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HomeMy WebLinkAboutTHE VILLAGES TIDE VIEW LT 11The Villages Tideview Lot I I #020-091-55 Municipality of Anchorage On -Site Water and Wastewater Section a (907) 343-7904 Page 1 of2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211067 PID Number: 020-091-55 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New R Upgrade Christopher Ori Site Address 16921 Tideview Drive Phone ABSORPTION FIELD R Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound ❑ Other Number of Bedrooms (Soil Rating Total depth from original grade 6 1 an LEGAL DESCRIPTION vrviar Depth to pipe invert from original 4.0 �+.� grade Ft Ft. Gravel depth beneath pipe 6 Ft. Subdivision Block Lot The Villages Tide View 11 Fill added above o riginal grade 0 Ft. Gravel length 49 Ft. Township Range Section Gravel width 3.0 Ft. Beds: Number of Lines Distance between lines SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 588' Ftz Number of trenches 2 Ft. Dist. between trenches 20.1 Ft. Well 81.3'=00'+NA NA 25'+ TANK ❑® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1500, 1000 Gal. Surface Water 100'+ 100'+ NA NA Material Number of compartments Lot Line 10'+ 101+ NA NA NA HDPE (2ea) Foundation I 10'+ 10'+ NA NA LIFT STATION Manufacturer Capacity Remarks SEE FILE FOR PERVIOUS LOT WAIVERS Gal. *(N)&(E) FIELDS MEET 1176FT^2 RED'Q FOR 6 BR Alarm location Electrical installed by Installer A+ Excavation PIPE MATERIAL House Drainfield to tank Tank to 3034 drainfield 3034 3034 CO/MT3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 100.0 ft Inspectiones: v 6/30/21 2„, 7/1/21 Location and description 3 r 7/3/21 4” West Corner House Trim ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date _ DF A/ qg TH CE 8 14 9 . , A Septic Syste Approved Date Note: this appro does not include well permit requirements. (Rev 05/02/181 Municipality ®f Anchorage I)rp;ntmrnr P.O. Box 196650 e 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV211017 -Revised COSA#: Permit#: OSP211067 PID#: 020-091-55 Legal Description: The Villages Tide View Lt 11 Engineer: Pannone Engineering Services Your request for a waiver of the required 100 feet horizontal separation from the septic tanks to the private wells have been approved. The approved separation distances are from the 1000 gallon tank to the Northeast well 82', 1500 septic tank to Northeast well 81' and the 1500 tank to the Southeast well 91' This waiver approval applies to the existing tanks only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 3 Z Z-3 Approved by: 1&47 p� Name of Re ef **** VARIANCE/WAIVER REVIEW **** v-i�mmnc)0—U D 0 CO z C0 o C ' -yG 0 0 P X A fy*'I j-rj �r n�� mm> -V O (-) C m r- O c� -Dirl my am Z � ZO z 0 2 O rr- m —I (n ;a 0 D r y O Z � cm N 1c: N m -I-II ZC DOcomlln w O� C W O N Az. D c (� m p ------------- m r �7 m N r f *t ;J � ;u (n W Cn D O O 0 -00 -DI >i740 �f?i OZ i Fj;Q o mmZE -00-DI DN 0 -im (Z -Im . V :P O .p V Cn ID N Cn O .p V -A V -P N a' -co CSI W p V D 00 -, O cO Gn -. N -P O -. O � D CO O c� -9m 0 m P N v Un Cn N) N -P- DO N CO 0 = n rn O O > � Gn O � m Ifl V -, - N 0(n 1c: K: Cf) D(n m--iz [�OmDOm zlnm� m -I-II ZC DOcomlln KM D w -0-i Z -<�OmDO-0 zlnm-�z C C) rm x Az. D c W z--ir- m ADX m p DCC)r n� m r �7 m < (,-� z r f *t ;J � ;u (n W Cn D O 0 -00 -DI >i740 �f?i OZ i Fj;Q o mmZE -00-DI DN 0 -im (Z -Im . r09 z x o IimO z O Om U (n Dx m � m .. o S o.. "m Fri ��orn N u cnJo� O mZ rn�o, ����D N-0 O(Jlxm L' ^ O NCnp0)n� �' o � r*I � -q G-) KQ0 In `Q CY) � � n � � D � r9m Q pO � 0 I O -q - -9m 0 N z 0 = n rn O O > � Gn O � m m - 0 -I n O r mzm to r m coo coo m r- -q > A In 8 N % x x C) Om mooD (. X; o x x pmi -p0D 00 �� Smmz / Og "m oo n r D C7 TI m= d / Op O\OOm N�- V�`�S � no o _ mDD / m'il D z r ' = cc/)O td 10 n Com,., I� /Ry / � GK• �/ N • M { o. y � r m N S ZOZ � w DO" - J0 Z -i m TI z z \y0 I nm ICN D X rp (n (n\ bd l7 O .. i �-0m0 m-9�� �-I�yD rm-0 mXm "per zoo m0 amm� m I �Z{ z—I K _ :E 4`x- >mz� �N pf-'TIC�Cn30L �— 1D nN� / 4 z X 0 0 r m 1 0� 0 m -ID 0C 0C) m s m'o m rmO o p\ m \ m n m 0 { tic I '� / D —� �o;o ' cl0 --- - - ED 3 Dr \/ mnln 4 / m n=m / / d0 cn r z �- 0 pZ NOTES: PANNONE ENG SVC LLC (C.1. 1088) """ ,,, REVISIONS DATE RECORD DRAWINGS ?HONE (90B) 745OX -82001LUM, AK FAX (907)9745-8201 _=��?��' 45 of A��s�9'� REV06/17/2022 Sc0ALE09/2022 1 = 50' THE VILLAGES TIDE VIEW, LOT 11 's P.I.D. NO DRAWN ��C CHRISTOPHER ORI - ............. 020-091-55 � ,�-, Steven R. Ponnone ,- 16921 TIDEVIEW DRIVE ce-alae �= PERMIT N0. SITE PLAN �- OSP211067 ANCHORAGE AK 99516 '��,°° �-Ess`u��,= SHEET 2OF2 Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. O. Box 196650 Anchorage, Alaska 99519 Subject: The Villages Tide View L11 Septic System to wells on lot. Ladies and Gentlemen: Due to space constraints on this lot, we request a separation distance waiver for existing septic tanks to the existing wells on the lot. The existing well heads lie at a higher elevation than the existing septic tanks so it is not likely that effluent would travel toward the well heads. The distances frorn the existing wells to septic tanks are as follows: 1000gal Septic Tank to Northeast Well: 82.8' 1500gal Septic Tank to Northeast Well: 81.3' 1500gal Septic Tank to Southeast Well: 91.4' The Villages Tide View Lot 11 Septic Tank to Well: Distance from sewer system bottom to groundwater 0.78 Soil sorption below sewage system 3.00 Soil permeability below the system 1.25 Water table gradient 2.00 Horizontal separation 2.28 Total Points 9.28 The sum of the above values could equate to the following conditions: "Contamination is unlikely from bacteria but could be possible from chemicals or virus". In my opinion, this waiver request meets the above criteria for approval and likely does not constitute a risk to health. I hope the above information will assist you in determining that the waiver should be granted. C.O. `OX 1807 Palmer, 13d( 99645 ielephior? : (9107) /745 8200 ['A.`•'i: (9,07) 74515 320.1 Page 2 of 2 If you have any questions or concerns, please contact me at 272-8218. Sincerely, ®®E OF q as 41 Co Steven R. Pannone . �Q 81 '�Ca a r4®au>A©sm��� Steven R. Pannone, P.E., F. ASCE Owner/Civil Engineer ir`ailiE'ig: P, C). Box 1807 PaIri,(,tr, .':; 1C; 5 Ielep gone: (907) ;745 8200 FA",". (go-, c -a -{m zr-=a r n 0 m coam:z cn 10 izo� z �° MZo SQX CD o z o zmQ �mXP Doom 0 X m� o= a z 3a dl c 3 N ( N 6 m c d so < < m n _ m = x < N j i- N N O n .p7.. mCD m tD 7 N N N 'o N A N N m = D LS mvmSo N I omC, 0 D n m n D o o CD 0 2D N m d c m Ertl c O N m m -.,N a— N cr p� cr N 0 ? = s 0 t't0 Nn m n �so q�0 M a fm o v,Zl< m N N cr m m m m E roomno N m n N = n Ey � o o c (D CD m N m s n<° m w . m m N °'; o m o cp0 o m m o .v , o co = a N C. N _ ngnm,N C: m o CnL'3 mos N N O O N N N N (O (D ��`, N O m7 3 O C,, = N O c Er N m cr N 0 O m O =. C a' _ msvno. CO m i O n � momma wm0.a0 En�m m�.000.0s nm � M O m Al -ft) CD 10 qm cr 0 `G rn Nc=i m o m m o CD m �� � 0)�� Co (1)_a m,< S O � p= O O Col SD D N O Sll m c< T oo���wa m`«m = Q 0 � ch D - c0 to - mm m mv�o�n'o _ ;U n,;cn•CD 0 � m m _gym N m m O Ll1 CRI 0 � > C `G CD 3 27 � = D1 c a m X N, � cn ( EF nm �• � CS' ON n CL m o to - � N -Cc: m�v � Cf) N n O -O _ p � O` CD Q O N O �. 'a a_rL m D al m 0.0 �.�� m (a CL z CD cn CD r ch ca / alp 0 W,, s� =r _cn fD o (D 7611-1 / i B �O 9 sA / / C� o C) 0 -o VO 0 � r obi O O oy 2 2 n� A o = n O O oy 2 2 n� A N000 15'41 "W 118.57 �6g ,X% •STSto .�' 0�, • =�,` • - V--� . n D00Z r f -{ 0Aco C9 xw hoR 0 tVN\c,PAL,7- r0 t 1UNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program o"�cnr AS< j PO Box 196650 4700 Elmore Road t Anchorage, Alaska 99519-6650 Phone: ,(907) 343-7904 Fax: (907) 343-7997 c http://www.muni.org/onsite De 1)artnient On -Site Wastewater Disposal System Permit E Permit !Number: OSP211067 ��� `� Effective Date: 6/30/2021 Work Type: Septic Upgrade Expiration Date: _ 6!30/2022 Tax Code Number: 02009155000 Site Legal Address: THE VILLAGES TIDE VIEW LT 11 G:3336 Site Mailing Address: 16921 TIDEVIEW DR, Anchorage Owner: ORI CHRISTOPHER RUDOPH & Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Z Disposal Field Q Septic Tank ❑ Holding Tank ❑- Privy Lot Size in Sq Ft: 43560 Total Bedrooms: 6 ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B Issued By: Y Date: �u Date: L Municipality of Anchorage / P.O. Box 196650 ® 4700 Elmore Road Department Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV211017 COSA#: Permit#:OSP211067 PID#: 020-091-55 Legal Description: The Villages Tide View Lt 11 Engineer: Pannone Engineering Services Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the private wells have been approved. The approved separation distances are from the new tank to the Southeast well 75', existing field to Southeast well 95' and the tank and existing field to the Northwest well 95'. This waiver approval applies to the existing absorption field and proposed tank only. Any fixture upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. .................. 0 M a 0 M M ...... 0 X X X M X ........... ■ 0. 9 ... 2. 0. t t t t .. t 0 M 0 0 M 0 ...... ■ 1 Waiver is Granted: X Waiver is not Granted: Date: Approved by: lam/ Name of Reviewe **** VARIAN C E/WAIVER REVIEW **** MUNUPAUTY OF ANCHORAGE Community Development Department `�y Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-091-55 Property owner(s) Christopher Ori Mailing address 16921 Tideview Drive, Anchorage, AK 99516 Site address 16921 Tideview Drive Day phone Legal description (Sub'd., Block & Lot) The Villages Tide View, Lot 11 Legal description (Township, Range & Section) Lot Size 43,560 Sq. Ft. dumber of Bedrooms 6 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank FKUpgrade ❑X Duplex ❑ (D) Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Septic to existing well Distance: 75 I certify that the above information is correct. [.further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: -0,5q5 Waiver Fees: 1(SO Date of Payment: Receipt Number: Permit No. 0-!5/02 110 G % Permit App__- :. I Date of Payment: Receipt Number: Waiver No. 0!21 Z ( Municipality of Anchorage On-site Water and Wastewater Engineering g REVIEWED FOR CODE COMPLIANCE Pannone i ' LLC OSP211o67, Deb Wockenfuss, o6lml21 Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com June 29, 2021 Subject: The Villages Tide View, Lot 11 Septic System Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic system to be issued for this property. The proposed systems will serve an existing house that will be renovated with a new total of six (6) bedrooms. Currently the lot is developed. This lot and the surrounding developed lots are or will be served by private wells. Required separation distances to the surrounding wells will be maintained. The system will maintain the existing 75 -foot separation to the existing wells on the lot. See waiver request. 1. Soils. One test hole was performed on the lot in the vicinity of the system in 1977. One test hole was performed by PES in June of 2021 and groundwater was monitored for 7 days. No groundwater was observed. Based on the results of the percolation tests and overall soils appearance as found by PES an application rate of 1.2 gallon/day/square feet was used for a conventional wastewater system. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. 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. 4. Topography: The existing topography generally slopes from the northeast to the southwest in the area surrounding the septic system at approximately 10%-15%. 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 this or the surrounding lots. Steven R. annone, P.E. s f4 xiiint(3: P.O. Box 1807, Palmer, AK 9964-5) e ephone. (907) - 2(C Y: J7t 7/1-5 -8201. Municipality of Anchorage On-site Water and Wastewater Engineering REVIEWED FOR CODE COMPLIANCE Pannone LLC OSP211o67, Deb Vbbckenfuss, 06l3al21 Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com 12 March 2021 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P O Box 196650 Anchorage, Alaska 99519-6650 Subject: The Villages Tide View, Lot 11 Septic System to wells on lot. Ladies and Gentlemen: We request a separation distance waiver for an existing absorption field and a proposed septic tank to the existing wells on the lot as follows. Septic Tank to Southeast Well: 75' Septic Tank to Northwest Well: 95' Existing field to Southeast Well: 95' Existing Field to Northwest Well: 95' Conditions have not changed since the waiver was issued to the system through Toben Spurkland in November 2005. All justification and points assigned at that time are still applicable and valid. If you have any questions or concerns, please contact me at 907.745.8200. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.0, Box 1807, P ire' er, Al< 99645 elepi":one: (907) 745-8200 FAX: (9 7) 745-8201 UPGRADE SEPTIC SYSTEM NO. BEDROOM: 6(900 gpd) TANK SIZE: 1750g (MIN) PERC RATE: 1 —5 MPI SOIL RATING: 1.2 GPD/SF AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 6.0'ED MIN LENGTH: 62.5 LF RESERVE SEPTIC SYSTEM NO. BEDROOM: 6(900 gpd) TANK SIZE: AS REQD FOR CAT III PERC RATE: 1 —5 MPI SOIL RATING: 6 GPD/SF AREA ROD: 150 SF SYS. TYPE: DEEP TRENCH 6.0'ED MIN LENGTH: 12.5 LF USE: USE: EXISTING TRENCH 49LFx3'Wx6.0'E.Dx10.O' TD 20LFx3'Wx6.0'E.Dx10.0' TD PROPOSED TRENCH 49LFx3'Wx6.0'EDx10.O'TD TOTAL AREA: 1,176 SF Municipality of Anchorage REVIEWED FOR CODE 1 WATER SS NEW SEPTIC ABBREVIATIONS TH TEST HOLE (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. FC FOUNDATION CLEANOUT FS FLOW SPLITTER MT MONITOR TUBE NO. TYP TYPICAL R.I. RIGID INSULATION 0' I �\ SZ WELL (E)14 i OD \ 41 \\ 1` I I \ \'o 2 ���� 10 w /W 95.1 WELL (E), `,. \\\1 76.2 6BR HOUSE w TH- 1 DECOMMISSION EXISTING 1250g SEPTIC TANK 'INSTALL MINIMUM 1750g SEPTIC TANK (P) PER 15.65.205 \ yaps INSTALL DOUBLE CLEAN OUT AND FLOW DIVIDER CONNECT TOt EXISTING AND PROPOSED FIELDS 1\ , I UPGRADE DRAIN FIELD A \ \ TRENCH (E): 49LF x 3'W x 6.0'ED x 10.0'TD TRENCH (P): 49LF x 3'W x 6.0'ED x 10.0'TD1 "A I INSTALL CLEAN OUT AND MONITOR TUBE AT EACH END i� -w RESERVE DRAIN FIELD 20LF x 3'W x 6.0'ED x 10.O'TD , '3 I \ INSTALL CLEAN OUT AND MONITOR TUBE AT EACH END NOTES: PANNONE ENG SVC LLC 3(C.i. 1088) " ""`t, REVISIONS DATE FOR CONSTRUCTION PONE O. BOX X71808200ALIAR, AK 907)9745-8201 _ �P�� �F A�gs�9'/' SCALE06/29/2021 THE VILLAGES TIDE VIEW, LOT 11 - P.I.D. NO DRAWN DRM CHRISTOPHER ORI 020-091-55 i '• Steven R. Ponnone ; 16921 TIDEVIEW DRIVE ce-8149 -- PER,;Pyx . osPxxxxxx SITE PLAN ANCHORAGE, AKS: SHEET """` 1 OF 2 NOTES & SPECIAL PROVISIONS: REVIEWED FOR CODECOMPLJE 1. SCOPE AND SPECIFICATIONS: 1.7. ALL CONSTRUCTION SHALL INSTALLED SPECIFIED THE MOST CURRENT EDITION OF THE MOA COMPONENT PARTS AND MATERIALS USED IN COOSP211067, Deb Vlbckerlfuss, 0 NSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS IN AND AND N ACCORDANCC E WITH AMC 75.65 AND 15.55. 1.2. CONTRACTED WORK WILL BE IN COMPLIANCE WITH MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) DIVISION 10 & DIVISION 20 AS APPROPRIATE. 1.3. SCOPE OF WORK: INSTALL NEW 17508 (MIN) SEPTIC TANK, AND SOIL ABSORPTION SYSTEM. 1.4. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 16.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 1.5. STRUCTURES DEPICTED ON THE SITE PLAN ARE BASED UPON ONE OF THE FOLLOWING:O�UAL PLOT PLAN DEVELOPED BY OWNER; A PLOT PLAN DEVELOPED BY RLS; OR A SURVEY AS -BUILT. 2. CONSTRUCTION SPECIFICATIONS: 2.1. ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN 2.2. EXCAVATE THE DRAIN FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE AND END OF TRENCH BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL. 2.3. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. 00 NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO ti" PRIOR TO INSTALLING THE PERFORATED PIPE. 2.4. ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4 FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER. 2.5. ALL INSULATION SHALL BE 2" THICK DOW HI -40 INSULBOARD OR ENGINEER APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK OR LINES. 2.6. GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2 FEET MINIMUM. 2.7. COVER THE DISTRIBUTION PIPE WITH A MINIMUM OF 2" OF SEWER ROCK AND COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL. 2.8. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS, 2.9. SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MINIMUM SLOPE AND 3:1 MAXIMUM SLOPE AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MOA CODE. 2.10. RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE AND END OF SYSTEM. 2.11. MAINTAIN 5' SEPARATION BETWEEN PERCOLATION HOLE AND THE DRAIN FIELD TRENCH. 2.12. EXPOSE, PUMP AND FILL LOG DISPOSAL CRIB OR CONCRETE TANK WITH SOIL TO ABANDON IAW WITH MOA CODE IF NEEDED, 3. CONTRACTOR RESPONSIBILITIES: 3.1. THE CONTRACTOR SHALL FAMILIARIZE THEMSELVES WITH THE SITE CONDITIONS AND LOCATIONS OF ALL LOT LINES, EASEMENTS, WELLS (E & P), SEPTIC SYSTEMS (E & P) AND SHALL MEET MINIMUM SEPARATION DISTANCES OR AS NOTED. 3.2. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 3.3, THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 3.4. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 3.5. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 3.6. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 3.7. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED -LINE AS -BUILT DRAWINGS TO THE ENGINEER. THE RED -LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 3.6. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN -OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 4. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WILL BE PERFORMED IN ACCORDANCE WITH THE APPROVED PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS -BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY: TITLE: TEST HOLE 1 7 FILL MIXED FILL 2 3 WAS GROUND WATER ENCOUNTERED? N 4 IF YES, AT WHAT 5 DEPTH? -NA-' 6 DEPTH TO WATER AFTER MONITORING? -DRY 7 DATE: 29JUNE2021 8 DATE NET TIME WATERRATE LEVEL READING 9 (MPI) 1 22JUNE2021 GM/ SILTY GRAVEL 10 SM AND SAND 11 6.00 3.9 12 5.04 13 PERMIT NO. Osaxxxxxx 4 14 7.76 2.72 15 5 16 6 BOH 7.69 17 3.8 7 is 5.04 SOIL TEST RESULTS /ANALYSIS • PERCOLATION RATE 4 (minlinch) • PERC HOLE DIAMETER 6" • TEST RUN BETWEEN 4 FT AND 5 FT. SOILS LOG READING DATE NET TIME WATERRATE LEVEL READING NET DROP (MPI) 1 22JUNE2021 5.04 THE VILLAGES TIDE VIEW, LOT 11 CHRISTOPHER ORI 16921 TIDEVIEW DRIVE ANCHORAGE, AK 2 23.3 MIN 11.04 6.00 3.9 3 5.04 PERMIT NO. Osaxxxxxx 4 10 MIN 7.76 2.72 3.7 5 5.04 6 10 MIN 7.69 2.65 3.8 7 5.04 8 10 MIN 7.60 2.56 3.9 9 5.04 10 10 MIN 7.57 2.53 4.0 11 5.04 12 10 MIN 7.54 2.50 4.0 13 5.04 14 10 MIN 7.52 2.48 4.0 COMMENTS: Test hole excavated by A+ HOME SERVICES. PERFORMED BY: PES. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. 19 -) I DATE PERFORMED: 22JUNE2021 NOTES: PANNONE EMG SVC, LLC. (C.I. 1088)1" PHOOE BOX1029548?ANCHORAG18 9, ANCHORAGE,AK -_��P�� �� A4gs9,, "' "' ""' Stever, R. annono, �., ce-alas %; REVISIONS DATE FOR CONSTRUCTION THE VILLAGES TIDE VIEW, LOT 11 CHRISTOPHER ORI 16921 TIDEVIEW DRIVE ANCHORAGE, AK S06E29/2021 P.I.D. NO 020-091-55 DRAWN DRM SOIL LOG PERMIT NO. Osaxxxxxx SHEET 2 OF 2 r ♦_ MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I` ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-0720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW �QL{VytOnt) T S"I'rht:t(�ptr 3YiS-AoaUPGRADE MAILING lDRESS PO 60(l 1D-78'7 rjljt, a5.a, gQSl 1 LEGAL DESCRIPTION L-11 Ike- (Itl(a5P5 TIbeVlew LOCATION NO.OF BEDROOMS l) i (10 Sce,j ic� (lirkLwAy 4 Sf.,5n,f h Well I- OT fQ Absorption area f Dwelling PERMIT NO. vY DISTANCE TO: 1n/o'rbSe-t.-' 1 $s rNOT IIj g 1 030-7 W2Q WF lT JJ Manufacturer(` yepl, MaterialC_`( No. of compartments Liq. cr�-5oallons Inside length Width Liquid death IF HOMEMADE: d Y DISTANCE T Well Dwelling PERMIT NO. -10Z CI Z 4 Manulact �� / Mate �y,iquidc'aPacitY in ksiw— _\ O Well Foundation Nearest lot line . PERMIT NO. W= DISTANCE TO: ,.may -••,BMJ - - i0 ?100-7G � LL 2 No. of liineh Length of each line Total length of Jipe� Trench width ` Distance t� lines H Z W 4 inches H Top of the to finish grade r Material beneath the FT- Total effec�e.absorption area O 4 �j-J.ws.es l9 y Length Width Depth PERMIT NO. W Q F- Type crib Crib tliameter Cr' depth /Total effective abs ption area ) H B ding fou ion Nearest lot line DISTANCE TO: Depth Driller Distance to lot line I PERMIT NO. W W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) � OTHER PIPE MAT RIALS 303 y 1Cr�sr r (p{ SOIL TEST RATING INSTALLER p - �Lt-tih�i. REMARKS 0 . �1/�• reins 7 I/v r1 tY o3�sf 2Sd bra E•r TtanK rr' n:oz� 10 fits sv sti it"211 qzt-1 ^ M - APPROVED/ DATE LEGAL �'�L�vt-d� 72-01 Rev. 3/78) MUr4I C I IfnL- I TY 4F F=l tJ(-,HQFZFiGE DEPARTMENT � HEALTH AND ENV I RONMENTAL,"t OTECT I Ott 4U 825 -L-STREET, RFICHOR.RGE, RK. 9S e�1 264-4720 6 vvFcii ` WELL F=l tJO �OtJ— I TE SE44ER F=>ERM I T 1:,30 PERMIT 410. ( 810076 ) ` 'aLt ILI_i0-91 APPLICANT RAYMOND T SLAYMAKER; PO BOX 10-787 ANCHORAGE 99511 345-2032iSL00 LOCATION VILLAGES SCENIC -PKWY r LEGAL 1_11 THE VILLAGES TIDE VIEW LOT SIZE 43560 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER. OF BEDROOMS = /4 SOIL RATING CSO FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: OEP•TH= 110 LEtJGTH= 4Z� GFSF:f4PEL OEF"TH= 6 THE LENGTH DIMENSION I5 THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IF! FEET). RI_=QU I REF? SEF=T I C -rnNF'l S I ME= GFiL_L_ONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- T44Q C ^ ] I M'SF}ECT I CMS ARE FZaIDU I REO --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY 041 -SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE 14ELL TO A PRIVATE TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND AVAILABLE TO INSURE PROPER, INSTALLATION. SEWER LINE IS 25 FEET AND DEPARTMENT WITHIN 30 DAYS CONSTRUCTION DIAGRAMS ARE F?ERM I T tZXF=' I RES E>EECEME3ER 31.. I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR 041 -SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE RESIDENCE I5 REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED:/-.', A ISSUED BY PPLICANT" RAYMOND T SLAYMAKER 1.S�C1 AND WELLS AS SET ENLARGEMENT IF THE V4. 0 • �,-- LOG OF TEsi BORING • •2-11-77 j'•� (�[ c f;rs :n • � -` 11-77 lte;y ff V toansbJr� lssociof� Co-;>leted c- Sheet i i% Engineers — sorvelors • Tolcl O:plh Ifo 75-103 Anchorage, . AfasPa e,'� r io,.e TIDEyiuf cotton •thadU.ed f�Cy Poe -V intoe on D-3 ele potty •aJi-r Cool, Cloudy +25° F 3 \ OJ � • 1a ero�od lialer Table �ep•'!> in ft 1 VAtnoinr ea G'kk`o".G.t i tasacer rime Ocie rI Sandy Gravel T S!4 [ocmia+Cafes £ Dirra.r.,- Ar ON 6Irk No. V/5 -t I5 1. :'iGrav>l�_;5�3 til occ?ccional rnhhlP Boulder Ston. -ti ",1i- I�cSCG: �O �uhAwc7�ai-/L�lsn/ Ill�Wt'� OESCR/PT/ol/ Sai/ /ype, cebe fe tv'e, estimated poricle s%: e, sampler di/ring notes, k depths circalotian /ssl, •, h notes on drittinq cos e., e bils ased, etc. •w ` F Vrgelolion: - I ?T j ()rgpnir rI Sandy Gravel T S!4 [ocmia+Cafes £ Dirra.r.,- Ar ON 6Irk No. V/5 -t I5 1. :'iGrav>l�_;5�3 til occ?ccional rnhhlP Boulder Ston. -ti ",1i- I�cSCG: �O �uhAwc7�ai-/L�lsn/ Ill�Wt'� C-R-� �-c. Pc"„ p ,I 4s Mui�ii�ri�fi�iiiv� ENVIRC '� NT "- r,;CTCCTICN $016 m;i9, STAB ROUTE A ANcnonAGE6 ALASKA 99502 RJFULL F �8 1981 -34344-'7'714 SIX INCI'C WA7ER WELL DRILLED AND CASED OUT TO THE DEPTH OF 500 Teet. DRILLED AT THE RATE OF 520.00 PER FOOT. PROPERTY OWNER Otdeted by, rvt. Trent S.tcupnaket 345-2032 LOCATION OF WELL SITF Lt -1/ D k. Sub- l4le A.-cs- 1 -pr j//Ia/ DRILLER Be&n ie CLau4 of Rar4wAt D-Utt inq Uo4k.4. 0-----21' 94avet. 30;o ctaly bdnde�t Broken bcdtock Pwrz 12 to 21 Aet. 21---500' Bedrock. A 4e&tacn twuy dock. Ro water ptoduattoa ,to 300 feet. Y.iet.d of water from. 300 .to 400 feet 4how4 1/2 qat4 pet nwuae. Ptoductton from. 400 .to 450 feet 4how4 a 1/2 gPri1 4nzAea4e. Tton 450 .to 500 feet .indicates 1/2 ,to one qa,C pet raruae 4n. 4z"e. Tota(. wa teA ptoduc tion. ahou td .Dhow ju4 t unde t Two AWN with an .incAe"e .in, y i.etd wZUL uje. Ove& 2000 qa l4 pec dal. p2oduc tion. ava i to .te. 1.6 gzt4 peA foot In ca4 ng. Totat teeoVCVj. ahoutd come within 15 .to 20 A of Outface. Ove t 700 gcetA of wa to t In tesetve. Subr c&4.i,bte Pump 4houtd be tiwtatted at .tea4t 25 feet off bottom.. Aftet water t4 100^, etwA punp nay. be .i"tatted ten feet deepen. One 110&4e 5UtMWA.Jtbt.e PUMP 4houtd be u4ed. Cort Of Dei tA.tnry: 50 feet no Change. 450 feet X 520.00 pee Pot: $9000.00 no Change for IJe.0 Seat. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 59000.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE 62=1 17th., 1981 �^Y JAN^• SERVICE CHARGE OF IVA% PER MONTH WILL BE AS 5ED ON PAST ACCOU lana N ma; BOX 13E39, STAR ROUTE A A>rCIIQItAG �1f rsia I)O502 344-7714 F I` . , r'), I I (IEEiPTI-ISIX INCH WATER WELL DRILLED AND CASED OUT TO THE OF° I DRILLED AT THE RATE OF 9 -:Moo PER FOOT. r PROPERTY OWNER (;t. i' r-" !Ialt & Slatfrll. rtr�,rho 345-.56n 11-72S4-9!.511 r Hv LOCATION OF WELL SITE Wit. B.U-. SILL. DRILLER 13etn.lc Ga" ar Ra'te22t D>Zi.1,Uit7 %lo,tP.A. ErNIF<Otyµ"rttw-t"iii I WELL LOG: n ---- 7r?T �.Tl irl ns.rr..,/ fli+�►/. r....a ?n•! ntn.. lr%n .%n^ RL�4 V 1. 1R --;SCI nrr/Anr b_ ^ ^,r•lT-.... in ,.r nnrb r.aJ:R :4 ?7 nrnnA n0 .,n•m-A R nr ^nrr ln,w a.r..n nrr rl.'Ln!Ir,+ n' 1••nfn,• nAn�lnr.',Jnn_ Thr ./r-. f r.+r^ n/ r•.n f r+ rr�fn Jr{ AA rAar ;In +n iin /?qf paid. n nnq.f rnnA^? nwnn N.lrA. P nr1ArsjA nn feyilr%. A.IAn of?rA oAnn 450 .+n Sn!1 lrrd n?rr^rl 1n rAnr/n,rn r nctu.ln#t( n n.r OeGt. Thdn, rl!r2-i n! nnJrorrA l+^rlAneA M!nrlrrr (l ^ r..n,±nA P• 4hn•+.bn n roa!! nraalrr..+lnn, rr i?.ill at%eJf. n.lnht. ']r.+.e.t lrnflllnA to .I.rA<t thrn 10 .Pent n0 .+h.e. AUAi(v'e. on ta,P(. 1. 1.6 adlA nett 1.t. .In 2rAe_ we_. Oven ,535 lerti nP wa e't 800 n0,bj. Ta -tat t.tr_ d dn. e 24 hawk tb.•cjtt:c 4hotyj 1440 Cal . T2odueiAnrz. ruaw. he aArrtet a4 .the weU td twed. Varc ptave .to be 120 raU pet howt. One Ha&4p_ Ttlnp 4houtd be dit4t aUcd _tort 4001tc 450; o2 4arewhct dee e -t .iJ,J de4tted. 5t w.LU. be bettst .to dace .the Sutneltd,vjt . Tttar_ ¢ qutte e bit alcove whate the cvtra ar pta&ctdon 4,40,7,ta. fc. v.uz.r ktzat atw.. tvtd-t4ttvdrad .'iron .Unc eritc.0-an o -j ; tnnin.n. Panpw t )Attt4nn &ttt CAatne !02 400 'feet anA,.. 123.00 pet loot 400 �,t. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF +9200' 00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE "FLLL 15thv 1$0"3 � • __SERVICE CHARGE 0P 11.% PER MONTH WILL B`7\� E 1C86ESSE�J D ON PAST DUE ACCOUNTS. Gare SPU, Municipality of Anchorage Development Services Department :• �, • Building Safety Division On -Site Water and Wastewater Program ° 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us , r f > (907)343-7904 ,) CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. Wo - n9l— 5s . HAA # 05 DS(07 - 1. GENERAL INFORMATION Expiration Date: Complete legal description Tilt Vi��or�e5 ^ Tilt View Lot 11.., Location (site address or directions) 16821 Teat.":°,) Orivc Current Property owners) Jta.. $a"..Z.a Day phone 345- 34.63 Mailing address Lending agency Day phone Mailing address Real Estate Agent r-Incis Swirta Day phone 3313-829'1 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System g TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address 203 W 1 4% Aycnv� Ane_ �or� t i�K 99501 Engineer's Printed Name Tobixn SF.+rislanc� 5. DSD SIGNATURE Approved for 4— bedrooms. Disapproved. Phone 2.79.39110 Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements . Supplemental Engineer's Report Other By. Original Certificate Date: (Rw 01102) 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 Legal Description: Tht. Vi Uk. ec — Ti4uiew wt 11 Parcel ID: O 2 O — p q A. WELL DATA Well type r Date completedq IS 03 , 51111 SI Total depth SSS I. 5001 If A, B, or C provide PWSID # Sanitary seal (YIN) Cased to b�ft. FROM WELL LOG Date of test 415le3 J Sl et r Static water level lot Zo ft. Well production 1n0,.+ 2 g.p.m. WATER SAMPLE RESULTS: Coliform _colonies/100 ml. Nitrate 'a /L mg./i. Arsenic: mg./I. Date of sample: > B. SEPTIC/HOLDING TANK DATA Tank Type/Material Greer 15fea1 Tank size 1250 gal. Number of Compartments 2 Well Log (Y/N) Wires properly protected (YIN) Y_ Casing height (above ground) *IS in. XZ AT INSPECTION �. g.p.m. Other bacteria <L colonies/100 ml. Collected by: _Lars Sov. k. lamol�' Date installed 41101 81 Cleanouts (YIN) y Foundation cleanout (Y/N)j i Depression over tank (Y/N) A( High water alarm (Y/N) Date of pumping , f 0� Pumper o0.0.C�r5 C. ABSORPTION FIELD DATA Date installed q )0 Soil rating (g.p.d./ftZ or ftZ/bdrm)175 System type Detip Trenc� Length 4011 ft. Width 3 ft. Gravel below pipe (0 ft. Total depth 4•V ft. Eff. absorption area 588 ftZ Monitoring tube Y Depression over field _k Date of adequacy test 23 o 5 Results (Pass/Fail) Dass For q bedrooms Fluid depth in absorption field before test in. Water added_fiW gal. New depth in. Elapsed Time: SSL min. Final fluid depth ('T in. Absorption rate >= (000 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Ak4l. 60%4-N If yes, give date D. LIFT STATION Dale instal71evW� Size in gallons Manhole/Access (Y/N) "Pump on' in. 'Pump off" level at _ in. High water alarm level in. Datum Cycles tested Meets alarm 8 cir requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic lankfift station on lot t 9(" * On adjacent lots > too' Absorption field on lot > tooOn adjacent lots 7100' Public sewer main > >% 1 • Public sewer manhole/cleanout >,zi,>/00 v S Sewer /septic service line > ZS r Holding lank N A . SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: � r 1 Building foundation > S Property line > S Absorption field > 5 r Water main > -45, Water service line i 25 Surface water N. 0. Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line > 10, Building foundation > fO' Water main > 2S � r Water Service line >25 Surface water N. O. Driveway. parking/vehicle storage >10 Curtain drain At. A. Wells on adjacent lots > 100' F. COMMENTS 6 .... _ G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name To66r, Sp%r ILIanA Date 1O14109 HAA Fee $ Date of Payment 1D�Z�OS Receipt Number (Rev. 12/01) r/ Waiver Fee $ Date of Payment Receipt Number 7611-1 `\ Lot 12 310 2a \ N81°13'14 E r- . Ln 06 U1%'1HoKFto S-\ 50 ,o o. \ 7� ° cS \ SCALE: 1`= 40' EASEMENIS OF RECORD. OTNFR MAN \ THOSE SHOWN ON THE RECORDED PIAT ARE NOT SNOWN HEREON. HVL e SATELUTE DISH L rye LOT 11 lk S. 55 Lot 10 2�5 . 2 i rAi ASBULT NDCOWENSSETTHGOATE 1 iwl.by ortty aN I �� pert.nrd a IY.Vacfan d M bfwMrg daw+Ead Froparipv N it, 11. Tae VlMgnt TNa VIay.4•.J6d age fulwarml n�m. am um Tfi- 6ipiw is &bjmw 0. ns Mein a. DAP•dT kw MW m M4 &Mtap"GAMaa on na rVWV" s*wuM aww. FN m WwWV0.0rbm ar PMP" "V w4wsN Swab a wmacA m to FrwFMH In gMNbn wd aN San an w madraya, twwNssim Lias or dam Da�N N ArrJiwapa, AwtJ d VY 2001 FRED WMATKA A ASSOCIATES Enpi...n.ai Swvyon (901.24w16") ✓ �, a Municipality of Anchorage 1'O. llox 19(i;74) • Anchomgc, AL+ska 9!kil9-C)(:-,1 • Telephone (ln7) 3t3,RW)1 • 1'aC (�MY7) at.4 RMla : t'L^� / 47(X) Ilmgaw Stmet • +juhomgc, ALska 9W7 s . e . r x�+�xmun).org Dlayor Mark Begicl) Building Safety Di -vision November 1, 2005 Tobben Spurkland Tobben Spurkland Engineering 203 W 15th Ave, Suite 203 Anchorage, AK 99501 Subject: Waiver Request for The Villages Tideview Lot 11 Waiver Request WR#: 050096 Parcel ID # 020-091-55 IIA050567 Dear Tobben Spurkland: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the Easterly located private well has been approved. The approved separation distance is 75.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there arc any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Cc Goodall Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3,1985) Waiver Request for: The Villages Tideview Lot 11 ParcelID#: 020-091-55 Waiver Request Number WR#: 050096 Waiver Requested: 75 FOOT HORIZONATAL SEPARATION FROM WELL ON EAST PART OF LOT TO ON LOT SEPTIC TANK Engineer: Tobben Spurkland IIA050567 Seatic Tank Data The septic field was installed in 1981 and has encroached the well for more than 20 years. the septic tank depth is approximately 10 feet deep. From the bottom of the septic tank to bottom of the well the soil strata consists of 8 feet of gravel and 537 feet of bedrock. Well Data This well was installed in 1983 and has encroached the septic tank for more than 20 years. A water sample was collected from the combined flow of well #1 and well #2 as designated by Spurkland Engineering. Both wells are connected to the house plumbing. The water sample results show the Coliform, Other Bacteria, and Nitrates well with in Minicipal Standards. Municipality of Anchorage �t Development Services Department Building Safety Division On -Site W and WProgram 47070 0 Dragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 ww A.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#:050096 PID#:020-091-55 HA/Permit# IIA050567 Date Received: November 1, 2005 Legal Description: The Villages Tideview Lot 11 Engineer: Tobben Spurkland Tobben Spurkland Engineering 203 W 15th Ave, Suite 203 Anchorage, AK 99501 Applicant: Jean Soundy Waiver Requested: 75 FOOT HORIZONATAL SEPARATION FROM WELL ON EAST PART OF LOT TO ON LOT SEPTIC TANK Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: 8.36 0.99 0.90 4.50 2 Total: 16.744 .......................................................................... Waiver is Granted: X Waiver is not Granted: List Conditions or Reasons for above: Date:1/11 /05 By: Joe Goodall Name of Reviewer .......................................................................... Rec#: 76055 Amount: $1130 Date Paid: 11/112005 State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3,1985) Waiver Request for: The Villages Tideview Lot 11' ParcelID#: 020-091-55 x, Waiver Request Number WR#: 050096 Waiver Requested: 75 FOOT HORIZONATAL SEPARATION FROM WELL ON EAST PART OF LOT TO ON LOT SEPTIC TANK Engineer: Tobben Spurkland IIA050567 Water Table Points ,.,. Depth of well: 555 8.36 Depth of septic system: 10 545 Distance from the bottom of the system to the highest water table in feet Point Value 0 0 8 1 17 2 24 3 30 4 40 5 85 6 100 7 290 8 1000 9 *Use the predominant soil type but values can be averaged for a mixture 10 Straight line Interpolation Is permitted between any two values Soft Sorbtion Points .�. 0.99 8 0+ 537 1+ 0 0+ rI 0 0 Solt Type I Point Value Clean Gravel 0 545, f 545, [ 545 1545 Fractured Rock 1 Course Clean Sand 1.5+ 0 0+ 0 0+ 0 0+ 0 0 Sand w/ Small Amt of Clay 2.5 545, [545, [545, (545, Silt 3.5 Clay and Sand Equal 4.5 0 + 1 + 0 + 0 Clay 6 0 + 0 + 0 + 0 *Use the predominant soil type but values can be averaged for a mixture Permeability Soil Type I Point Value Clay(will channel) 0 Silt and Sandy Clay 2 Clayey Sand 3 Fine Sand 1.5 Sandy Gravel 1 Fractured Rock 0.9 Course Sand (30 grit) 0.4 Clean Gravel 0 Points ,.,. 0.90 l 585, 1 +j 554351 .9 +r X051 1 + r F051 1 + 545 1 +r 545 J, 1 + 545 ) 1 + [ 545,1 1 0.01 + 0.89 + 0.00 + 0.00 0.00 + 0.00 + 0.00 + 0.00 'Use the predominant soil type but values can be averaged for a mixture Gradient 4.5 Slope Points Value Separation -60% 0 30% 0.3 25 -20% 0.7 slopes toward well -10% 1.2 100 -5% 2 5 0% 2.91- flat 5% 4.5 10% 6 slopes away from well 60% 7 'If the gradient is unknown, assume the worst case Horizontal Horizontal Point Separation Value In Feet 0 0 25 0.7 50 1 75 2 100 3 150 5 200 6 300 7 Points .>. 4.50 Points mm 2 'Linear Interpolation between two point value Is acceptable. Horizontally means straight line distance to the well not the contaminate travel distance to water table which may be greater. Conclusion: Grant Waiver Total Points:1 16.744' � Municipali�.3T of Anchorage 6• b V. O � 1'0. Ibc 1Wfii0 • Mchom}!c, .Unslw �691'Jfif:� •Tek �krn�e (�J(YI)133fCStl1 . � ` e 7 Puy (.N17) 3).'i�fi'(MI �� �- � 471M) IS,uS,me tiSrcct • Anchorngq Ah�sim ffi).i(17 �s . � , A MayorMark Bcgich Iluil<xMW..muni.org ling Safcty Divislon November 1, 2005 Tobben Spurkland Tobben Spurkland Engineering 203 W 15th Ave, Suite 203 Anchorage, AK 99501 Subject: Waiver Request for The Villages Tideview Lot 11 Waiver Request WR#: 050095 Parcel 1D # 020-091-55 IIA050567 Dear Tobben Spurkland: Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the Northwest located private well has been approved. The approved separation distance is 95.0 feet. This waiver approval applies to the existing absorption field to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, rcGoodall Civil Engineer On -Site Water & Wastewater Program Coln mlilt ity, Security, Prosperity State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3,1985) Waiver Request for: The Villages Tideview Lot 11 Parcel I D#: 020-091-55 Waiver Request Number WR#: 050095 Waiver Requested: 95 FOOT HORVONATAL SEPARATION FROM WELL ON NORTHWEST PART OF LOT TO ON LOT SEPTIC FIELD Engineer: Tobben Spurkland IIA050567 Seotic Field Data The septic field was installed in 1981 and has encroached the well for more than 20 years. the septic field depth is approximately 10 feet deep. From the bottom of the septic leachfield to bottom of the well the soil strata consists of 11 feet of gravel and 479 feet of bedrock. Well Data This well was installed in 1981 and has encroached the septic feidl for more than 20 years. A water sample was collected from the combined flow of well #1 and well #2 as designated by Spurkland Engineering. Both wells are connected to the house plumbing. The water sample results show the Coliform, Other Bacteria, and Nitrates well with in Minicipal Standards. Municipality of Anchorage v Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bmgaw Street P.O. Box 1%650 Anchorage, AK 99519-6650 ww A.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#:050095 PID#:020-091-55 HA/Permit# HA050567 Date Received: November 1, 2005 Legal Description: The Villages Tideview Lot 11 Engineer: Tobben Spurkland Tobben Spurkiand Engineering 203 W 15th Ave, Suite 203 Anchorage, AK 99501 Applicant: Jean Soundy Waiver Requested: 95 FOOT HORIZONATAL SEPARATION FROM WELL ON NORTHWEST PART OF LOT TO ON LOT SEPTIC FIELD Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: 8.28 0.98 0.90 4.50 2.8 Total: 17.460' .......................................................................... Waiver is Granted: X List Conditions or Reasons for above: Waiver is not Granted: Date: 11/1/05 By: Joe Goodall Name of Reviewer ........................aa..a.aa..............•.•..•••.•.•..a•............ Rec#: 78055 Amount: $jM Date Paid:/11 11200 State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3,1985) Waiver Request for: The Villages Tideview Lot 11 - ParcellD#: 020-091-55 Waiver Request Number WR#: 050095 ;:, t,- , •.x; Waiver Requested: 95 FOOT HORIZONATAL SEPARATION FROM WELL ON NORTHWEST PART OF LOT TO ON LOT SEPTIC FIELD Engineer: Tobben Spurkland IIA050567 Water Table Points ,... Depth of well: 500 8.28 Depth of septic system: 10 490 Distance from the bottom Point of the system to the highest value ,... water table in feet 0 0 8 1 17 2 24 3 30 4 40 5 85 6 100 7 290 8 1000 9 10 • Straight line Interpolation Is permitted between any two values Soil Sorbtion Points ,... 0.98 Soil Type I Point value 11 0+ 479 1+ 0 0+ 0 0 Clean Gravel 0 490 490 490 490 Fractured Rock 1 Course Clean Sand 1.5 + 0 1 0 + x 0 1 0 + r 0 1 0 + r 0 l 0 Sand w/ Small Amt of Clay 2.5 I 490 J 490 J 490 J 1490 J Silt 3.5 Clay and Sand Equal 4.5 0 + 1 + 0 + 0 Clay 6 0 + 0 + 0 + 0 *Use the predominant soil type but values can be averaged for a mixture Permeability Soil Type Point Value Clay(will channel) 0 Silt and Sandy Clay 2 Clayey Sand 3 Fine Sand 1.5 Sandy Gravel 1 Fractured Rock 0.9 Course Sand (30 grit) 0.4 Clean Gravel 0 Points 0.90 l 490, , , + 490 .9 +[490,' + 1490, , +f 0 t 490, 1 +r 490, 1 + 490, 1 + [ 490, , 0.02 + 0.88 + 0.00 + 0.00 0.00 + 0.00 + 0.00 + 0.00 *Use the predominant soil type but values can be averaged for a mixture Gradient 4.5 % Slope Points Value -60% 0 In Feet -30% 0.3 0 -20% 0.7 50 -10% 1.2 2 -5% 2 150 0% 2.93- .9}5% 5% 4.5 10% 6 60% 7 slopes toward well flat slopes away from well *If the gradient is unknown, assume the worst case Horizontal 0 Horizontal Point Separation Value In Feet 0 0 25 0.7 50 1 75 2 100 3 150 5 200 6 300 7 Points ,. 4.50 Points ,,* 2.8 *Linear Interpolation between two point value Is acceptable. Horizontally means straight line distance to the well not the contaminate travel distance to water table which may be greater. Conclusion: Grant Waiver Total Points:- 17.4601 NJ Environmental Consulting and Design October 28, 2005 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99516 Subject: WAIVER REQUEST LOT 11 THE VILLAGES TIDEVIEW PID 020-091-55 Gentlemen; We are applying for a waiver of the separation distances required between the septic tank and drain field to the wells serving this lot. There are two well on the above referenced property. A field measurement shows that the clear distance (ouside pipe to outside casing) between the well casing (well #1 on survey asbuilt) and the cleanout at the end of the drain field is 100.2 feet. The drain field can be as much as 3 feet wide with the cleanout in the approximate center. The cleanout may also be on either side of the trench. Therefore, the true separation between the well casing and the trench is between 100.2 feet and 97.5 feet. In the spirit of safety and concern for environmental and human health we request a waiver 95 feet. ADEC granted a waiver for the septic tank in 1984. The documentation for that waiver shows the trench standpipe to be outside of the 100 foot radius, therefore the request did not include the trench. The distance between the clean out on septic tank and well #2 is approximately 81 feet. The cleanout could be located on either end of the septic tank or possibly in the middle, therefore we are requesting that the current wavier be amended to 75 feet. Well #1 was drilled in 1981 to a depth of 500 feet. Bedrock was encountered at 21 feet. Well #2, drilled in 1983 to a depth of 555 feet with bedrock at 18 feet. The ADEC waiver of 1984 identifies the wells. Both wells are connected to the house plumbing. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net WAIVER FEE: s'i.i�a•or PAYMENT DATE: RECEIPT #: 74110-;07 pur and Engineering Environmental Consulting and Design Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99516 Subject: WAIVER REQUEST LOT 11 THE VILLAGES TIDEVIEW PID 020-091-55 Gentlemen; October 28, 2005 We are applying for a waiver of the separation distances required between the drain field and the well serving this lot. A field measurement shows that the clear distance (ouside pipe to outside casing) between the well casing and the cleanout at the end of the drain field is 100.2 feet. The drain field an be as much as 3 feet wide with the cleanout in the approximate center. The cleanout may also be on either side of the trench. Therefore, the true separation between the well casing and the trench is between 100.2 feet and 97.5 feet. In the spirit of safty and concern for enviromental and human health we request a waiver 95 feet. ADEC granted a waiver for the septic tank in 1984. The documentation for that waiver shows the trench standpipe to be outside of the 100 foot radius, therefore the request did not include the trench. There are two wells on this lot. Well # 1 was drilled in 1981 to a depth of 500 feet. Bedrock was encountered at 21 feet. Well #2, drilled in 1983 to a depth of 555 feet with bedrock at 18 feet. The ADEC waiver of 1984 identifies the wells. Both wells are connected to the house plumbing. Water samples collected on 9/27/05 show 0.216 mg/I of Nitrate -N, and 0 e -coli. A well flow test conducted that day found the static water level at 28 feet, a drawdown of 370 feet after pumping 600 gallons, and a recharge rate of 1.4 gallons per minute. 203 West 151" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net Lask Spurkland Engineering Environmental Consulting and Design a Mitigating Factors: The lot slopes from the well towards the septic system. In the event of a septic system failure, this would tend to carry any surface effluent away from the well. Water quality analysis indicates that the nitrate and total coli form levels are well below the required standards. At this time we are applying for an On Site System Approval, and request that a formal waiver be granted. If you have any questions or are in need of additional information please contact me at 279-3916. Well logs and the 1984 waiver application is on file. inicerely, be Spurkland 203 West 151° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net Environmental Consulting and Design Water samples collected on 9/27/05 show 0.216 mg/I of Nitrate -N, and 0 e -coli. A well flow test conducted that day found the static water level at 28 feet, a drawdown of 370 feet after pumping 600 gallons, and a recharge rate of 1.4 gallons per minute. Mitigating Factors: The lot slopes from the well towards the septic system. In the event of a septic system failure, this would tend to carry any surface effluent away from the well. Water quality analysis indicates that the nitrate and total coli form levels are well below the required standards. At this time we are applying for an On Site System Approval, and request that a formal waiver be granted. If you have any questions or are in need of additional information please contact me at 279-3916. Well logs and the 1984 waiver application is on file. Sincerely, Tobben Spurkland The' WAtkA.p�co -'A%Ap' �i--W\ W?- t[ '0 1 'X ^k P�umloinq . LP.r5 SpkAr\& Vl 9I21lo5 are Como" M0 .Jtvs G« coAv'Ae(U ccm�htA ctot.J 203 West 15i° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng(a, gci.net :.t \ KFFl� Lot 12 N81°13'14„E 310.2a CH is \ -4�- JO '� Q \ SATELLITE DISH O �0 CC,) C \ s m e \ \ s� \ \ -�A - \ CO X -'>a \\ cS 0 \ ;CALF: 1"= 40' OF RECON. OTHFR TRAM \ TNJ THE RECORDED \ WN MERLON. HN. LOT 11 l20. i2sfq � � 65 Lot 10 `LT 7611-1 LO c6 G ASDLALT NO COMENS SET TRPS DATE I I.�Y wLYy 7IW 1 n,.• o•rYmrd • I.browob wf+xbn d d„ bw.wg dacdbd a•Fwt7'. Lot,1. T17e V7aan•• TQM VMv 4-hA xawiQ76 4-- Inprw is shwW 07weon m wltdn tn, powody kn W4 m"wrtapw Wa• mMi7•a•M 1&0 •ci"m IMw,u tut n” Mawaenm m dr PMP" IYHp •dl•c••I4w,b m'm ,n M prw,ia, In gw,7bn W Mal Man ars n" m,dwa^ tanw tuian Ina a dn,r 17ceor7�w DaW ,1 ArcLaap,, A4UUJ Um ien d,Y,l VY 70M FRED WAIAT"A &ASSOGAtES Enpi.,•n,nd Sw Yo KFFl� Lot 12 N81°13'14„E 310.2a CH is \ -4�- JO '� Q \ SATELLITE DISH O �0 CC,) C \ s m e \ \ s� \ \ -�A - \ CO X -'>a \\ cS 0 \ ;CALF: 1"= 40' OF RECON. OTHFR TRAM \ TNJ THE RECORDED \ WN MERLON. HN. LOT 11 l20. i2sfq � � 65 Lot 10 `LT 7611-1 LO c6 G ASDLALT NO COMENS SET TRPS DATE I I.�Y wLYy 7IW 1 n,.• o•rYmrd • I.browob wf+xbn d d„ bw.wg dacdbd a•Fwt7'. Lot,1. T17e V7aan•• TQM VMv 4-hA xawiQ76 4-- Inprw is shwW 07weon m wltdn tn, powody kn W4 m"wrtapw Wa• mMi7•a•M 1&0 •ci"m IMw,u tut n” Mawaenm m dr PMP" IYHp •dl•c••I4w,b m'm ,n M prw,ia, In gw,7bn W Mal Man ars n" m,dwa^ tanw tuian Ina a dn,r 17ceor7�w DaW ,1 ArcLaap,, A4UUJ Um ien d,Y,l VY 70M FRED WAIAT"A &ASSOGAtES Enpi.,•n,nd Sw Yo • `� Gk'u' 1i1 1%O� MR ► I AMU m�I6IbII�YC� RC qr4T^ r.CTLC1iON Ai�"x X13(39, Srmt Rolm A A2VCIl0llAGvv A"*;KA 991502 (�JFU(L� F g 119F811� 344-7714 SIX INCITP uy P/ELL DRILLED AND CASED OUT TO THE DEPTH OF 500 7"A. DRILLED AT THE RATE OF $20.00 PER FOOT. PROPERTY OWNER 04deArd b.t Cit. Trent StalpwLet 345-2032 LOCATION OF WELL SITF u-1/ " Ste• 1411A1tt- %1vr �t.r DRILLER B"aU Ctau4 vA Raapadt P.tttttag *414. WELL LOG: 0----21' 9mvel. 305 etW &Z:d-t . Broken -bedtaek {doa 12 to 21 deet. 21---500' BedtocL. A 4edtLIPlI tatlj tack. 110 wa.ted ptodue.ttCn to 300 sec t. gJe.td o� wateA {don 300 to 400 Act 4hour4 1/2 Sato P" tt(nute. Ptaduatdan. {,wa 400 to 450 acct 41ww4 a 7/2 Pd' tmcacr4e. Tram 450 to 500 Feet ZuUzatee 1/2 to one gat pet ni utte tnc4ec4e. Total wateA ptaduetton 4hautd 4how ju4t unded Tura SPCl with an dncte"e .Lt Vtetd wlth u4e- Ovet 2000 gate ped da+t ptaddaton avattable. 7.6 gate pet {oat tn.co4tng. Total teeavedg. 4houtd cane wtthtn 15 to 20 /t C� 4MtFa4e. Ovid. 700 gate v� wateA -t t,Aewe. Scd=m4ttrde. Pune 4houU Le 4natatted at tea44 25 {eat a"-- -bottom.. /I{.tzt wateA t4 100 etedt p=,a matt -be Jn4tatted tut {.tet deepe't. One 110t4e SUtnCA4tGlc Pump 4houtd Le uecd. C044 0� DR,U.Ung: 50 {tet Ro Charge. 450 Ae.t X 520.00 pet {oat: $9000.00 R0 Chadge At UeU Seat. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 89000.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATF C'al 77ths 7981 SERVICE CHARCEOF IY.% PER MONTH WILL BE M BEO ON PAST ACCOU Dox 1300, Srwu Ro» A Alvcn G �' �Bl�" 1mrso2 344-7714 F ' SIX INCH WATER WELL DRILLED AND CASED OUT TO THE kPTH OF' 555 iPr DRILLED AT THE RATE OF 321.00 PER FOOT, r i PROPERTY OWNER rt. ' rte. '-'TaJA & 3lUAJ4;t C•r{,uta t 345-2560 -112S4-9!.511 i LOCATION OF WELL SITE ..t. W. Sufr. DRILLER Dcam a CtauO 0f. Raapatt D.,tW tn; tlotke. : trMi°I�"trtK WELL LOG: p E1" LD n��-1Al Cll •n w.r.:..l t I f� 11•. r..+•. 9M, r lw.. Irrn Jr. 1R—SSi' t'rfrdnr�. '! .rdJ-+n•r•.. •vl r+!•�A ♦AJn nrr of •fir + 7• �r t �.. r nn+r ervtr.f r r..,Jw,. wtr Jnr•Jn+. Thr Jr-At r.•r^ of rr-lr• r'JttC! JAfACM 5?n Jn "n 1001 p.7�4 w wwnA rrwrA^ ^rl!/rlr. l rn.�rrrA RIAs rh.-A Ieor 4Stl Jr Sn7 .401 ArOr^d fn rAndrr.- r`r.tr.t Amoittnttfn. r.fleat. TMA "n -A n! 0,n20rr4 J^v►wnrh, M.nlrlGfr^ r..;trw I. Ahn�jrn n raa,� ria �1'h�1,r.r, IrJOJd nvrt. PJ. -h.#.. '!rint t&,fsLlnA 1_o JwAA :'•rn n0 .lr^f. of Jh.r. 4uwlrtr.. on tatnt ancnvrl�t. 1.6 oatA net U. JA "-Ae vr. C.vet 53.5 1.�et nf, wtte't 4lrlwAm. Cvet 800 noJA. . Tota.t tar -td Jn c 2f. heat .tire ?Arm- 4hame 1440 rata. P.eodvet cm aw. be a4zatet a4 .the mU .ta twed. [ran move to be 120 gate pet haul. One Racer• Fun* 4hoatd be Z%4taUed lAan 400'ta 450; 0t 4onenhat deepet Lr dc4ttrd. 9t vLU. be &cttet to ptaee the Sutmet4tbte. Tate a rimae c 4Lu 0bove mhete Vte atra 0f. pRoduettan 44attt4. C"vbr. t'--Zt CLCr. cAdt4Vjt lyd •-Nn .the Cr-MmUtan Di rtvtpLtn. P.artpatt ALLU,tJtrt Matte wtU chat.^e 4,t 400 {.cat cAA,. .23.00 pet toot;: 400 f;•.. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF +9?00.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS t ' DATE Rp.LLt 75th, 1$u^3 • _ v( ��w �� I .^___SERVIeI CHAROCO► IV.% PCR MONTH WILL S+C-WSSESSED ON ►AST OUEACCOUNTS. 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 GENERAL INFORMATION (a) Legal pesgiption (include lot, b k, subdivision, section, tow p, ra ge) l41," ���l"lyz I Location (ad or directions • ,t T'L'w.1 �fLI�O �__s r' A i, (b) ApQ%l'at�e 1 ele hone: Home a ^ZS Business :Ss., rn � x' (c)pr,cant is (check one): Lending Institution 13wne ilder.r- Buyer 13 Other 13(explain); _. z (d) L~!'r�rt,�r.j�� hvtron/r Telephone ke- +• �, (e) Real Estate •/��-.�/�P J�� �. . �oirtpa: y and'Agent ' Address ` •7 t � Telephone (f) Mail the HAA tot e f I;owing ad ress Aw- - / 2. TYPE OF RESIDENCE Singe -Family Alulti-Famll p Other I / I .. Number of Bedrooms r a WATER SUPP Y Individual V:el< Community ❑ Public ❑ Note: If community well system, must havewrilten confirmation from the State Departmentof Environmental Consp an attesting to the legality and status. I 4. SEWA E DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Nc-.e If community well system, must have written confirmation from the State Department of Env; entalConserva•ic attesting to the legality and status. 72.0 Page 1 of 2 5 ENGINEERING FIRM PROVIDING INSPECTIONS TESTS FILE SEARCH , DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below. I verify that rry investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system Is safe, functional and adequate forthe number of bedrooms and type of structure Indicated herein. I further verity 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 inspec io nU'// Name of Firm ��"`Z hone 1r�(�/J�TV Address /�iC /. ��tP Date 6. DHEP APPROVAL Approved for �/10 -• bedrooms b ' ;/ ate Approved vA Disappr�6zd Conditional Terms of Conditional Approval CAUTION Engineer's I" G ►Id Jr. r NA 2251.1 �. The Muncrpality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certf Cates 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 MNful00PALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH 6 HEALTH AUTHORITY APPROVAL (HAA) L"ONNIENTAL PROTECTION CHECKLIST UARY 1984 2 "720AUG O LegalDesC��/; pt �`4Y1.WED J� Jr rn- L A. WELL DATA Well Classification If C, D.E C�,Aj�pp�roved (Y/N) Well Log Present ) Date Co plate/ t �i'3 Yield • �`.y.4 G/7 Total Depth area' Cased to'M �� �s'bepth of Grouting a Static Water Level 7100W 011 Pump Set At K asing Height Above Ground A'Z5., yZi Sanitary Seal on Casing ( ) rElectrical Wiring in Conduit (0) Depression Around Wellhead (Y�; Separation Distances from Well: To Septic/Holding Tank on Lot ' �A ; On Adjoining Lots AAW To Nearest Edge of Absorption Field on Lot pJ �� ; On Adjoining Lots of/tv To Nearest Public Sewer Line t0/Y To Nearest Public Sewer Cleanout/Manhole J %¢o To Nearest Sewer Service Line on Lot !� Water Sample Collected by Z O :Date Water Sample est Results — / } 1 _ / ter, ,p / Comments 69 �i wr& �/,'t/%..42 ^,tai */f(t*4aA;fr" B. SEPTIC/HOLDING TANK DATA Date Installed Jfa Size 494'-'0 No. of Compartments Standpipes N) Air -tight Caps Foundation Cleanout (Y Date Last Pumped _19iG ®V ;for Depression over Tank (Y1 Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) r/� Separation Distances from Septic/Hol i Tank: To Water -Supply Well _ta�` To Property Line 70 !14-40 " To Water Main/Service Line 7' Course Aek-l* M Temporary Holding Tank Permit (Y/N) 40/f To Building Foundation 0;42 le�� i To Disposal Field .1-tr To Stream, Pond, Lake, or Major Drainage Commen}� ux.��rf.�1A^ .,,/Ad`JfQ�N�Jl4� �j� -t NVf Jif�s! Page 1 of 2 72-026111,841 r To Water Main/Service Line 7! 7'j/ To Cutbank (if present) ,y/,10 To Stream/Pond/Lake/or Major Drainage Course T �d To Driveway, Parking Area, or Vehicle Storage Area Comments /lvw, /V-</ law /J .1P D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N)� "Pump On" Level at mp OffLeve" High Water Alarm Level at ��Qj� nt (Y/N) Tested for / " Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) / Comments •• Check Permitted Bedroom Rating Against HAA Request •• Icertif that) �chec v riff%�d,orconformedtoallMMO-n(dinspection. ection. Signed �// Date Company ���� MOA No. OF At It Receipt No. �rt - TN 1 •••• ' *,I� Date of Payment �•..:..j� .::»F. Amount: $ r •••• •... 0 Jr. 2251 Page 2 of 2 72-026 (11,64( A, C. ABSORPTION FIELD DATA Soils Rating Absorption Strata Type System in �j �/ Y of Design 77 Date Installed Length of Field /U Width of Field Depth of Field Gravel Bed Thickness t Square Feet of Absorption s6 9ig Standpipes Present IJ) nArea Depression over Field (Y4N,, Date of Last Adequacy Test Results of Last Adequacy Test AW Yzw Separation Distance from Absorption Field: �L�// To Water -Supply Well To Property Line To Building Foundationy� To Existing or Abandoned System on Lot �//7 ; On Adjoining Lots •/ 7/* To Water Main/Service Line 7! 7'j/ To Cutbank (if present) ,y/,10 To Stream/Pond/Lake/or Major Drainage Course T �d To Driveway, Parking Area, or Vehicle Storage Area Comments /lvw, /V-</ law /J .1P D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N)� "Pump On" Level at mp OffLeve" High Water Alarm Level at ��Qj� nt (Y/N) Tested for / " Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) / Comments •• Check Permitted Bedroom Rating Against HAA Request •• Icertif that) �chec v riff%�d,orconformedtoallMMO-n(dinspection. ection. Signed �// Date Company ���� MOA No. OF At It Receipt No. �rt - TN 1 •••• ' *,I� Date of Payment �•..:..j� .::»F. Amount: $ r •••• •... 0 Jr. 2251 Page 2 of 2 72-026 (11,64( A, .(In MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date ///,1/y (a) Legal Description (include lot, block, subdivision, section, township, range) All Vie Z5trV///ates 7Tri'Pv/6147 Location (address or directions) /4�0 %%GrC_di'pc�. Dry cue_ /^ 3 ys :�sZ,a (b) Applicants Name �, em dro Ff" Telephone - Home Business Applicants Address 'P. 1). I2)'� X I I 1 a 1: q Il Fj C 1'. 11 R. r ri f I I (c) Applicant is (check one) Lending Institution builder mr; Buyer ; Other E -::l (explain); i (d) Lending Institution 11 1:-1 a I-., ATelephone r111. it SI r c,.4 Address (e) Real Estate Co. b Agent Address Telephone (f) Mail the HAA to the following address: 1.11a�} t �A�rr�c if _3q-s-d°il.G 2. Type of Residence Single -Family pEf— Multi -Family Other (describe) Number of Bedrooms 3. Water Supply Individual Well.^ Community Im 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 OnsiteX4 Public Community Holding Tank Q 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) J 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm ` �¢�C <5)� W_; Telephone Address I&X% W 53—tw :e -r �1'10? 1PMj-,P_ tet_ OF AL 11 Date (ENGINEER SEAL) 6. DHEP Approval 'VQ Approved for/� bedrooms By -Ptj ��Q G�a2� L�Date Approved X Disapproved tJ Conditional Terms of Conditional Approval CAUTION oy C. PoW, Jr. No. 2251-E THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRON'MNTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 .LGf OF ANCHO.'.AC: . WEPT. OF HCALT:I & MUNICIPALITY OF ANCHORAGE (MOA) CNVIR01,VACNTAL P., TiCT=l HEALTH AUTHORITY APPROVAL (HAA) PJOV 26 1994' CHECKLIST - FEBRUARY 1984 RECEIVED Legal Description: 4 1/ ?0- A. WELL DATA 7%/E- V14J_46 E5 77D£!//45Q Well Classification 10r�vade. Well Log Present ) Total Depth $ d 56 -$/Cased to Static Water Level 7$/6) *Casing Height Above Ground }Electrical Wiring in Conduit) Separation Distances from Well: If A, B, or C, D.E.C. Approved(Y/N) Date Conpleted 5,19')*' /i/'73 Yield C:Z)A 555 ' Depth of Grouting 't) /i4- V Pump Set At ua Krt + Sanitary Seal on Casing (Y ) Depression Around Wellhead (i/NQ To Septic/Holding Tank on Lot q.9 i $(o/ ; On Adjoining Lots 00 / To Nearest Edge of Absorption Field on Lot /Qp" ; On Adjoining Lots Y -/Q4 / To Nearest Public Sewer Lira MIA- To Nearest Public Sewer Clearcut/Manhole (UTA- To Nearest Sewer Service Line on Lot Water Sample Collected By ; Date 101/0l44 Water Sample Test Results 51-/-75Ffe7m Comments C oa qw 4ed f-pJ ;L5 ' l 73-00" ccva c� 9 M.o- yf_ V} week ra,lrhS eE� �.bo+k wells va� n UAP--40Ka� aE yr.q 0 oc v.evr� .0 �^cm n � AQ' 4 0� d a +C'_F^arti (mac, B. SEPTIC/HOLDING TANK DATA Uu JJ Date Installed 4 !�� Size I Z No. of Compartments Standpipesrltx)nl) Air -tight CapsKY'YN) Foundation Cleanout (Y�1 Depression over Tank 06) Date Last Pumped /0//0/W Pumping/Maintenance Contract on File (Y/N) AA- ; for Holding Tank High -Water Alarm (Y/N) V1 _ Temporary Holding Tank Permit (YIN) Ah - Separation Distances from Septic/Holdirg Tank: To Water -Supply Wall 1%a'1 X./ To Building Foundation To Property Line y0'4 ao To Disposal Field 16' To Water MairV8ervice Line t ZZ/ To Stream, Porti, lake, or Major Drainage .Comne-41v..+� er.�¢ YinoQ�S a� Receipt N 36��\� Date Paid: Amount: �� (Page 1 of 21 2-15-84 All C. ABSORPTION FIELD DATA Soils Rating in AbscrptiStrata 1z'5'Type of System Design 7X', CF fj� Date Installed Al 710 Length of Field yq / Width of Field 3 / Depth of Field /Q Gravel Bed Thickness /o Square Feet of AbsorptionArea,S$'V Standpipes Present�Y N) Depression over Field (Y/N)/ Date of Last A --quacy Test /O//o Results of Last Adequacy Test /ooZJ�,o� Separation Distance from Absorption .Afield: -it To Water -Supply Wall %�/ To Property Line 7 �Af- To Building Foundation To Existing or Abandoned System on !, Lot /J /A- On Adjoining Lots -J-7/ To Water Main/Service Lire *'Y51 To Cutbank(if present) hi IA - To Stream/Por:d/Lake/or Major Drairage Course .r- /UC) To Driveway, Parking Area, or Vehicle Storage //Area 3/ a Cmients{7CCaDLcce/etc, Cm �%d�wCl�s?s+o / �o�T Y aa-6c<c�f D. LIFT STATION Date Installed fr r sSize in Gallons J Access "Pump On" Level at / Level at High Water Alarm Level at Vent (YIN) Tested for �n-p11Cycles during Adequacy Test. Meets MOA Electrical Ccdes(YLNi� Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. �e���t� Signed n v" / Date /1 /lei/ I/ �w A�q �� Or Company /fiCS� K�NC. MOA No. ST -W-499 �J, 49 RS ... j KBl/d5/s � s •••a. ;; jG Y C. Re7dfi , QQN No. 2251.E (Page 2 of 21 2-15-84 n ALASKA EnUIRM611TAL COnTROL SCRUICES, IX Engineerinq S Enuironmenial Studies November 26, 1984 MUNICIPALITY OF ANCHORAGE CEPT. OF HEALTH & ENVIR07:1I,ENTAL FROTECiION Department of Health and N 0 V 2 Environmental Protection 825 L Street/Fourth Floor RECEIVED Anchorage, Alaska 99503 Re: Lot 11, The Villages Tideview Well Flow Is on Private Well There are two wells in use on the property. The first well, drilled in 1981, Is 500' deep, with a static water level of 78' (October 11, 1984). There is 620 gallons of water In reserve In the pipe. The second well was drilled in 1983 under is 555' deep with an estimated 800 gallons of water In reserve. See attached well logs. The wells are both connected Into the water system, because they have a slow production rate -- about 1 to 2 gallons/minute at the time of drilling. On October 11, 1984, we performed a well flow test on the subject property. The 1981 well was flowed at a rate of 5 gpm. A drawdown of 219' was obtained and 209 gallons of water were taken from the well. At the point, water level was 297 feet --the limits of our probe. The flow was stopped, although there was another 200' of water In the well. The recovery was 17' in two hours, so the estimated recovery time would be 24 hours. We were unable to get the probe down the 1983 well, because of a blockage at 201. However, 340 gallons of water was pumped at a rate of 5 gpm. Both wells are capable of providing the required amount of water to this house. The slow recovery rate is offset by the availability of two wells. The wells provide adequate water for this 4 bedroom house. Approved By: Leroy C. Reid, Jr., PhD, P.E. President Sincerely, ly 94a Owen Turner Environrnental Scientist G Reid, Jr. 225t•E 1200 West 33rd Auenue, Suite 6 -Anchorage, Alasko 99503 •(901) 561-5040 •' Allunicipali y of Anchorage W 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 2644111 GEORGE M. SULLIVAN. MAYOR DEPARTMENT OF HEALTH AND ENVIHONMENTAL PROTECTION June 30, 1981 Raymond T. Slaymaker Post Office Box 10-787 Anchorage, Alaska 99511 Subject: Lot 11 Villages Tide View Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. Jh (2) A well log submitted to this office for our files and review. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Alaska Mutual Savings Bank 1503 West 31 Avenue 99503 n n ST& RUN& DEPT. OF ENVIROor NMENTAL CONSERVATION / ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 November 8, 1984 Alaska Environmental Control Services, Inc. 1200 West 33rd Avenue, Suite B Anchorage, Alaska 99503 BILL SHEFFIELD, GOVERNOR Telephone: 19071 Address: SUBJECT: Waiver Horizontal Separation between Well and Septic Tank, Lot 11, The Villages Tideview (8521 -WA -060) Dear Sir: 274-2533 The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 86 feet on the subject property for a 4 bedroom single familey residence only. This waiver approval is contingent upon the septic tank being a sealed tank with coulder couplings or the equivalent on tank entry and exit joints. Sincerely, ir6i E .`Eric so7n =/—,—.. District Engineer BEE/dd Movcrtier 19, 1984 GREAT WESIEM CONSTRUCTION P.O. BOX 110787 ANaiORAGE, AIASKA 99511 I, Rayrmnd Trent Slayrmker do state that in the construction of the hcme that I built for Walter P. and Shirley Craycroft I did use Caulder Couplings throughout the Septic System. Year Built 1981 IAT 11 THE VUTAGES TIDE VIEW SUBDIVISION L'% Le at Weste�'n '[ruction Ray d' Trent Slayrreker Subscribed and Suvrn before me this I Cj4h DAy 0()I)0111ti Q, 1984 Notary in and for State of Alaskan � My Ca rmission Expires: a,'( j'Q� J "� t// ih^ v;ll, e. Tdeview x ALASKA ENVIRONMENTAL _ CONTROL SERVICES. INC. SHE" *0. or 1200 West 33rd Avenue Suite BTurrtpY` ANCHORAGE, ALASKA 99503 e•uu vrto er DAT[ /O//(i /Et: Phone 561.5040 CH[CItto er DATE SCALE = 140'• i r- I — r, _— 14 --- j I ! 1 i — ,I I RECEIPT /j Dote` It /l. 19 PL 6449 Received From nl" l.UvaI&A I) A dress P.b_ u15tY /D-'7 Pr% :- 1 a,r- // ro' Dollars $Z�b.O O For CASH oACCOUNT HO IW PAID ! f, p 0-e4 BALANCD 1,p, L, MONEY f �� By � ausoe u 1'1 '_• INSPECTION APPOINTMENTS TIME DATE INSPECTOR r1 DATE RECEIVED TIME TIME \J c�l_14C4AJ .�raP DATE / DATE L� - f�e\ -S'1 INSPEC OR INSPECT(D,,, MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & oe* DEPARTMENTOF HEALTH& ENVIRONMENTAL PROTECTIt]MjtgRONMENTAL Pf,OTECTION 825 L Street • Anchorage, Alaska 996011 ENVIRONMENTAL SANITATION DIVISION JON 241981 Telephone 264.4720 ^ � k�� D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER A DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. [TOPERTY OWNER F/1t4 M0kl1T �- SL��f YH /i int i1 MAILING ADDRESS P. +spy. PROPERTY RESIDENT (If different from above) 2. BUYER WP.tT<yL CVN-kc PpP'-T MAILING ADDRESS 3. LENDING INSTITUTION Ak MfaAwIL MAILING ADDRESS 0. REALTOR/AGENT MAILING ADDRESS 5. LEGAL DESCRIPTION zll> // I/r&1M6 c7 /Ib£ vlzts STREET LOCATION Scg�l& U/Kme, C's le�+icXw'+ 6. TYPE OF RESIDENCE 125 SINGLE FAMILY ❑ MULTIPLE FAMILY 7. WATER SUPPLY ;K INDIVIDUAL - 0 COMMUNITY ❑ PUBLICUTILITY S. SEWAGE DISPOSAL SYSTEM Z INDIVIDUAL/ON-SITE" ❑ PUBLIC UTILITY NUMBER OF,BEOROOMS ❑ One .1t Four ❑ Two ❑ Five ❑ Three ❑ Six PHONE 39 S-- 2C3z PHONE 34 S-Zo3 i PHONE PHONE .179-2ss'/ PHONE ❑ Other ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach tog if available.) YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 in". 6/79) DATE CP"'APPROVED FOR 4 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certi cate) ED DISAPPROVED IBy � C L� 72.010 (Rev. 6/79) ❑ OTHER Nearest Lot Line THIS SIDE FOR OFFICIAL USE ONLY -- -- 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX PERMIT NUMBER 2. WATER SUPPLY ❑ INDIVIDUAL DEPTH OF WELL ' ❑ COMMUNITY DATE DRILLED ❑ PUBLICUTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY DATE INSTALLED L4— Connection Verified INSTALLER ❑Septic Tank or ❑Holding Tank I a Size: -Sq If Tank is homemade SOILS RATING give dimensions: I j� TYPE OF TANK MANUFACTURER (�) TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank (Absorption Area (Sewer Line WELL TO: Absorption Area to nearest Lot Line - 5. COMMENTS DATE CP"'APPROVED FOR 4 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certi cate) ED DISAPPROVED IBy � C L� 72.010 (Rev. 6/79) ❑ OTHER Nearest Lot Line