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HomeMy WebLinkAboutHIGHLAND TERRACE LT 5Highland Terrace Lot 5 #050-312-09 Development Services Department Building Safety Division On -Site Water & Wastewater Program{ U 4700 Elmore Road P.O. Box 196650 4 Mark Begich Anchorage, AK 99507 Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: 650- _j12 _bGt Legal Description Property Owner Name & Address: f� S t4 ,ems �,- qq S- 7 Pump Installation Date: e.3j3 /)1� Pump Intake Depth Below Top of Well Casing: 170 feet Pump Manufacturer's Name: Pump Model: )UG Z -t �5�a Pump Size Y2_hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? %Yes ❑ No Method of Disinfection: �d liy�2. P_L&U'I�T Comments: Pump Installer Name: A AzJivevcy— Z Ptt,—, jo Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Municipality of Anchorage Community Development Department Page 1 of 4 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141234 PID Number: 050-312-09 ❑ New ❑✓ Upgrade Name: FLORENCE & ALBERT KAHKLEN ABSORPTION FIELD ' Deep Trench El Shallow Trench El Bed E1 Mound ❑ Other Address Phone Number of Bedrooms Soil Rating Total depth from original grade 3 2.8 GPD/SF - 10 Ft. LEGAL DESCRIPTION - - Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 6.5 Ft. Subdivision Block Lot . - MGHLAND TERRACE 5 Fill added above original grade 0 Ft. Gravel length 45 Ft. Township Range Section Gravel width 2.5Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 585 FP Number of trenches 1 Dist. between trenches Ft. well 102.9 111.2 NA N/A TANK ❑p Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 1250Gal. Surface water N/A N/A N/A N/A Material Number of compartments Lot Line 59.8 19.9 N/A N/A NA Steel 2 Foundation 69.3 102.7 N/A N/A LIFT STATION Manufacturer _ Capacity Curtain Drain N/A I N/A N/A N/A Gal, Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer - - PIPE MATERIAL Housetotank 3034 Tank to drainfield 3034 JR'S SEPTIC PUMPING Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCHMARK (Assumed elevation) 100ft Inspection ise 8/8/2014 a dates: 2^ 8/9/2014 Location and description 3" 4" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval Date a�OF Akj P......k.4�9 �* TH * 51 Steven I.` ESanr orae/ CE 8149 Approved DateIt RZPv •_ � 1- 1 c.uw sLrM \ AREA\ VACANT \ \ � - DRIVEWAY -� — - DRIVEWAY- HIGHBLUFF DR 2 �?94 � EXIST HOUSE i 72 Ti C2, EXISTING FIELD TO BE USED_AS A C1 a �EXI ING WELL RESERVE FIELD LOT 5 — 74 LF x 2.5'W x 7.O'ED x 11.0'TD-`` 29', V � DIVERTER VALVE_ 1250 GAL SEPTIC - _ TANK (N) DCO 3. DCO 4 v� ,.�1 1 1.2 ...M1 - - .. 1 .0 Cl 2 IV LOT 8 `\ \ s, REPLACEMENT FIELD APPROXIMATE KEYBOX LOCATION 45 LF x 25W x 6.5'ED x-10.O'TD LOT 4 41 TIC _ THIS LOT IS OWNED BY A - _ .� 'THE OWNERS OF LOT 5 AND HAS NO SERVICEABLE - \ -\BUILDINGS OR WELLS NOTES: PANNONE ENG SVC, LLC RD ER P.O. BOX 100217 ANCHORAGE, AK 99510 tAWINO PHONE (907) 272-8218 FAX (907) 272-8211 HIGHLAND TERRACE LOT 5 FLORENCE & ALBERT KAHKLEN 19306 HIGH BLUFF DR PLAN EAGLE, AK 99577 mill Scale P.I'50- D NO % 050-312-09 Steven fR^ Ponnorae � PERMIT NO. 2 O 3 A B DC1 67.90 89.50 DC2 68.20 89.80 T1 70.30 91.70 T2 77.90 98.30 DV 79.70 99.90 DC3 80.70 100.20 DC4 81.20 100.50 Cl 105.00 111.80 M1 104..-10 110.50 C2. 121:40 119.30 M2 120.60 118.50 sLrM \ AREA\ VACANT \ \ � - DRIVEWAY -� — - DRIVEWAY- HIGHBLUFF DR 2 �?94 � EXIST HOUSE i 72 Ti C2, EXISTING FIELD TO BE USED_AS A C1 a �EXI ING WELL RESERVE FIELD LOT 5 — 74 LF x 2.5'W x 7.O'ED x 11.0'TD-`` 29', V � DIVERTER VALVE_ 1250 GAL SEPTIC - _ TANK (N) DCO 3. DCO 4 v� ,.�1 1 1.2 ...M1 - - .. 1 .0 Cl 2 IV LOT 8 `\ \ s, REPLACEMENT FIELD APPROXIMATE KEYBOX LOCATION 45 LF x 25W x 6.5'ED x-10.O'TD LOT 4 41 TIC _ THIS LOT IS OWNED BY A - _ .� 'THE OWNERS OF LOT 5 AND HAS NO SERVICEABLE - \ -\BUILDINGS OR WELLS NOTES: PANNONE ENG SVC, LLC RD ER P.O. BOX 100217 ANCHORAGE, AK 99510 tAWINO PHONE (907) 272-8218 FAX (907) 272-8211 HIGHLAND TERRACE LOT 5 FLORENCE & ALBERT KAHKLEN 19306 HIGH BLUFF DR PLAN EAGLE, AK 99577 mill Scale P.I'50- D NO % 050-312-09 Steven fR^ Ponnorae � PERMIT NO. 2 O 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS. 3. SCOPE OF WORK: INSTALLED NEW SOIL ABSORPTION SYSTEM & VERIFIED INTEGRITY OF TANK. 4. GROUNDWATER WAS NOT ENCOUNTERED BELOW EXISTING GRADE IN ANY OF THE EXCAVATIONS LESS THAN 11 FEET BELOW EXISTING . -- 04 V!_. 1IVIV 1250 g SEPTIC TANK DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1250g PERC RATE = 2.8 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 563 SF SYS, TYPE: DEEP TRENCH 6.5' E.D. MIN LENGTH: 43.3 LF USED: 45 LF X 2.5' WIDE, 6.5' E.D TOTAL AREA: 585 SF NOTES: RECORD DRAWING DESIGN DETAILS 10.0' TD PROFILE COPPER DIP w m r FC FOUNDATION CLEAN OUT T# 4" 0 PERF PIPEDRAI o z w ROCK 6' Z E R.I. ABO ABOVE PIPE INV n n wo 0 0 w wo BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE OV w > O w O UU In pV Z SII n n n nn = E 1250 g SEPTIC TANK DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1250g PERC RATE = 2.8 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 563 SF SYS, TYPE: DEEP TRENCH 6.5' E.D. MIN LENGTH: 43.3 LF USED: 45 LF X 2.5' WIDE, 6.5' E.D TOTAL AREA: 585 SF NOTES: RECORD DRAWING DESIGN DETAILS 10.0' TD PROFILE TRENCH SEE DESIGN LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 HIGHLAND TERRACE LOT 5 FLORENCE & ALBERT KAHKLEN 19306 HIGH BLUFF DR EAGLE, AK 99577 ABBREVIATIONS CU COPPER DIP FILTER FABRIC m r FC FOUNDATION CLEAN OUT T# 4" 0 PERF PIPEDRAI o z w ROCK 6' Z E R.I. ABO ABOVE PIPE INV n n TRENCH SEE DESIGN LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 HIGHLAND TERRACE LOT 5 FLORENCE & ALBERT KAHKLEN 19306 HIGH BLUFF DR EAGLE, AK 99577 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT N0. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE —,Date OF•AGq nll'_ 04/06/15 *:-49T NTS P.I.D. NO " -ow PERMIT N0. CE 8149 .'� j OSP141234 970FE`0_ Sheet3 OF 3 On -Site Wastewater Disposal System Permit Permit Number: OSP141234 Tax Code Number: 05031209000 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Work Type: Septic Upgrade Permit Effective Dates: July 18, 2014 to July 18, 2015 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: HIGHLAND TERRACE Site Legal Address: HIGHLAND TERRACE LT 5 G:0155 Owner/Address: KAHKLEN ALBERT & FLORENCE 10979 HIGH BLUFF DR EAGLE RIVER AK 995778404 Site Mailing Address: 19306 HIGH BLUFF DR, Eagle River Lot Size in Sq Ft: 37661 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By; Pate:`G Date: �� Municipality of Anchorage Development Services Division On -Site Water and Wastewater Program Ment S C % d n y Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP141235 COSA#: Permit#:OSPI41234 PID#: 050-312-09 Legal Description: Highland Terrace, Lot 5 Engineer: PES Applicant: Florence & Albert Kahklen Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the 25% or steeper slope has been approved. The approved separation distance is 36.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: Approved nv. Name of Reviewer MUNICIPALITY F NCH �� rn�' "HL JUL 0 3 204 Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 050-312-09 Property owner(s) FLORENCE & ALBERT KAHKLEN Day phone Mailing address 10979 HIGH BLUFF DRIVE, EAGLE RIVER, AK 99577 Site address 19306 HIGH BLUFF DRIVE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) HIGHLAND TERRACE LOT 5 Legal description (Township, Range & Section) Lot Size 37,661 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption FieldX❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank ❑ UpgradeX❑ Duplex ❑ (D) Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: STEEP SLOPE Distance:36.8' certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: $ S-bq Waiver Fees: Date of Payment: UM11 Date of Payment: /c3I fY Receipt Number: (fit �$ t? Receipt Number: ' I Permit No. OST/ a3Y Waiver No. 6,521IA 5 Permit App_-'.: 1L,:c Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(cDnanen ag k.com July 2, 2014 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. O. Box 196650 Anchorage, Alaska 99519 Subject: Highland Terrace Lot 5 Septic System Permit Request Ladies and Gentlemen: I am writing to request a permit to install a new septic system be issued for this property. The proposed systems will serve a existing three (3) bedroom house. Currently the existing house is served by a conventional drain field . The proposed system will utilize the existing 1250g septic tank and a conventional drain field. The surrounding developed lots are served by private wells with the one to the west on city water from the west. There are no wells on surrounding lots within 100 feet of this system. Soils. We performed one test hole on this lot, and groundwater was monitored on 7/2/2014 and ground water was not observed below the ground elevation in the test hole monitor tube. From 0.5' to 1.5' was organics silt, from 1.5-16 'was a silty gravel. It is my opinion, based on the results of the soils tests, the use of a conventional system and overall soils appearance; an application rate of 0.8 gallons/day/square feet should be used. 1. Soil Absorption System Design. a. See Sheet 2 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The existing topography slopes from the northeast to southwest at approximately 6% in the area of the proposed drain field. There is a steep slope located 36.8'from the proposed drain field. Mailing: P.Q. Box 100217, Anchorage, AK 99510-02:17 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 4. Waiver Request for a steep slope within 50% There is a steep slope located 36.8' from the proposed drain field. With the top of the drain field located five feet below ground the effluent will be far below the ground surface at that location of the toe of the slope( See Steep Slope Details pg. 4 of 4). 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.0. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-821.8 FAX: (907) 272-8211. RESERVE FIELD SS • LOT 5 �\ 74 LF x 2.5'W x 7.0'ED x 11.0'TD' 1250 GAL SEPTIC TANK(E) INTEGRITY TO DOUBLE CLEANOUTS BE VERIFIED AT TIME OF - TO BE INSTALLED CONSTRUCTION .I NI 1 .0 IN - 1.0S NOTES: ����Date FOR CONSTRUCTION PANNONE ENG SVC, LLC OFAt'gd 7/11/2014 P.O. BOX 100217 ANCHORAGE, AK 99510 �� 9S t( PHONE (907) 272-8218 FAX (907) 272-8211 /"yip ---yScale j,t: L( 71-1 •*�� 1"=so' �.....1.. .. P.I.D. NO HIGHLAND TERRACE LOT 5 `_i 050-312-09 FLORENCE & ALBERT KAHKLEN Steven R. annone / PERMIT NO. Pc^'. CE 8149 �� OSP141234 19306 HIGH BLUFF DR f c PLAN EAGLE, AK 99577,�1�� ••••• P� Sheet �� �OFESSIO'*- 1 OF 4 IN IN W -. LOT 8 '---._ _ '_-- -- PROPOSED REPLACEMENT FIELD APPROXIMATE KEYBOX LOCATION --- --.� .. 45 LF x 25W x 6.5'ED x 1D.O'TD �M LOT 4 —_ TT THIS LOT IS OWNED BY THE OWNERS OF LOT 5 = AND HAS NO SERVICEABLE - - -- .. BUILDINGS OR WELLS NOTES: ����Date FOR CONSTRUCTION PANNONE ENG SVC, LLC OFAt'gd 7/11/2014 P.O. BOX 100217 ANCHORAGE, AK 99510 �� 9S t( PHONE (907) 272-8218 FAX (907) 272-8211 /"yip ---yScale j,t: L( 71-1 •*�� 1"=so' �.....1.. .. P.I.D. NO HIGHLAND TERRACE LOT 5 `_i 050-312-09 FLORENCE & ALBERT KAHKLEN Steven R. annone / PERMIT NO. Pc^'. CE 8149 �� OSP141234 19306 HIGH BLUFF DR f c PLAN EAGLE, AK 99577,�1�� ••••• P� Sheet �� �OFESSIO'*- 1 OF 4 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS. 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM & VERIFY INTEGRITY OF TANK. 4. GROUNDWATER WAS NOT ENCOUNTERED BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 11 FEET BELOW EXISTING GRADE THE ENGINEER IMMEDIATELY. 1250 g SEPTIC TAN K (E) DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 12508 PERC RATE = 2.8 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 563 SF SYS. TYPE: DEEP TRENCH 6.5' E.D. MIN LENGTH: 43.3 LF USE: 45 LF X 2.5' WIDE, 6.5' E.D., 10.0' TO TOTAL AREA: 585 SF PROFILE COPPER DIP w j 00 4" 0 PERF PIPE 2 0 z TANK CLEAN OUT NO. Q CLEAN OUT NO. DRAIN ROCK 6" MONITOR TUBE NO. R. 1. ABOVE PIPE INV n n DV DIVERTER VALVE FS Qo 0 o w wo wo o � ZQ TOPSOIL & VEGETATE Jz m� o z 10 U U Ct DU OU Z nn n n nn nn s 1250 g SEPTIC TAN K (E) DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 12508 PERC RATE = 2.8 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 563 SF SYS. TYPE: DEEP TRENCH 6.5' E.D. MIN LENGTH: 43.3 LF USE: 45 LF X 2.5' WIDE, 6.5' E.D., 10.0' TO TOTAL AREA: 585 SF PROFILE TRENCH SEE DESIGN LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC ABBREVIATIONS CU COPPER DIP FILTER FABRIC j 00 4" 0 PERF PIPE p 0 z TANK CLEAN OUT NO. Z CLEAN OUT NO. DRAIN ROCK 6" MONITOR TUBE NO. R. 1. ABOVE PIPE INV n n TRENCH SEE DESIGN LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFC BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE NOTES: PANNONE ENG SVC LLC -ooF q \p Date FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 r ~� ••• �qsl- �717�2o1a PHONE (907) 272-8218 FAX (907) 272-8211 /rrj�Q �yf� Scale *: TH *�I NTS �""' '�.. v P.I.D. NO HIGHLAND TERRACE LOT 5 � ` I a50-312-09 n• venR. •oe FLORENCE &ALBERT KAHKLEN � Ste•an n .,� /PERMIT N0. I �cf•r� OSP141234 19306 HIGH BLUFF DR ��� CE 8149 DESIGN DETAILS EAGLE, AK 99577 .'•.... Sheet -- tl\\0 SSA ~ 2 OF 4 DATE PERFORMED: 6/25/2014 SOILS LOG - PERCOLATION TEST WAS GROUND WATER ENCOUNTERED N IF YES, AT WHAT DEPTH? NONE' READING DATE TEST HOLE 1 NETTIME WATER LEVEL READING OR ORGANICS 1 OL ORGANIC SILTS 2 12:30 10 MIN 8.75 3.19 3 1230 5.33 4 12:40 10 MIN 8.11 2,78 5 12:40 5.33 6 12:50 10 MIN 8.14 2.81 7 8 GM SILTY g GRAVELS 10 11 12 13 14 15 16 BOH 17 18 19 20 DATE PERFORMED: 6/25/2014 SOILS LOG - PERCOLATION TEST WAS GROUND WATER ENCOUNTERED N IF YES, AT WHAT DEPTH? NONE' READING DATE CLOCK TIME NETTIME WATER LEVEL READING NETDROP 1 6-25-14 12:20 5.56 2 12:30 10 MIN 8.75 3.19 3 1230 5.33 4 12:40 10 MIN 8.11 2,78 6 12:40 5.33 6 12:50 10 MIN 8.14 2.81 PEROLATION RATE OF 3.6 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4.5 FT AND 5.5 FT COMMENTS: Test hole excavated by JR'S SEPTIC SERVICE. Prec hole was presoaked. Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE ENG SVC, LLC—` P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211/�6j�P pF A���\< r (�• qS i( �yil *II ...f�ij ... .. c- r 1r ' �.::-:z I Steven `R.'Pannone / CE 8149x/ ••• PG ~ Date 7/11/2014 FOR CONSTRUCTION Scale NTS HIGHLAND TERRACE LOT 5 FLORENCE & ALBERT KAHKLEN 19306 HIGH BLUFF DR EAGLE, AK 99577���A� P.I.D.NO .I.D. N-09 PERMIT NO. OSP141234 SOILS LOG Sheet 3 OF 4 2:1 ROAD SURFACE STEEP SLOPE DETAIL DRAIN ROCK -1 2.5 [- NOTES: .������\\\ Date FOR CONSTRUCTION PANNONE ENG SVC, LLC . pF A� \A P.O. BOX 100217 ANCHORAGE, AK 99510 C ......••.49 l( 7/>>/zo a r CP •' Scale PHONE (907) 272-8218 FAX (907) 272-8211 * :4 TH *f// I•�-50' �.... ,t ...... I P.I.D. NO HIGHLAND TERRACE LOT 5 a 050-312-09 �•'-•steven R. Pannone FLORENCE &ALBERT KAHKLEN / /PERMIT No. 19306 HIGH BLUFF DR lj'P�s CE a a9 �/ 0SP141234 PLAN EAGLE, AK 99577 11� ••••••awe Sheet 4 OF 4 Tatifirb Drilling tog - I DOC Co. dba SULLIVAN WATER WELLS P.O. 13OX 670272, CHUG IAK, ALASKA 99567 > TELEPHONE 688-2759 OWNER OF LAND ADDRESS DLPFH OF 1�'ELL STA I K LEVEL OF W:1TER PF. LEGAL DESCRIPTION •'. _ '_l % _ DR. %, DOWN 1 T. DATE •Started {" — Ended !%' ` - GALS. PER HR- PERMIT NUMBER _ _ KIND OF CASI,\'G KIND OF FORMATION: 2 5 r -' From Ft. to —Ft __� f' ` ` — From. Ft. to__—.__.Ft. From Ft. to E. FY ;r,- 1' : --_----_ From --_--_Ft. to ---Ft. — MUNIc►aALI From " 'Ft. to Ft - From Ft. to —_--FL F �y kA - ��'�EP . OF H�ALNFMo GF From Ft. to Ft '`1 ` , From _ Ft. to___Ft._ MENTAL n >M & - N From --Ft. to—`t —Ft.- From Ft. to--�--Ft 14A n ri 3nnn From Ft. to Fl t _ - From __Ft. to "-- -- Fp — From.. 7 t -- -- r �1� %1 _Ft. to r ._ :I Ff r = From Ft. to_-- _ Ft. D From' �i=_Ft. to ``>._Ft s ,,,+ ; 'From Ft. to ----a Ft. From Ft. to Ft. - -; From Ft. to Ft. From , Ft. to: +'" Ft s From 14 Pt. to -.---_Ft.- - - From -Ft. to —Ft _ From _ _Ft. to—Ft.---- From--Ft. o Ft. -- From_Ft. to Ft. From_—__Ft. to_ _Ft. From Ft. tai `' `' Ft =` L ;-J f 't = . From --- -_--Ft. to --Ft. —. From Ft, to_Ft From ----Ft, to Ft. From Ft. to__Ft. _: From Ft. to__ 17 1. MISCL. INFORMATION: Frmn___Ft. to----Ft­-------------­- o— -Ft.-_— -- --- --From From FL to Ft. From Ft. to Ft. From Ft. to_ Ft - DRILLER'S NAME MUNICIPALITY OF ANCHORAGE Depart inon of Beal -th zinc! Environmenta Protection Pouch 6-650, Anchorage, AK 99502 264--4720 -03 x€I�ne� /[eater Permit IIAN DWRITTEIN Permit No: Date Issued: 'Z---( Applicant: A 14 k.(P�-� Address: `I / 2 Legal. Description: S/D: �fi' �1�2 �!t ���Rc-�= Lot: 5 Section: Township: Lot Size: _ G'T� (Sq. Ft. or Acres) Lot Location: n� Max Bedrooms: Block: A�lj Range : 2 ( (-J^ Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. TRENCH BED W. DRAIN Depth to pipe bottom(ft.) Gravel. depth (ft.) Total depth (ft.) Gravel width (ft.) Gravel length (ft.) Tank size (gal.) Soil rating (sq. ft./br) Gravel length 75 feet requires multiple runs (not exceeding 75 feet each) Tank must have at least two compartments I. certify that: I_. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage(MOA) and the State of Alaska. 2. I will install. the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3, I will adhere to al.]. MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent: or nearby lot. 4. I understand that this permit is valid for the maximum number of bedrooms stated above, and any enlargement or modification wiJI. require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED: z_ C�P ��=---------- DATE : 2- /� -- ---- Applicant �� �1- «,. DATE: I S SUED B Y: �---_—_-__ _-- SWP/024 rev.1/85 API 'LlCAN! : A! HER D. KAHKLEN [SSUEU BY DATE: , IL, /", /-,&) U�WUJ V T , 1. P y W! A A. . 1 X-1 , 1 1 T= M Q Al KX- 5 C 11 0���� DEPA�TMENT OF HEALTH AND ENVIRONMENTAL Mu 11 825 L STREET, ANCHORAGL, 264�4720 AK 99501 PERMIT NO: 860052 HAND WRITTEN DA[E IGSUED: 02/20/G6 APPLICANT: AL8ERT D" KAHKLEN 13 to WAY EAGLE RIVER� AK 99577 CONTACT PHONL: 271-408B LEGAL DESCRIP: SUBDIVISION: HIGHLAND TERRACE LOT: 5 BLOCK: 0 SECTIDN: 7 TOWNSHIP: 14N RANGE: 1W LO� SIZE: .8A (SQ,Fl. OR ACRES) LO7 LOCA[ION: 112 BONNIE WAY I certi[y that: 1. I am familiar with the requirements �or on-site sewers and wells as set forth by the Municipality o� Anchorage (MOA) and the State of Alaska. 2. l wil1 insLa|i the system in accordance wiU ll MOA codes and regulations, and in compliance with the design criLeria of this permiL. 3. I wiere ;Al all MUA and State of Alaska requiremenLs distances {rom any existing wei1, wastewate/ 1itop osal system or �ublic sewerage sysLem on this or any, by lot. S[GNED DATE: API 'LlCAN! : A! HER D. KAHKLEN [SSUEU BY DATE: , IL, /", /-,&) �\ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION G E—Nt�TT&1 ENVIRONMENTAL 72 ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 9fdd&-_Z - "7 � ON-SITE SEWAGE DISPOSAL SYSTEMAND/OR WELL INSPECTION REPORT NAME __ - Npp P�rHr�O N� E/ ® �❑ NSE W lC_. �% jQ �y[/tC SLG I�j IH^( 'tcu PGRADE _ MAI LING ADDRESS an"t- - ,9 WS"7' LEGAL DESCRIPTION LOCATION .� NO. OF 13EDROOMS Well / t Absorption ajea Dwelling f DISTANCE TO: ,[.'_' �7� PERMIT NO. 4nn U Y � s� Csus �&v o~. Z Manufacturer � Materi� No. of compartments Liq. capacity in gallons Inside length IF HOMEMADE: g Width Liquid depth pJ�Y z DISTANCE TO: Well _ Dwelling e PERMIT NO. z h Manufacturer Material Liquid capacity in gallons Lu Well Foundation i� DISTANCE TO: �� Cif Nearest lot line r� PE IT NO. �� a a- Z I— Q No. of Tines Length of each line � Total length f lines Trench width % t inches Distance between lines cc p T��%9p off title to finish grace e _ _ Material beneath the Total effective absorption area a 046 ':P- s 7-D / "''ll inches Length Width Depth PERMIT NO. U Qh LU Type of crib Crib diameter _ Crib depth Total effective absorption area A to DISTANCE TO: Well — Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT UJ JBuilding DISTANCE T0: foundationSewer line Septic tank Absorptio AarZ) OTHER PIPE MATERIALS j � 7 Gt`liC� A,- ,-SOILL -Tr — — SOILTESTRATING INSTALLEnnR,,,,'' ��!e.. 11 ._/I:KXJN9 p `—(mak=-t�—r�s•'� REMARKS itn rN Eat, cr APPROVED DATE LEGAL jtsI l Z., /! :y lam/ q U.,_J 5 1-J. I ,=— a a . ..... F,_"il 'HII-4 RA C'") F. If"ll C -i E_ ­ HEAL M Al'A", Ehl',.Q RCIPAVIEPTI"Al_ :17 1.,* C"I" 10 N 7 V-4 ':..R BOX CHIJC.3IAI­::.' LO1::1 ITI C.,Jki 'T L. 1 2-, ITl,"-5TEM IS, : TRENC:H I TIN." I F`_ '-� .5 ID't' ,'QUARE­ FEEI BECIFT. )OMC; SOIL RATING F"F,-`BF: mn 2 8 C', .FIJE.. I` I E -S'O I L. AB,,`;ORF­,TIO[,.i SYSTEM IS: .. REG!UIR[ED SIZE Of:' 'I T" 1-1 - "..z. .11 17 1=: P-4 CE4, a:-, f:l%-, F,-- I- I -HE LEkli.3 TH DIJ,,IEI,-,GIcIN IS THE LE6IGl'H Cl Nd FEET) OF," THE TRENCH OR DRIAD-IFIEL.C.; '!HE I)EF"I'l-I CIF' A TRENC,':H OR PIT IS 'I'*HE DISIFAhlIDE BET"EEr.,l THE SLIRF:'A]'-'.E C'IF THE GROLRAD I IND THE I BOTTU'l (")f" THE E;-,,'C:A',,-'FITION FT."ET.". THERE Is i.,,o i r.: T 1411TH F. -OR T'R, EhIC.1 -1E, S. THE GRA'�-UL I -E; THE I'MAIVIUM DEPTH OF GRAVEL E,,ET1..IEEI,-,I THE OUIT.-ALL F`IPE' "I"M" BOTTOM OF- THE EXC.:AIvlATION -AN FEET'.�. C" , 90 1 Fe EE F -*-*n 'n -7o- iEE F*,, 1- -11- -.1 N V-.1 "-:5 1 ;Z", I J_ Ci) CE -,s jC,_m"F-H I .. IL_ C11 0-4 1 C". F I." f"ERNIT f`iF-,PLIC.AhIT HAS THE REESF-01'151BILITY TC) IWORM THIS "14T DLIRINE, G TH :IJI.,.­PEC.:-rI0NS OF:' ANY NELL.2; TO THIS FROPERTY AND I+IE NUMBER ('.IF RESIDENCE'S THAI' "I"HE IAELL WILL SERIVE, X CAP -4'_S3' Ii F`4 I=L' LJ X FC 0-H E,'m OF Ai' -JY IdITHOLIT Fll,.JAL. lN,._.,PEC.TIC)I,4 AND APPIRCIVAL BY THIS F"Pl,"IR)"HE ill WTI L. BE SUBJEC":'J" Tu"i PRC.)_-,ECUTIOI,-,L EIETI-CEN A WELL ANE.', ANY Cl N —S, IT I-: SEWAGE DI:POSAL IS J.01D r-,E,.E"F F'OR 1-1 I-RDil'i"i"E I. -JELL OR J."50 TO G 1N 1 FEE"I" FFZ011 A PUBLI'C. WELL DEPEND11,4j'3' iJP0l'--1 "I"HE 1"YPE CIF' I*-*,UF3l 1.41EL.L. MININUH J,,).,STANC.:E F­-ROi,,,l A PrelVATE WELL. TO A PRII..-li:'iTE SMIER LINE I'S 25 F'EET f -WAD ..r.0 1 1-1 SEWER LII`,,IE IS 7r,:i FEET. CiTHE'R MAY APPLI.1-1. SPECIFICATIONS. F-iJAD CONSTRUCTION DIFIGRAMIS FIRE Tc) :01E.".URE PRCIIDF"R IN'...;TAL LATION. F"i F-".,hwh 1 A— E 1 C'm F_,.: C"": FEE' Ill FE". FEE F,;.', ::-:-- -.,L .. 02"N I C.E.RFIF"Y I'llAl 1: 1 All F"All'I'LIFIR WITH TfiE RECDUINDIENTS FOR 014 --SITE SE WEF AND WEI FIS, SET BIT' THE' Ml 11'.11 C I PALI TITI (.IF ANCHORACIE. 1 IdILL Itti."JALL I"HE STEll IN ACCORDAWE 14ITH THE G,01')E.S. A- E SEWER SlYSTEN MAY Rf,-,.,!IJIRE ENUIRGE11ENT IF:' THE." I I.JklGERSTAND THAT THE OW11" 1. D F J Cl, E ISA-ElICIDELED TO It-CLUE'lE MiDRE THAN 3 BEDROONS, fif T ERICI`.-,Ohf`' BAC'I-,,J-IOE' z O & E ENGAEERING & DEVELOP HENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Performed for: Name:- loe A-Aa4-s-le, No. 6cla - ?tirl5rz Mailing Address: Legal Description: Z—, Z) -r- Depth (feet) Soil Characteristics 0 Mz— —7 �0/p il-nec— tz')l pc'ewr'. 2 3 11 6 7 1 `0 / AJPC�41�r-5 4614 -- 6. 9. 10 11 12 13 14 15 16 Ground Water Encountered: Yes— NoIf yes, what depth Proposed Installation: Seepage Pit— Drain Fleld-l%— Comments: 11 PLOT PLAN PERC. TEST Performed by u!52 G- Date: 19VAse 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) Lot 5 Highland Terrace Subdivision Location (address or directions) (b) Applicant Name Albert Kahplen Telephone: Home 694-9582 Business Applicant Address 112 Bonnie Way, Eagle River (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ®x Buyer ❑ ; Other ❑ (explain); (d) Lending Institution City Mortgage Telephone Address (e) Real Estate Company and Agent Address Telephone — (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Mk Multi -Family ❑ Other Number of Bedrooms three(3) 3. WATER SUPPLY Individual Well l–xlxx Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsitesax Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-028 (11184) 5. ENGINEERING FIRM PROVIDINw INSPECTIONS, TESTS, FILE SEARCH, DA i A AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, .the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S Engineering, Inc. Telephone Address Date Engineer's Seal This department has received written confirmation from the engineer regarding the Conditional Approval of March 10, 1986. The corrections have been accomplished and an inspection has been completed by the engineer. The subject property meets with Municipal standards and is now approved. 6. DHEP APPROVAL Approved forrhr_e (tel bedrooms by • ' �^ �' �Y ^^ Date �T1ien 40, 7 98b XXXXXXXXXXXX Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84( a HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 7 June 27, 1986 Muwicipati-,ty o6 Anchorage Department o6 Health and Human Services 825 L Strut Anchorage, Alaska 99501 ATTENTION: Steve Monris ROBERTA.SHAFER CIVIL ENGINEER 694-2979 REFERENCE: Lot 5; HighCand Terrace Subdivision In February 1986 you i.6sued a conditi.onaC Health Authon.ity Appnovat {yon .the residence Located on ,the 4e6enenced property. At that time a new wee had been dn.illed but could not be placed .into senv.ice due to the winters weather conditions. This wee has now been placed into service and a new coti.6onm bacten.iat analy.6is showing sati.s6actony resutts is attached. The otd weld has been pnopeAty abandoned. Request you issue a 6inat HAA on .this pnopenty. elket MUNICIPALITY OF A,,C,,O'AG:: DEPT. OF HEALTH F rNVIP.C�VA4ENTi'L P�OTtCTl0��1 A. HAFER, P.E. 1986 /ss C _IV- SRB 196X EAGLE RIVER, ALASKA 99577 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 d 1. GENERAL INFORMATION (a) Legal Description (include lot, /block, subdivision, section, township, range) e2eo--- J✓ Location (address or directions) (b) Applicant Name C<( /� ��aL�i'`� Telephone: Home (O p X6_9��Business 71-- Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer E7 ; Other ❑ (explain); z Lending Institution r( Telephone Address (e) Real Estate Company and Agent /V " Address Telephone (f) Mail the HAA to the following address: Esgl*'FIvft, Alaska 90Si7 2. TYPE OF RESIDENCE Single -Family Multi -Family [] Other Number of Bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ❑ Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (1 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DA, A AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm __..'- E #jhx,* ro Telephone Address SRB 196X Date Brag a Rayer, Alaska 99b"li 6. DHEP APPROVAL Approved for -1 Approved 1—f .p '""l s �T��YYf f ' i,Y4e9..}ty W 1457.4 bedrooms by j"'' 'Q �� Date Disapproved Condijiona��r Terms of Conditional Approval 55C 2O 4J /'cCNO X 7'0 a,-�o CL. O w cz�(_ ,11v19 Hoo kc . t y 7a New AU X& L 8y Al, Z-, z: /S ck4xi 7/F /'0 5 i�`GI�IL� w/L� r3r 2�9ui7��p 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) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) MAR 0 61986 CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: � 7- S� 4 1 R,e,it-c°i� A. WELL DATA Well Classifications VI�'�I`¢- If A. B, C, D.E.C. Approved (Y/N) Well Log Present t9/.N) — Date yompleted - Yield Total Depth t(oC"' Cased to 3� c 9CO epthGv of Grouting Static Water Level L4 $ Pump Set At k,t-Lt - Casing Height Above Ground - Electrical Wiring in Conduit,( Sanitary Seat on Casing d9/NT---- Depression 9/NT--- Depression Around Wellhead KS) Separation Distances from Well: To Septic/Holding Tank on Lot On Adjoining Lots l cs t] To Nearest Edge of Absorption Field on Lot t cs'm *% . ; On Adjoining Lots (� To Nearest Public Sewer Line r`t To Nearest Public Sewer Cleanout/Manhole - A - _ To Nearest Sewer Service Line on Lot 5G ~ Water Sample Collected by G4 'S (fib {huefi�rK_ t^t�" ; Date Water Sample TestResults'Sp�-ib'-�` �b,9L4_ ) Comments �t/ -�wC ►N 1t-13r� i n! d'/�2i/�!6 , ��sl��sn✓G S0K%N.G (1)6oUr S oni 7_�%16ti45'w) B. SEPTIC/HOLDING TANK DATA Date Installed �' tZ�� Size No. of Compartments - Z Standpipes&Xr- Air -tight CapsoXy_ Foundation Cleanout ek-_ Depression over Tank (4) ate Last Pumped _ 2' -&'36 Pumping/Maintenance Contract on File (Y/N) —;for for Holding Tank High -Water Alarm (Y/N) /J4- Temporary Holding Tank Permit (Y/N) 1J/A_ Separation Distances from Septic/Holding Tank: �aa I L - To Water Supply Well To Property Line F d` To Building Foundation To Disposal Field __ To Water 4 aiwR/Service Line vary To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �c¢7d �1 t'�– Type of System Design /AcX(6H Date Installed ['/-Z -,jb Length of Field 7y Width of Field 3 Depth of Field Gravel Bed Thickness is Square Feet of Absorption Area %/ /b Standpipes Present©k Depression over Field,(6 Date of Last Adequacy Test Results of Last Adequacy Test A i rA-t- GX)/ Separation Distance from Absorption Field: To Water -Supply Well To Property Line ZOt+ To Building Foundation % To Existing or Abandoned System on N/ i �- Lot On Adjoining Lots To Water-Ma+n/Service Line 5-0 a To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Dimensions Size in Gallons anhole/Access (Y/N) "Pump On" Level at "Pump Off' Level all High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA an HAA guidelines in effect on the date of this inspection. S & S Engineering 3 �( Signed SIB 6 Date Company Eagle River, Alaska "Vy MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) . �. ....,....i. Babxt A. Slafe? No. 1457-S t APPLIr NT FILLS OUT UPPER HX. ONLY - Property Owner /;' i _ i; -, -,' ) �� r /! /-/ Ir Phone Date Date Mailing Addressk' �. Zip Code J"..j.. %� h i` i - .,• [: �c - Buyer �. Address _ Zip Code Lending Institution Phone Address Zip Code Realty Co. & Agent Inspector Phone Address Zip Code I Legal Description i Street Location ri ,l Type of Residence IKSingle Family JUN ® 61583 ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply [Y -individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility e0 1.1,nt, of tic.", IN Sewer Disposal �l Individual Year Individual Installed: / ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. (i/) Clrin T)efl '> lime Time Time Time Date Date Date — pale g U/ Inspector Inspector Inspector Inspector Field Notes: � "� E0 (fin I JUN ® 61583 1.1,nt, of tic.", IN ( - VAPPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE _ Soils Rating Date Sewer Installed j- Well To Absorption Area Well Log Received -- V Well to Tank Septic Tank Size >J