ \ \ VV LLL3 Mp1. PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950186 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SPALDING ALAN L & DARLENE M OWNER ADDRESS:10949 HIGH BLUFF DR EAGLE RIVER, AK 99567 PARCEL ID:05031207 LEGAL DESCRIPTION: HIGHLAND TERRACE LT 3 LOT SIZE: 63017 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: � Cl % X5-1- l -S DATE ISSUED: 8/01/95 EXPIRATION DATE: 8/01/96 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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: RECEIVED BY: ISSUED BY: DATE: DATE: ilA_ HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN S&S ntnq July 24-, 1995 MUNICIPALITY OF ANCHORAGE Department oU Hea th and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 3; H.ightand Terrace Subdivision ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Reyuea.t you ,issue a penm.i t to upgrade the septic system uAv,ing .the thAee bedroom houee on the xeJeiceneed proputy. A test hate was excavated and a percotation test perbowed .in the area o6 the proposed upgrade. The approximate tocati.on o6 the test hate is tocated on the attached site pian. At the time o6 excavation, water was encounteAed at 17.5 fleet and a4te✓c seven day ground wate✓c monitoring water was Uound at 16 geet. Attached is the proposed upgrade design. (0e do not anticipate, any adveAse e6ect,5 on neighboring weM, septic systems or drainage patterns by the .inlstattation o4 the proposed septic system. There ane no patinas o6 contamination within the wee radius which can be seen on the attached site pian. Due to ,the tow production o6 wett6 .in the area, the temporary abandoned wets w,i t remain .in ptace. I4 you require add Banat .inUormation ptease contact us. Sinemet y, Robert C. Cowan, P.E. RCC/gk ENCLOSURE 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 SCALE orr O �r-0 ZMx o CA o c." H 7 M n mzo -o A O u 0 UPGRADE z � w m r Z N N LO �� � P (n W tzj z� HIGHBLUFF DRIVI;J �„ N? cn O m ----- ----- - �/ O — W -90 o z m n� N II In ;3 o f O o < I"`� In l . o X �' ' 1 r� 0 -. m O pia,{ G7 m� pi z a �' Cf)-uO m N n Z ` MC)N D O -u .yy 00 o n F- �O -u ^� >0 0 O —i f 'l O nn \ F- 0 N ^� �� NFBD��NGoprn o�/SFR�14 -v o ss(A Y.TI (nD « ➢ �C 100' wul. RADIUS �_— �oo-a\ -� Z r� � CmZ�M(I" 0� ^ C-) m SK OOZ 0 ➢ n ti9C R�D1U5 d�^� SPIQz Omy vO C ;u 1p0. F-f'- mZ ;tl-ZN4<-irq - \ -� mmr (N m 1r--��-�) o 'o --i .Q -< AI— A I— (n �p ✓tiY ZV rcp z� D \ �\ ➢ A rzimx o7mm < z z m rn ➢ o �o 0 ovo� Y FTI --- 0 > oo> zz vi � z 10' UTILITY EASEMENT 0 A W O\'AAA�� A O ➢ -t a Z v A' oc(D =i o A' 4 r b m COn t© r Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: /'1\l/-"" �1�D�L> \'- (' _DATE PERF( LEGAL DESCRIPTION: 3 k l-At"p `D--rLopkj, `oWnship, Range, Section: �. SLOPE SITE PLAN P Li R� y,A l� 2 r 3 P 4 0 s7 t�,Nll� 0 P 5 6 ,v o 7 o 8 9 s 10 12 /�rx 19 20 COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? F"5 S L 11 ,S ° E Depih to Water Aller Monitoring? 1 L-0 Dale; 14- 1-`1S Reading Date Gross Time Net Time Depth to Net Water Drop 19 -1 S 2 ", ti 3_ — _ PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER LP TEST RUN BETWEEN FT AND `-� —FT PERFORMED BY:—_a_7nZd[[��srtlt8 �iV61' Loop Road No. F y`Mt ,�, _�,Jn CERTIFY THAT THIS TEST WAS PERFORMED IN Alaska 97 ACCORDANCE WITH APa9K E AWIJ MUNIC PALGUIDELINES IN— EFFECT �ONNTTHIS DATE. DATE. -nnn Rn' &JAIL i s&s� ,ineeninq ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. ON-SITE WASTEWATER DISPOSAL SYSTEM CIVIL ENGINEERS 694-2979 CONSTRUCTION PRACTICES FAX(AX (907) 694-4- 1211 and MATERIAL SPECIFICATIONS HEALTHAUTHORITY APPROVALS REFERENCE: Lot 3, Highland Terrace S/D #1 July 21, 1995 SEWER&WATER GENERAL: MAIN EXTENSIONS 1. The scope of this project includes the installation of a leachfield trench to serve the three bedroom residence located on the referenced property and SEWER&WATER excavation of the existing 1000 gal septic tank to INSPECTION verify its integrity. If the integrity of the existing septic tank is poor the existing septic tank is to be excavated, pumped, crushed, and abandoned in place and a new 1000 gal septic tank installed. ENGINEERING STUDIES AND REPORTS 2, Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal WELL INSPECTION &FLOW TEST Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITE PLANS 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own SOIL TEST systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: PERCOLATION TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer_. Construction shall include two 4" cleanouts for pumping access. STRUCTURAL& MECHANICAL 2. The septic tank shall be sufficient) bedded to INSPECTIONS prevent settling or shifting of the tank• 3. All standpipes on the septic tank shall extend a ONSITE minimum of 12 inches above final grade. WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 3, Highland Terrace S/D #1 July 21, 1995 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel. (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel. is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final. grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 3, Highland Terrace S/D #1 July 21, 1995 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by -the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 3, Highland Terrace SID $1 July 21, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 3, Highland Terrace S/D #1 July 21, 1995 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/:CNSTALLER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT NAME J�`P''H�O',N,'EEl �?4-.-394l_1•[QUPGRADE NEW Vern Flowers MAILING ADDRESS P.O.Box 4-27.33 LEGAL DESCRIPTION Lot 3, highland_ Terrace LOCATION NO. OF BEDROOMS l,agle River Well Absorption area Dwelling 2) PERMIT NO. 80942 7 j �! DISTANCE TO: 135 50 — X P z Manufacturer Material No. of compartments a. a w M -- Liq. caps i y in gallons 1b�0 IF HOMEMADE: Inside length Width Liquid depth O Well Dwelling PERMIT NO. a z DISTANCE TO: TZ Manufacturer Material Liquid capacity in gallons Fa- O Well a Foundation Nearest lot line r 1I.J PERMIT NO. JX DISTANCE TO: 200 75 same J LL Z No. of lines 1 Length 9�@ ach line Total length of Dn es Trencl�yaidth O Distance between lines 27 7z w 7 > inches _ F Top finish Material beneath tile Total effective sprption area of tile to grade 6o 12 inches Length Width Depth PERMIT NO. LU <(F Type of crib Crib diameter Crib depth Total effective absorption area to W V) Well Building foundation Nearest lot line DISTANCE TO: _ Class Depth Driller Distance to lot line PERMIT NO. J — W � Building foundation Sewer line Septic tank Absorption area (s) DISTANCE TO: OTHER PIPE MATERIALS 4 :i.n. perf pvc SOIL TEST RATING 9 5/bd rrn INSTALLER Owner � REMARKS Pipe in place over trashed rock with plastic. Pipe properly connected -to _ ex.st:i.ng system. — _ \ mac. nE / nenOo P. �� �: � Q a f nanono o -n 3 r �}ua Gr�runa<u .coueooannoap ec J. Harmttn tp� t . I o ��• E� (e�� APPROVED////DATE /! /•. �l �1.� gnsd�l2i /t LEGAL TYPE OF SOIL AE?SORESTION SYSTEM IS: TRENCH MAXIMUM NUMBER (IF BEDROOMS a 9 SOIL RATING (SQ F T,'BF.) = 95 THE: REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM I',: aE IES' i Er # L_Ems.,"C_n'"d"H': - 2� !E THE: LENGTH DIMENSION .I S THE LENGTH <: I N FEET) CIF' THE: TRENCH OR DRA I NF I EL D. THE: DEPTH OF A TRENCH OR FAIT I'S THE; DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE: BOTTOM OF THE EXCAVATION ON FEET). 'THERE 15 NO SETT WIDTH FOR TRENCHES. THE: GRAVEL DEPTH I'_=; THE MINIMUM DEPTH OF' GRAVEL RETWE.EN THEM OUTFALL_ PIP. AND THE BOTTOM OF THE: E.XC:AVAT'ION <IN FEET). l? IF GAF LJX W,V J-0021" PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE.- INSTALLATION HEMINSTALLATION INSPECTIONS OF ANY WELLS ADJACENT 'TO THIS PROPERTY FIND TEIF: NUMBER CIF' RESIDENCIES THAT THE WELL WILL SERVE. _r k-4 ci < r > x t F=' FF e.:x '"f' I I0"' Fl E"_" 1E, IFS" FE 9-015 LJ I Fes= F —.. _..... BAC:'KF'ILLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION AND APPROVAL.. BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SUJAGE: DISPOSAL SYSTFJ,l IS J-00 F€:ET FOR n PRIVATE: WELL; Ore. 150 TO 200 FEET FROM A PUBLIC WlE.LL DEPENDING UPON THE TYPE: OF F'I iF:L l: C: WELL.. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AI''dD CONSTRUCTION DIAG'RAFif.,; ARE. AVAILABLE: TO INSURE PROPER INSTALLATION. I CERTIFY THAT A.: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON ---SITE SEWERS AND WELLS AS ',E=T FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL. INSTALL THE; SYSTEM IN ACCORDANCE WITH THEM CODES. 3: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAI? REQUIRE E NLAROE::MENT IF THE RESIDENCE IS REMODELED TO INCLUDE. MORE. THAN 3 BEDROOMS. APPLICANT CARLA HUDSON j> ISSUEDF�'T'.m� �_ __� _ w. `'� �/J�JC(�_ rv___DATE �._.l �� „ � ,._"�� V 3. 2 (J f-wi Safi i`4 X 0`7, .TC F i !_.:i: -VV I`:a �"' t�-1 R'A d:`: if -A f---1 6QCi-� c DEPARTMENT ,F HEALTH AND ENVIRONMENTAL PROTECTION 825 'i_.' STREET, ANCHORAGE, Ak:. 99t-510:1 264--4720 PERMIT NO. C 780942 � cvv, 4 � APPLICANT CARLA HUDSON 82:19 NADINE CIRCLE 2' 4-3944 LOCATION CAGLE RIVER LEGAL L-3 HIGHLAND TERRACE LOT SIZE 63000 ;f?L1(-RE`: FEEET TYPE OF SOIL AE?SORESTION SYSTEM IS: TRENCH MAXIMUM NUMBER (IF BEDROOMS a 9 SOIL RATING (SQ F T,'BF.) = 95 THE: REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM I',: aE IES' i Er # L_Ems.,"C_n'"d"H': - 2� !E THE: LENGTH DIMENSION .I S THE LENGTH <: I N FEET) CIF' THE: TRENCH OR DRA I NF I EL D. THE: DEPTH OF A TRENCH OR FAIT I'S THE; DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE: BOTTOM OF THE EXCAVATION ON FEET). 'THERE 15 NO SETT WIDTH FOR TRENCHES. THE: GRAVEL DEPTH I'_=; THE MINIMUM DEPTH OF' GRAVEL RETWE.EN THEM OUTFALL_ PIP. AND THE BOTTOM OF THE: E.XC:AVAT'ION <IN FEET). l? IF GAF LJX W,V J-0021" PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE.- INSTALLATION HEMINSTALLATION INSPECTIONS OF ANY WELLS ADJACENT 'TO THIS PROPERTY FIND TEIF: NUMBER CIF' RESIDENCIES THAT THE WELL WILL SERVE. _r k-4 ci < r > x t F=' FF e.:x '"f' I I0"' Fl E"_" 1E, IFS" FE 9-015 LJ I Fes= F —.. _..... BAC:'KF'ILLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION AND APPROVAL.. BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SUJAGE: DISPOSAL SYSTFJ,l IS J-00 F€:ET FOR n PRIVATE: WELL; Ore. 150 TO 200 FEET FROM A PUBLIC WlE.LL DEPENDING UPON THE TYPE: OF F'I iF:L l: C: WELL.. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AI''dD CONSTRUCTION DIAG'RAFif.,; ARE. AVAILABLE: TO INSURE PROPER INSTALLATION. I CERTIFY THAT A.: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON ---SITE SEWERS AND WELLS AS ',E=T FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL. INSTALL THE; SYSTEM IN ACCORDANCE WITH THEM CODES. 3: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAI? REQUIRE E NLAROE::MENT IF THE RESIDENCE IS REMODELED TO INCLUDE. MORE. THAN 3 BEDROOMS. APPLICANT CARLA HUDSON j> ISSUEDF�'T'.m� �_ __� _ w. `'� �/J�JC(�_ rv___DATE �._.l �� „ � ,._"�� V 3. 2 (J 'f' SOILS LOG MUNICIPALITY OF ANCHORAGE / • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION O PERCOLATION \\ TEST Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Vern Flowers LEGAL DESCRIPTION: Lot 1 2 3 4 5 6 7 8 �- 9 10 12 13 14 15 16 17 18 19 ii i ROUND WATER NC; S _----- --' - - JNTERED? L- - 0 h -a AT WHAT I ding DATE PERFORMED: n/--20--78 Gross Time and Terrace Subdivision Depth to Water SLOPE SITE PLAN i _- -. J� .vel_ rP rMr{ y �- Ne, rEgg, F F�E�s I ROUND WATER NC; S _----- --' - - JNTERED? L- - 0 h -a AT WHAT I ding Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS Lo"L has good na-tural. drainage and soils rate aL 95 sq. _ft, peY Test is for upgrade of existing system. PERFORMED BY: 72-008 (7/76) S Fra CERTIFIED BY: Bd_ rm . �C/DATE: 10-1-78 .E,. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Prooram 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.sk.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROvAL - I-0R.A SINGLE FAMILY i.AVEDUNG Parcel I.D. -0 SO — 312- 07' HAa _JOS() a -Expiration Date: _ l 2- La -0-3 1. GENERALf1N lSRMA'RON Complet$legal description Location (site'address or directions) RLJFie Ax , Fa(Lf Rtis Current Property •owner(s) l ,4 ��� fP7 y Day phone I � Asi. Mailingaddress "''""',oyl�9 fry1JOK BLd6c OR. Lending agency Day phone Mailing address Real Estate Agent L Day phoneL�. Mailing Address 0 G 6�rLF_ &164 Unless otherwise requested, HAA will be held by DSD forpickup. . 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY:' TYPE OF WASTEWATER DISPOSAL: Individual Weli - Individual On-site Individual Water Storage ❑ Individual Holding tank 11 Community Class Well ❑ Community On-site 0 Public Water System ❑ Public Sewer 11 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 -sitz 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 we!I and may be reissued with new water sample results. (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. I 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(arej safe, functional and adequate for the number of ` bedrooms and type of structure indicated herein. l further verify that based on the information obtained from the Municipality of Anchorage files and from my irnestigation 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... Marie Address 17d37 8f4ie !''y� > _re (��`+ `:• .'�:�'�(!. ` . '. • / ' - Date'FJEngineer's Printed ntedName ll� �3 •. ... -,-3. .y::: L`<..: y>i •••Ja_i: �. .- .v 0l s• f•••i•i.rf : ••r - .. ,.t.t •i v.! .{'ir:;. .f;A.'-S�i ter. t•' .. ti'625 - S. DSD SIGNATURE AE ,r •a�� Approved for 3 _ bedrooms."; - pROFESStON�+ :. Disapproved. :.bedrooms 'with the foiloi An• sti • ula Conditional approval for 9 p tions: . .`i` .rC+3. �. J. �aii_::a r_: iS:.fiV �- ., :. �iC4-:i. n. ..1.. r.• tiff ♦. a ::'e :.).t _\ :: ;: •,,.... :yi1 •' ON-SITE Additional Comments' t��=` "'V1IQYfRdND' WASTEWATER Attachments: HAA Checklist.'X ' -'Maintenance Agreements Septic System Advisory* Supplemental Engineer's Report Well Flow Advisory Other By. (if/, Original Certificate Date: 9 — 3 (R•v. 01M) Municipality of Anchorage Development Services Department Building Safety Division 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 HEALTH AUTHORITY APPROVAL CHECKLIST Y�rt .,.BYE V.iT�Sf.. 1fn.��• t s•reT. Legal Description: 111ChflA44 769&Ae4 =VA' 407-- 3! Parcel ID: 050'3/2-Q7 A. WELL DATA Well type If A, B, or C provide PWSID # _ Well Log (Y/N) Date completed _ Sanitary seal (Y/N)--V- Wires properly protected (Y/N) Total depth _44 C ft. Cased to L16ft. P/ Casing height (above ground) /Z in. FROM WELL LOG (0107% AT INSPECTION Date of test Static water level S ft. .s S ft. Well production d.�f a g.p.m. !l( g.p.M. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate . ?y7ig.A. Other bacteria _ I� col onniies/100 ml. Arsenic: mg./I. Date of sample: ��- 4�" 3 .. Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material 5TF_ELZ4�65tftrcar I/Pf`fk- Date installed Tank size _/06a gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N) 'Depression over tank (Y/N) ISP High water alarm (Y/N) �(�A Date of pumping Pumper .f C. ABSORPTION FIELD DATA Date installed S Length Z 3 ft. Soil rating (g.p.d./ft2 or ft2/bdrm) 116.2 Width 2-. S ft. System type 10,W w?n(L' PF Gravel below pipe �7 ft. Total depth 12- ft. Eff. absorption area t1LJJft2 Monitoring tubeDepression over field A( Date of adequacy test 2 z/0-7 Results (Pass/Fail) 104* 'S For 3 bedrooms Fluid depth in absorption field before test in. Water added�G�al. New depth in. Elapsed Time: min. Final fluid depth L in. Absorption rate >_ ' #P" g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) W1%1Kmn&iA! If yes, give date D. LIFT STATION /,I/,* Date installedSize in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level atin. High water alarm le I at _ in. Datum Cycles tested Meets alarm & cir it requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot I St7 r t On adjacent lots . loot, - Absorption field on lot I r� On adjacent lots / C a''" Public sewer main AIA Public sewer manhole/cleanout Sewer /septic service line ,SG l l Holding tank K�A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation .SG'r Property line 20`t Absorption field Water main X14 Water service line _ SQ �* Surface water Wells on adjacent lots 100't SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line IS t Building foundation _ O �t Water main Water Service line $O �' Surface water / 4G /4' Driveway, parking/vehicle storage /4 S Curtain drain A�0 Wells on adjacent lots /OO r0, F. COMMENTS ASCC)A1Wx/t•r'ZrQ r4y?,�,2./)1iT� w�l!_.t F-rT .SE(>,f-QrP-Tianl Re:-,ac1• G. ENGINEER'S CERTIFICATION"' ty or At`44�N 1 certify that 1 have determined through field inspections and v C-j:r review of Municipal records that the above systems are in j * 49 T►1 conformance with MOA HAA guidelines in effect on this date. •too iv •• Y• •.• ♦.Y•••• ..•t Engineer's Printed Name A�• : �! ea r Stevcn V`:. 4 �� Date�l�9 • • PE 6255. •.�rVi HAA Fee S7, p, _ Waiver Fee $ Date of Payment "1 "s Date of Payment Receipt Number 3 Receipt Number (Rev. 12101) Sep 10 03 10:24a Cindy Wilson (907) 094-4213 p.2 JRs Pumping PO Boz 773415 Eagle River, AK 99577 (907) 694.6454, Service Agreement Number. Olow Ordr Dete: 1T.luI.2003 Cordce Date: 2S -Jul -2003 12:00 am t$Un� IMoem$ton '— Todrkisn: Dow AnCre$ Fenattpny .ob DearAptien: 1000 p 10949 HIO Pliff P.O. Lumber. Eagle Rfrer, M 99677 Term. Net 37 ($07)6964"s SslosnW Kana JobTyoe: Repeat Map Bcm Msp Ord: 05 - - Job siu 4nolmatlon _ Crws 3:rwtr. WarACmtrit KOW Andrea Jeb Commeetr �ta t ury 07MI01 low sw 10049 Holt Bluff t toe f6wr. AK 90577 (SC7) 69026�b Tax Pe garb 0 srvl$e type Cttr •rice tach x; Men T$x �^ . - ixlansten Actual So000 SwAco Lnar2k 1 $115.00 No N0 =115.00 AdAt w* U Alan Carnawls' sinal white House. to an hause.ur $0220 in bat: rank out tort! hallway dawn dwfO" No Dolls Or Fo'ros Olepram, Oasors Pkw&d. 1000 7 Oatlons Actual: Mctue Hose Lanpac 1 10949 Double Tank: ❑ _ Pum2 3ystrq: ❑ Bef les Mot C Baffle$ ouse0 ❑ t 1 •Taw* ' CM _III NanToxtbloTeW Toobfe Tool Tax Tout Orane TPUI EstmaMdCharpoa. $115.60 $0.00 $0.00 $115.01 Actual Oharyss: customer saws 10 Vre terns arty �nt'is:4s s pAntad an ms %,jeL 101E X R 61143M AGRECWGN7. Slpnaure and T1le Of Ciuttamar Repres09utt)ve De ire Ae"- V..tO by ;>`: fumpt� Date Acoep!e! rw y"t M!4]w coove-loica we ^all w take CM71 xve VW ie 'ts over the pfrane. J bi ASBUILT-NO CORNERS SET THIS DATE. SE'WARD HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE= =OLLOWING DESCRIBED PROPERTY: O;IZ4eww-e. DATE, IND THAT NO ENCROACHMENTS EXIST EXCEPT AS NDICATED. IT IS THE RESPONSIBILITY OF THE VWNER TO DETERMINE THE EXISTENCE OF ANY GRID+ :ASEMENTSr COVENANTS, OR RESTRICTIONS y.�iss IHICH DO NOT APPEAR ON THE RECORDED SUBDI- 'ISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F& iNY DATA HEREON BE USED FOR CONSTRUCTION sem` oto 1F FENCE LINES, OR FOR ESTABLISHING BOUND - AY LINES. DRAWN= AJVf bi MUNICIPALITY OF aNCHORAGE DEPARTMENT OF HEALTH & HUMAN SFHVICE,Q , ®1\ Division of Environmental Geraices� ri; On -Site S erVlces'_eCTIOn P.O. Dox 196650 Anchorage. Mask,- 995 1 9-6650 343-47,141 CER T IFICA -E OF HE l- T H AU -1 HOPI TY APPROVAL. FOR A SINGLE FAMILY DWELL INC1 -- % :1 -, r Parcel L.D- t — 1 — — — — ---- AA — - --- --- - --- - 1. OI=NEAA1- INFORMATIOI*,l I'_.j1. :.� _�.t i' �'-t. �1 X11 Complete legal description — —---------- Location (site address or directions) 7r�1rri Property owner r� r ( f --- =� — - - -— D< ,y phone u Mailing address-- r� � �i� _[1 ' C_ Lending agency .------- _—_-- _-- - --- --- Day phone . - Mailing address____- -- — — - -- ---- - - -- -- Agent Ra 9 r, =t_.r ur r_urr_ --- Day phone Address 01 Unless otherwise requested. I IAA will be heid for pickup. 2_ NUMBER CSF BEDROOMS- 3. TYPE OF WATER SUPPLY - Individual well_ --"--- Community well Public water - NOTE: if community well system, provide written confirmation frorr! State ADEC Attest- ing to the legality and status of system. 4. TYPE: OF WASTEWATEH DISPOSAL: Individual on -site- ! -folding tank Community on-site _ —_- Public sewer _ NO T E. If community wastewater system. provide written confirmation from State r\L)EC attesting to the legality and status pf system. S. A Ey: STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. G�9ti-�4, Name of Firm _. s R S ENGINEERING Phone -71i— 17034 Engle River Loop Road Na 104 Address Engineer's signature DHHS SIGNATURE X Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Date S'/I( (% S OF,4PS -A .•Y.M �M ROURr C. COWAN' Gi'{��.,,CE • 8801 �r bedrooms, with the following stipulations: 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 (R". 1/91) Sack MOA #21 WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO./q4 ! J' During a recent Health Authority Approval on --site inspection and test, of the potable water supply well on Lot -- Block of�f�� �` Subdivision, the well's productivity was determined to be 01 gallons per minute. The minimum well prod c�ivity required by this department (AMC 15.55) for a 9— bedroom residence is gallons per minute. Although the subject well currently exceeds this minimum requirement, all. parties concerned are advised that the production capacity of the well may fluctuate. Restriction of noncritical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Appr al. ® Municipality of Anchorage Aak Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ( (,T 3, 4-11e HLA"D Tia,2A.0 5/v Parcel I.D. vso3lao"7 A. Well Data Well type ?(;- kvAT C If A, B, or C, attach ADEC letter. ADEC water system number /,)/4 Log present &N) YES Date completed 11- 1,5 - 8t -I Driller wL_•L_1 `/A'J warms w��c s Total depth LIC)()' Cased to S5 I Casing height Sanitary seal (ON) ES Wires properly protected &N) 1=ROM WELL LOG AT INSPECTION Date of test I Z i Static water level a S 3 G, Well flow ��Sc�.?N. g.p.m. y3 SPH.—9.p.m. M. " tn o Pump levell UI< _ 222 ev + i.0 m m n z ` �.n " In z o SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot — I5 ; On adjacent lots _ /00 f m Absorption field on lot _ I G15, ; On adjacent lots too'./ - Public sewer main -75 � Public sewer manhole/cleanout ioo f _ Sewer service line a � /+ Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate 0.005- Other bacteria U Date of sample: Collected by: S & S ENGINEERING 17034 Bayle River Loop Road No. 204 B. SEPTIC/H9L f TANK DATA Eagle Giver, Aiafka '99577 Date installed .` �-•�-5 Tank size Ivuo (yALLJNS Compartments_ a Cleanouts MN)' : �/�S �_" `: Foundation cleanout (9N) yes Depression (Y/�l No High water alarm (Yo No _Alarm tested (Yk No Date' of pumping�A "a'AJ TANK _Pumper SEPARATION DISTANCES FROM SEPTIC/TANK TO: Well(s) on Iot-.F SS _,_On adjacent lots I ao ' 1- Foundation To property line :?-� ' Absorption field (I Water main/service line _ 10 '4 —_ Surface water/drainage IOD'4- 72.026(3M)•Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE D. ABSORPTION FIELD DATA TION TO: On adjacent lots at Surface water Date installed d- o` 95 Soil rating (GPD/Ft2) I System type �E�p Tn cN Length a.3 Width a h Gravel thickness q Total depth "a • 5 Total absorption area `//`/ � Cleanout present ON) Yc- S Depression over field (Y(9 No Date of adequacy test N4/4 ^Nom' sysTewgesufts (pass/fail) for Bedrooms Water level in absorption field before test After test Peroxide treatment (past 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /(ori On adjacent lots 10D '�Property line To building foundation -70 / To existing or abandoned system on lot _ IS On adjacent lots so/-/- Cutbank SD "�- Water main/service line ro f Surface water /U0 Driveway, parking/vehicle storage area �?0 Curtain drain NONE K,vowr/ E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effectaFo f this inspection. AL,�� 4 F a w Signature Engineers Name r ROBERT C. COWAN r Date r r/ q S` � C�•�s0t om\ �%4f �r at,, pRG1E53lootoa HAA Fee $ �&� ` 012-) Date of Payment / ` S� Receipt Numbers y Waiver Fee $ Date of Payment Receipt Number S&S� HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS 41 ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN `I�_m.<..... ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. TEST DATA: START TIME: 1 n 1 Z�_ STATIC WATER LEVEL: 3Z TRIAL PUMP TIME METER��AL./f14#k 1 CIVIL ENGINEERS WELL RECOVERY TEST DATA 07) FAX( 07)69412.11 CLIENT: Dkf-t_E;. EL seki-DI�(7 WELL LOCATION (legal): 'lLnr -�s TEST DATE: lo- ! 9 9 TESTED BY: I�� l cso,Jo WELL DEPTH: WELL DRILLER: 2r t' t C) CASING DEPTH: DATE DRILLED: TEST PROCEDURE: MISC DATA: 22• o� 1) Draw water down to pump. - Casing Height: OFF 2) Shut pump off 15-60 min. Sanitary Seal? -record time Wires in Conduit? -record meter reading Grading O.K.? � 3) Turn pump on. Drawdown. Pump Depth: Z LT 4) Shut pump off. Samples Taken? �[)( -record time Date: -record meter reading 1 �'. L� ZSR g 5) Calculate gal./min. recovery. OFF TEST DATA: START TIME: 1 n 1 Z�_ STATIC WATER LEVEL: 3Z TRIAL PUMP TIME METER��AL./f14#k 1 OFF �', a Le t • O L� 2-- LSI PA ON _ OFF 2 ON pl p p 2r t' t C) I 43 wI OFF ON 22• o� 3 OFF v' 0 ON OFF 4 O 0`r 00 ZA •• 1 `A-2, OFF v� ON 1 �'. L� ZSR g 5 OFF ON OFF LL CURRENTLY PRODUCES:C�Jk- NOT GUARANTEED --SUBSEQUENT VARIATIONS CAN OCCUR. Ia.Yrmwum ernrArru4• .H ROBERT C. f01VAPl 4.� CE -8801 !�5 e� p t�IN , 34 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 08/10/95 16:02 COMMERCIAL TESTING - 9076941211 AAME Environmental ServiCe9 Inc. M r2xwrx"0290� CC&r: Ref .# 95-3324.3 Matrlx WATER Client Sample ID L3 HIGHLAND TERR. 01 Cltent Name 5 & 8 ENGINEERING Ordered By BOB COWANB Project Name Project# P',I5TD UA ,ample Remarka: SAMPLE COLLECTED 8Y: RAY. N0, 108 D03 WORK Order 15951 Printed Date 00/10/95 V 15:18 hro. Collected Date 00/07/95 q 13:00 hru. Reoeived Date o8/08/95 o' 12:oo hro. Tochnical Director STEPHEN c, EDV Released By. 08/09/95 CMR QC Allowable Ext. Anal Parameter ReaUlta Qual Unite Method Limits Date ------------------ Date Init --------------- - ----------------------------,.....-- ------------ I ----------------------- Nitrate-N 0.05 11irrate-14 ...... ------------------ m L EPA 353.2 10. 08/09/95 CMR =_I9vv w s z v a c azs z.YMwwz z z a v z v e In Is w eNv..zwwzzzzvaa¢anav zvOVvwzewccaxa= ....... �ry vzva�aamwzzzwwMMWzwwawwavz sea special Inotvuotione Above UA w Unavailable see Sample Remarke Above NA . Not Analyzed Lr u Undetected, Reported value la the practical quantification llmlt. LT a LoaO Than D •= secondary dilution. GT a Greater Than ub/ lb/'jn lb : 16'3 WMIFILKI_ I HL I Lb I I NU d y0Yby41211 NU. 108 P05 Commercial Testing & Engineering Co. Environmental Laboratory Services ��.�rAos�A.rr�ri �a,,,,,,rdie�d✓ros�rs�®�a���r�r Drinking Water ,Analysis Report for Total Coliform Bacteria RL4-D .CNS'XRUCTIONS ON REVERS1; SIDE BEFORE COLLECTING SAMPLE MvaI tib UUMFJ-b tb1� 13 r WAIER SUPPLIER 0 PUBLIC WATTR SYSTF DS X.D. j X PRIVA17E WATER SYSTEM ��-SendRsluhs ❑ Send,(nvoire r "O�f S4mb[! 5 R S EN +�� \I � V fe>' e.•.� 17034 Nagle River L 19, G r askm 9 p Road No, 404 — O Send Rasu s In Scnd fnvo7 iCI NJn. SAI\9LE DATE: © 6 FO -F71 Month Dai- Year SAMPLG TY�F; k�Routine Q Treated Water ❑ Repeat Sample (for routine sample 0 tiotreated Water with lab ref. no. } ❑ 5peciatPurpose Time Collected SOTPLF LOCATI(DiN Collected By L �� /!Y/W6�L� nv a -4/;d,) Alwe 5633 8 Street Anchorage, AK 99518-'1600 Tel; (907) 562.2343 Fax: (907) 561-5301 TO BE COMFI�TF-D BY LABORATORY_ A alysis shows this Water SAMPLE to be: Satisfactory • Unsatisfactory ❑ Sample over 30 hours old, results rnzy be unreliable a Sample too long in Lrensit; sample should not be over 4S hours old at erarninatior. to indicate reliable results. Please send new sample ria special deli 'cr�� mail. bate Received 4 Tiwe Received b C Analysis Began BACT'ERrOLOGICA•I., WA 1 r -R .4n'.4.Z,YSZS RECORD MMO-MUG Result. Total Coliform _.. E Coli Nembrane Filtcc Direct Count 0 N ColonieV100 MI Vcrincatiou: LTB 13GB COLCFLRM Fecal Coll forn Conrirn"non Final Membra ul Reported H �_ hrs ThTC�rao A.ro W' To Coen' op -lith er &eCvi° QtIE DF -�+ Menber o1 the SGS Group (Societe GAnerale a SmW ane ) Et`'VIRONN�ENT:.,;. ?ACIL.ITI's5 IN ALASKA, COLORADO. FLORIDA. ILLINIOIS. M,ARYL-ANO, NRS' J9R5-Y- 0!![Q. VT; -H. w:ST VI�CINIA Analytical Method:Membr; ne Filter ❑ MMO-MUG ° Number of colonies/l00 ::il. Lab Ref. No. Result- A alvst Sent to A.D.E.0 -01, t Fblu Jun u J // r� Date: 9l• 10 Fazed Time: Client notified of unsatisfactory results: Phone) SgoktMith Faxed bete: Tuns. _ BACT'ERrOLOGICA•I., WA 1 r -R .4n'.4.Z,YSZS RECORD MMO-MUG Result. Total Coliform _.. E Coli Nembrane Filtcc Direct Count 0 N ColonieV100 MI Vcrincatiou: LTB 13GB COLCFLRM Fecal Coll forn Conrirn"non Final Membra ul Reported H �_ hrs ThTC�rao A.ro W' To Coen' op -lith er &eCvi° QtIE DF -�+ Menber o1 the SGS Group (Societe GAnerale a SmW ane ) Et`'VIRONN�ENT:.,;. ?ACIL.ITI's5 IN ALASKA, COLORADO. FLORIDA. ILLINIOIS. M,ARYL-ANO, NRS' J9R5-Y- 0!![Q. VT; -H. w:ST VI�CINIA V� rVP 9-a'l - ld MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION - -. 825.L Street • Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Pleaseallow ten_ (10) days for processing. 1. PROPERTYOWNER 1 1V9X14 _ Gt PHONE 6eG9�499B'G_ MAILING ADDRESS 4) /ve�- 14/c.1citinzx1?A—�_rLeG) PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS : 3. LENDING INSTITUTION �� PHONE S MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS n 5. LEGAL ESCRIPTION 5�-� r" v to 13 STREET LOCATION t� 1),49/U — 6. TYPE OF RESIDENCE �® NUMBER OF BEDROOMS El One L7-1Four❑ Other I SINGLE FAMILY t�' ❑ Two ❑ Five ❑ MULTIPLE FAMILY [A Three ❑ Six 7. WATER SUPPLY —�— INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975; For wells drilled prior to that date, give well PUBLIC UTILITY depth (attach log if available.) _❑ 8. SEWAGE DISPOSAL SYSTEM [ INDIVIDUAL/ON-SITE** **If individual/on•site,give installation date_--. If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FETE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-9lolsn6) i THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED '- TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR - DIRECTIONS: 1. TYPE OF RESIDENCE SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY E� INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SAF AGE DISPOSAL SYSTEM INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED /�� L INSTALLER tic Tank or ❑ Holding Tank Sizer V _ If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ce 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) I DISAPP OVED "" DATE a �-- BY (Title) LEGAL DESCRIPTION 2-uiO kFiev. 3iio) x f13 t.akirl"I Nla(14 v1k !1 9101. e..FiY�rr`sJ}�s.'",v -:'r fw"..ill ,`i9.13:3l?e,g .130 1tic'i_�,,:i5}{� "he }")e$"('C3lf1tiol7 '`t,oln'. a 3c.:Y'%'17t,._..,";dk on t4,;_G3 sE3vvx).r ty€3tulm F '.r;�:t,lcd to Yfan.?J tiaF'" a(lClt-qu;gtFy, "Gt'sto i:}liwei'•ts;4lg ?2efWO at'I)- Oval 'lh¢! I -In wrz" X(' In LttdC;Y<Oo t,,,I—JJ;l_ );)e i0t'i3l?.f:vdo Prjox, ;C; ;i3 's LA})'; ikltl it !"In Obtainod : ar. %k3dFli .°c,C4S% if? VIOLS Z3"1: 7,(;;to :po that ',I per .',l�'d, can. b 3.€3silse:£.3a .Li 01,f?re :aro any r�g3 ar �;:l.f)�'S;3 p �� � r1'3C q:btll;elt', �.' UIS rji:t'T �s�t r. 26A_-47201 ��`� a 3'3'{�t')L;.s']514? F•;�(?r'i`Cv';'si:., "' „l �.� r a 953''f't Fit>�'it .�'rxc�s�.. � t3•,.t. _ , �, � 3 Auqi.mt, '30t :1.978 i,', 14'IrvIv 9101 Juniol Lal't"o Roart Anchc)rar. k;�,, Alaska 99 if Subjrwt; ,Lcov 3 1A."P bnn-,ATerx"a(w rill, Otiivi ,., Ion Carla Ift0non ur tho sabjeol-, 'propnrty colm,ut-urn] on Aw.-ocifit 29t 1978 roiw�n,'V,_id tlio fcylio:tod�=I(J: The soptic" must IX) pwm y000, xrocuipt sub"nlittv_ml to thin deonxtriont. I leaoji 1.1-,-0-6 imust bavl:�,, AIA iA'_1cfQ,IjIC�y tkisto A Lint of! cowitictinq th'is typor of t.ont is cqjcjo_IvOl. The y"Or3kiltry ImArit be to this ,71M' wol), is gotinfavi,ory, Tho wiat"N'r smix-Plo, Was tohnn rumi onlxllitt�:.,d to It A Im I I I I Aro ro(iuire(l to uioln wo and fI(.A-j.wNI_0 tho alyla-17FAI's re"trmlit"q I -t this TV -thave.) fid`[-' any thio; ox-L'fica at o S bw.mroj,� y, 0, 1,3'i DBVIJ.�! 3201 C Mrs. Carla Hudson c/o Century 21 9101 Jewel Lake Road Anchorage, Alaska 99052 Attention: Randy Martin Subject: Adequacy Test on Existing Sanitary Sewer System; Lot 3, Highland Terrace Subdivision, Eagle River, Alaska Dear Mrs. Hudson: At your request of September 15, 1978, we conducted a test of the septic system on the above described property. During the test the liquid level in the septic tank was monitored as water was added to the system. The measurements are summarized in the following table: The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA Liquid Level Below Top Total Gallons Time of Standpipe Added 2:15 2.70' --- 2:22 2.50' 25 2:29 2.40' 50 2:36 2.25' 75 2.42 2.15' 100 2:51 1.95' 125 3:02 1.80' 150 3:16 1.50'- 175 begin drawdown 3:20 1.50' 175 3:25 1.50' 175 3:35 1.60' 175 3:50 1.60' 175 4:20 1.70' 175 24 hours 2.25' 48 hours 3.2.51 The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA September 22, 1978 Mrs. Carla Hudson Page -2- During the test the system accepted 175 gallons of water. The liquid level in the tank rose at a steady rate throughout the test. The test was termi- nated after the addition of 175 gallons because even though the last 50 gallons were added at the reduced rate of 1.8 gallons per minute, the liquid level was up into the standpipe and in apparent danger of overflowing. Drawdown measurements were not carried to completion since only 15 percent (0.20 feet) of the total required drawdown was accomplished in a period of one hour, From the performance of the system during the test it is apparent that there is minimal surge capacity and that the system is accepting effluent at less than 175 gallons per day, an inadequate rate for a 3 bedroom residence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours, R&M NSULTANTS, YNC. Gary Smith Seni r Geologist JMB/kah/12-E -MOM +��,-- O �rPw.-FCLi`'.-.:......' if - L u MUN��Ip DET 0 OF ANC/IOR ApE FNVIRON , F NEAIrH & Nrq4P, OCT orccripN 0 19% RECEIVED A6Z A4FA L rLE RIVER AREA U 3 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality Ao jauAl 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received August 30. 1976 C� I- `�p . 0 elof4 n �� � (-P'-0"q Time of Inspectioi Date of Inspection REQUEST FOR APPROVAL OF IL INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by Conv. Alaska National Bank Mailing Address: pouch 7010 Phone: 277-5511 x 31 2. Property Owner: Jerome & Marilyn Siedschlag Phone: Mailing Address: NHN Highland Drive 3. Legal Description: Lot 3 Highland Terrace Subdivision 4 Location: War Admiral Street and Highland Drive '.i. Type of facility to be inspected Single Family 6. Well Data: individual Indi A. Type �! B. Depth C. Construction •- 3rd lot to the north No. of bedrooms 1 D. Bacterial Analysis 7. Sewage Disposal System: On jite system A. Installed B/-; nstaller C. Septic Tank: 1./ tSize 2. Manufacturer �� �-- - e hi: 1. Absorption Area eepj-� E. 51 posal Field: Total length of lines _ 8. Distances: 2. Material A. Well to: Septic tank , Absorption area , Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages I+ MUNICIPALITY Of ANCHORAGE GREATER ANCHORAGE ARL(+ BOROUGH DEPT. of HEALTH d Department of Environmertal "C" Anchorage, Alaska Quality 99503 - 2"14-4561 LNVIRONMENTAL PROTECTION ,f. 3330 St., 6 AUG 2 1976 REQUEST FOR APPROVAL OF RECEIVED INDIVIDUAL_ SEWER & WATER FACILITIES 1. Type of Inspection: CNRO VA FHA CONV _xx___ 2. Property Owner: SIEDSCHLAG, Jerome and Marilyn ____ Mailing Address: NHN Highland Drive Day Phone Temporarily DisUonnecte Eagle River, Alaska 3. Name of Buyer: BOWEN, STEPHAN J. Mailing Address: 101 E. Lakeridge Drive Day Phone 277-2685 (Work) -'Eaa-g1 iv-Tt er, tII—aslca -��688-3412 (Home) 4. Name of Lending Institution: ALASKA NATIONAL BANK Mailing Address: Pouch 7-010_ Phone 277-5511 Ext.31 Anchorage, Alaska 99510 5. Name of Realtor or Agent: Roger C. Laber/Polar Realty — Mailing Address: 101 E. International Airport la4"n e 272-1541 Anchorage, Alaska 6. Legal Description: - Lot 3, Highland Terrace Subdivision Location: War Admiral Street and Highland Drive/3rd Lot North Eagle River, Alaska 7. Type of Faci 1 i ty to be inspected: Single Family B. Water Supply No. Bdrms. I Type of Supply: Public Utility Individual xx If Individual, number of dwellings presently served Unknown If Individual, depth of well Unknown 9. Sewage Disposal System Type.of System: Public Utility If Individual, date of installation Individual (on-site) xx Unknown Page 2 of two pages - Re st for Approval of Individual -er & Water Facilities Legal Description Lot 3 Highland Terrace Comments Zc/J N1V"A-c-�Ll dtA �.j Approved approved Date Approval .,Val f or one year from date signed `r �I7`6 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) GR_,iTER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 �I DATE RECEIVED: :-3,_i/I: - INSPECT: //,6/7. -�l TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR 1. APPROVAL REQUESTED BY: ADDRESS:L--�, PHONE:_ 2. PROPERTY OWNER:' -i� 9F r/ K- r'�PHONE j - 3. LEGAL DESCRIPTION:'u� 4. TYPE FACILITY I'D BE INSPECTED: ..Jlai'�� ���, � :STREET: NUMBER OF BEDROOMS: 5. WELL DATA: A . TYPE- 1. ��/�t B. DEPTH ,9(;. X25 C. SIZE�i��,� D. CONSTRUCTION'^�:-r --- E. BACTERIAL_ ANALYSIS 6. SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 1. SIZE 2. AGE 3. MANUFACTURER'//Z'/,/GiG/ 4. INSTALLERr.�Lf`%l�G�'C�, 001)=-�� APPROVAL REQUEST FOR SEWER & WATER FACILITIEz) PAGE TWO B. SEEPAGE PIT C. 1. SIZE 2. LINING__ DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH 7. REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT C. WELL TO SEWER LINE D. WELL TO PROPERTY LINE 10' E. WELL TO OTHER POSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK oI G. FOUNDATION TO SEEPAGE PIT_ d�b!.f- H. SEEPAGE PIT TO PROPERTY LINE 1c`14. 8. COMMENTS: APPROVED/,--\V't- %- DISAPPROVED:_ _ 7 - DATE: �` % DATE: _ APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY FHA Form 2573 DEPARTMENT DEVELOPMENT HOUSING ADMINISTRATION budget Bureau No. 63-R296.0 AUTHORITYFEDERAL HEALTH ... • INDIVIDUAL r SEWAGE DISPOSAL PART I.—TO BE COMPLETED INSURING OFFICE MORTGAGEE An • .•- • C. • + 91-1 MORTGAGOR ,. SPONSOR PROVEIRTY ADDRESS Highland Drive,.• Alaska SUBDIVISION NAME • i• • Highland1 BASEMENT New installation 1, Can attic or other area be made Into "VING UNITS IMOOMS, additional bedrooms? • ■ Moo MOWN ■■Ni■■■■■■■■■■■ ..�■.... mom ..' ■■ ■■...../■■■.■.■■■ :C:CCC:B:::C: ■ ..�.■■..■...0 ONE ■ NNr■N■■f0 .....■■■■_■.....■■ ■ N■■■■■■■ ._ loss . IN "I ■_■■ M .....■C■S■■ .........■ ......... :■.� :.■■� ■■.:■�■■■ _■■■ ■ f MM■■OMM .. . .. ■1■.■IN N PMN■!■ no MO .■■ ■ ■:■1■N■■■■■N■■■ .......■.■.............. IN C':CCCCCC'CCCCCCOMEN ....■ NNM■■..�..■.■ ■ - /■N ■ . �u■■ ■■ Orr rIV ■r■r.NUNN ■■ . ■O■i IN ■N :■■ :.=■■/M: .. 1■■..■NSM■■ so moms:::_:::III on 0 IN .... .......... IN MONO.■ ■MN■O ...' 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C'CCC CB:BCC'CC=: ■: ■■ .. . .�■. PART Ill.—FOR USE OF TO THE CHIEF UNDERWRITER: I have reviewed the foregoing .. water-supplyIndividual Acceptable Sewage disposal be considered 11 Acceptable 0 Not Acceptable. DATE SIGNATURE ARCHITECT DEPUTY FOR CHIEF ARCHITECT■CHIEF e9sA•T•1 AYTFIORITI APPROVAL FMA Form 2379 INDIVIDUAL WF®7i0 411001V Aun eel n.cnwua. .- .1. .... 'REAPER ANO-10RAGE AREA BOROUGH HEALTH DEPAR'1113NT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 279-2511 DATE RECEIVED INSPECT: TI'ML : REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES FOR I. Approval Requested By_ N;,h„ta�, Address Stam }3�x 138rg �_ 1.�J3 � vPr Phone , ,AI - 2. Property Owner Phone 3. Legal Description j03y H;ghtinrl �a_Eyy:;inn�T 4. Type of Facility to he Inspectedsinge fiamitr_ __STRI ET: Number of Bedrooms 3 S. Well Data: A. Type ` -dMi1l-ed-- B. Depth_ inn, &_=S, C. Size ^—_6m casing D. Construction L. Bacterial Analysis G. Sewage Disposal System: A. Septic Tank (If homemade, show diagram on back) 1. Size _LDQQgal7non Gel 2. Age tQ&4___ 3. "Manufacturer „nknQWn _ 4. Installer_ Gearliard.Exc. lq?proval Request for Sew F Water Facilities Page Two B. Seepage Pit 1. Size 2. Linin C.- Disposal Field I. Number of Lines unknown 2. Total Length-- unknown 7. Required Measurements A. Well to Septic, TankT 53' B. Well to XXX 00' C. Well to Sewer Line lo'+ D. Well to Property Line ___12�+ E. Well to Other Possible Contamination F. Foundation to Septic G. Foundation to rainfield MZtc 201+ drainfield H. )DdcPWM'K to Property Line 10'+ 8. COMMENTS: APPROVED.,.. DISAPPROVED: DATE: March 17. 1971 DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT ED11.70 MATER ANMORP-GE AREA BOROUG[I PEALTH DEPARTMENT 327 LAGLE STREET ANCHORAGE, ALASKA 99501 279-2511 DATE RECEIVED INSPECT:AT TIttE: �� 47J �) REQUEST FOR APPROVAL OF INDIVIDUAL SFIVAGE AND WATER FACILITIES FO/RR 1. App.rc Addre Phone 2.. Property Owner 3. Legal Description 4. Type of Facility to he Inspected Number of Bedrooms c,:Y— S. {Yell Data: Phone STREET: A. Type B. Depth C. Size " •/ �j D. Construction E. Bacterial Analysis :7z- !- cz G. Sewage Disposal System: A. Septic Tank (If homemade, show diagram on back) Z2. GG, 1. Size_ 2. Age_ 3. 114anufacturer /,'si/S�v<-t>>ri 4. Installer. Approval Request for Sew $ Water Facilities T`age Two B. Seepage Pit 1. Size f✓/�' r 2. Lining C. Disposal Field I. Number of Lines_ 2. Total Length 7. Required Measurements A. Well to Septic Tank _ B. Well to Seepage—Pi:t�✓,'p C. Well to Sewer Line---/ u / I�_ D. Well to Property Line / G j /- E. Well to Other Possible Contamination F. Foundation to Septic Tank G. Foundation to Seepage pit H. Seepage -411t, to Property Line/,, B. COMMENTS: APPROVED: C{_ DISAPPROVED: DATE:: �7 i��t � DATE : APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT ED1170 1