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HomeMy WebLinkAboutRAMPART #1 LT 4Rampart Lot 4 #015-071-17 ,t Municipality of Anchorage DEC 19 2019 Community Development Department Page' 1 of 3 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: OSP181231 PID Number: 015-071-17 ❑ New ❑✓ Upgrade Name: MARK & SARAH HARLAMERT ABSORPTION FIELD 0 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 5621 E 99TH AVE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.0 GPD/SF 12.4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.4 Ft. Gravel depth beneath pipe 8.0 Ft. Subdivision Block Lot RAMPART #1 4 Fill added above original grade 0.0 Ft. Gravel length 40 Ft. Township Range Section Gravel width 2.5 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 640 Ft2 1 Ft. Well 100+ 100+ N/A N/A 72.0 TANK El Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250Gal. Surface Water 100+ 100+ N/A N/A Material Number of compartments Lot Line 5+ 10+ N/A N/A PLASTIC 2 NA Foundation 10+ 10+ N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50+ 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 House to tank Tank to drainfieid 3034 A+HOME SERVICES Drainrield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 98.0 ft Inspection15' 10/19/18 nd dates: 2 10/19/18 Location and description Td 10/19/18 4'h 2/14/19 NE BOTTOM HOUSE TRIM COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date d OFA�.Qs��$ Age .'� • teven I�annorie roved l �i (� �� Date ;< a D�l� AppAvow CE 8149 Q�-­7 -7 �� `AFD L Incnarfinn Rannrt 1_1_17 rinr DESIGN PARAMETERS A PRIMARY SEPTIC SYSTEM J NO. BEDROOM: 4 (600 gpd) 47.1 TANK SIZE: 1250g J PERC RATE: <1 MPI —4— SOIL RATING: 1 GPD/SF 44.2 AREA ROD: 600 SF o� / SYS. TYPE: DEEP TRENCH 8.0'ED DV MIN LENGTH: 37.5 LF / WELL (E) g W L (E) USED: / 40LFx2.5'Wx8.0' E.D., 13.0' TD 3 TOTAL AREA: 640 SF / \ INSTALLED .5'DRAIN FIELD 40LF x 2W x 8.0'ED x 13.OTD W/ CLEAN OUTS AND MONITOR TUBES AT EACH END REMOVE AND REPLACE FOR RESERVE f � REMOVED 10OOg SEPTIC TANK E PER CODE, INSTALLED 1250g SEPTIC TANK W/ DCO BEFORE VV_____ AND DCO AND DV AFTER _ ' 10' UTILITY EASEMENMT T _ T1 M --''-M /M DC01 T2 i REPAIRED EXISTING CRIB TO BE RE–USED AS RESERVE 102.8 A \ 3 BR HOUSE I \ WELL 1( ';0 M I WE/� B Z .. w L (9a 1 � EXISTIN SEPTIC ARE EXISTING SEPTIC AREA _ ` w-- %At —J C 1 96 mis 0 3 SEP 1� EAST 991h A B C DCO1 38.0 47.1 T1 40.6 46.4 T2 42.4 44.2 DCO2 42.7 43.1 DV 43.10 41.70 C 1 74.70 46.20 M 1 73.70 45.30 C2 14.1 31.20 M21 14.9 31.30 ';0 M I WE/� B Z .. w L (9a 1 � EXISTIN SEPTIC ARE EXISTING SEPTIC AREA _ ` w-- %At —J C 1 96 mis 0 3 SEP 1� EAST 991h N OTE S: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 v(Q'�� ®P 0 "" "' ® Steven R. Pennons' !a ?'� CE 8149��®� � �����FD osS`"-= 2D/21/2019 RECORD DRAWING Scl le 40 DRAWN BY: RAMPART #1,. LOT 4 HARLAMERT 5621 E. 99TH AVENUE ANCHORAGE, AK 99516 ACP P.I.D. NO 015-071-17 REV 1: 1/3/2020 PERMIT NO. OSP181231 PLAN Sh2e0F 3 h h wo O O j m m mz Z Z �o 1- 06 w w ©W O p 0 oU ri ri O� Z 2 7 DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 god) TANK SIZE: 12508 PERC RATE: <1 MPI SOIL RATING: 1 GPD/SF AREA RQD: 600 SF SYS. TYPE: DEEP TRENCH 8.0'ED MIN LENGTH: 37.5 LF USED: 40LFx2.5'Wx8.0' E.D., 13.0' TD TOTAL AREA: 640 SF LEGEND W WATER LINE/ WELL RADIUS SS NEW SEPTIC — —GB— — — GRADE BREAK — — 4— --�— RETAINING WALL DATE PERFORMED: 06/26/2018 ABBREVIATIONS TH TEST HOLE EA EACH FCO FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER (E) EXISTING (P) PROPOSED TYP TYPICAL NOTES: ��T r LLC a0"o� RECORD DRAWING PAMONE ENG SVC, LLC �F A�`�� Dote P.O. BOX 100217 ANCHORAGE, AK 99510 �� ""' �s��l 2/21/tots DRAWN BY: PHONE (907) 272-8218 FAX (907) 272-8211'�P ScoNITS ACP �'"' "" "' P.I.D. NO RAMPART #1, LOT 4 osl-or-» HARLAM -RT Steven Pannone ® PERMIT NO. 5621 E. 99TH AVENUE CE S d9 �*1 OSP181231 PROFILE ANCHORAGE, AK 99516 $�� % ..". oyP� .� Sheet 3 OF 3 Wx — - X X X x O JS 00003'00" E 135.00' I ' I = o w Q w Qm z z d w W Z Q=W� O E- - p 00 S oR w m o mLL � I t I I QWn- 1 30' i z j U)O tri > UQZQ N x� o p z� �-- f- O w J U (Y p Z) p m Iac -Z 11 x Ce) w �E� :)>a p f indw CO cn�cnU p U m J x I I 0! > m = 0 H Z W w CD w J ti I rLL p QXw Q dw WOU z Z -� F- � z p W HX LL O �r W X ( =m 1W- >ao ~� o 0ix oww < (� C x o FZ I O zio¢a " c0n td- w0.0Z p �— :E -:W cn I 26.2' I F=w p :E elf d a w CL d a, c �z < < un { r- a1: �� z I 3� w� p O0I z '` O I w0 =LLO F-z0=I-z O Qz > c N> I N m N df-�w pd LL co w ( U)W cin W w Q Q 0vw> (n w O o.._ O rn` {��lt/ rrtl = w > w O it LL F - z I �; z, �O Qm DwCO 00I Z ,- I t- 0 o ASPHA` Y I ; I : � � � zo � z in = 0 W N in ORNEWA � I O _ I c� co E p d F- d ( N N ice• I-)� a �Z m= O�W Iw- O I N I - //��d �: Hcr FU Z W p W �� Irr�S ¢N D� I 26.2' 45.7' �5����' rrri��\\\\� �`. 0Wz = �I I (3 d z p O w m w x 3 I w O (.)-j�O� =� UUU z� co U)Oa Iw ~pzo Wow z I o N xW I oZ zrr �O WQ� ZU(I z 0 N I 05; 00> rd�ix U) U tI i ILL X 30' I N �o �F- > U -m ZU W °(n Boz UU= z I -,`l) Co UPri J — WO o(nQ zoo a N 00003'00" W 135.00' �W000 o - �wW o QQ z o uJw rdm z w o pmw 0 J gra---- of MUNICIPALITY OF ANCHORAGE .went On-Site Water&Wastewater Program �a 5��, /0 �.,,� PO Box 196650 4700 Elmore Roadr. Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 httpa/www.muni.org/onsite - [:1)clwrtttwnt ,hCH ON p,E On-Site Wastewater Disposal System Permit Permit Number: OSP181231 Effective Date: 8/21/2018 Work Type: Septic Upgrade Expiration Date: 8/21/2019 Tax Code Number: 01507117000 Site Legal Address: RAMPART#1 LT 4 G:2437 Site Mailing Address: 5621 E 99TH AVE, Anchorage Owner: HARLAMERT ALASKA COMMUNITY Lot Size in Sq Ft: 16200 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4 This permit is for the construction of: 0 Disposal Field I1 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 By: L I. '' A ' Date: v I • ��� 7'N18 Issued By: � Date: EPLIWS MUNICIPALITY OF ANCHORAGE ts Community Development Department 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. 015-071-17 Property owner(s) Harlamert Alaska Community Property Trust Day phone Mailing address 5621 E 99th Avenue, Anchorage, AK 99516 Site address 5621 E. 99th Avenue Legal description (Sub'd., Block & Lot) Rampart #1, Lot 4 Legal description (Township, Range & Section) Lot Size 16,200 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (IE all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade �X Duplex (D) ❑ Holding Tank n Renewal Li Multiple Dwellings ❑ Privy n (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I 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: (Qj Waiver Fees: Date of Payment: 19:714 Date of Payment: Receipt Number: -13Y0Receipt Number: Permit No. 0.5101V40 Waiver No. Permnt App_.•:• : c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181231, Rebecca Carroll, 08/21/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181231, Rebecca Carroll, 08/21/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181231, Rebecca Carroll, 08/21/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181231, Rebecca Carroll, 08/21/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181231, Rebecca Carroll, 08/21/18 "'4"r` MUNICIPALITY OF ANCHORAGE cent On-Site Water&Wastewater Program ko ;, 71 r PO Box 196650 4700 Elmore Road C!fr! Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ��" httpa/www.muni.org/onsite — : N 3 q\— a l ul„,"„„..11t NCHORpG On-Site Wastewater Disposal System Permit (z`/!7 Permit Number: OSP171373 Effective Date: 12/20/2017 Work Type: Septic Upgrade Expiration Date: 12/20/2018 Tax Code Number: 01507117000 Site Legal Address: RAMPART#1 LT 4 G:2437 Site Mailing Address: 5621 E 99TH AVE, Anchorage Owner: HARLAMERT ALASKA COMMUNITY Lot Size in Sq Ft: 16200 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: El Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 Special Provisions: 1. This permit is to repair the existing crib. The log structure is to be replaced, see the engineers letter. 2. Onsite must be notified 2 hours prior to the completion of the log removal for an inspection. I Received By: 'ti< < JL0'4j `moi! l I A _ Date: 12- 21 /7 Issued By: r / i. —../•---,, D//, 4 Date: I Z 07 l MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907- `7904 -�_?n •, Development Services Division Fax: 9O,733-, ', On-Site Water & Wastewater Program �� ,Nall 4. I o GEC 1 9 2017 ON-SITE SEWER/WELL PERMIT APPLICATION y 12; Parcel I.D. 015-071-17 << 0/ 6 s 9°\ Property owner(s) Harlamert Alaska Community Property Trust Day phone Mailing address 5621 E. 99th Ave. Anchorage, AK 99516 Site address 5621 E. 99th Ave. Legal description (Sub'd., Block & Lot) Rampart #1 Lot 4 Legal description (Township, Range & Section) Lot Size 16,200 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) n (w/wo ADU) Septic Tank ❑ Upgrade X Duplex (D) n Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy n (SF and/or D) Private Well n Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: Distance: I 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: 5119 Waiver Fees: Date of Payment: IdZ/IR Ii'' Date of Payment: Receipt Number: 061:6?6 Receipt Number: Permit No. 65PI7/t3'3 Waiver No. Permit App_ • .:.-c Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com December 19, 2017 Subject: Rampart S/D, Addition No. 1, Lot 4 Emergency Crib Repair Permit Request Design Narrative I am writing to request a permit be issued to repair the existing crib-type drain field on the above property. The side wall of the crib have collapsed and causing a back-up of sewage at the house. The proposed repair is to remove the collapsed wall and open the flow again; install a steel perforated tank in the void area created by the log crib; place sewer gravel around the perforated tank; extend the inlet pipe to the new tank; place a new cover on the crib and cover the entire exposed area with filter fabric. A monitor tube/Clean-out pipe will be installed in the new lid of the crib. The existing depth and foot print of the crib will not change. Existing separation distances will not change. An Inspection Report and Record Drawing showing our work will be submitted at the completion of the work to close out the permit. The proposed repair will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, • • .� •OV • • �♦ = Steven R.Pannone \ � • 2 4S 4. Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Municipality of Anchorage ••_ /• - Development Services Department __ `;< Building Safety Division - On-Site Water&Wastewater Program,4700 South Bragaw St. z !t' P.O. Box 196650 Anchorage,AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Page 1 of 2 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW020385 PID Number: 015-071-17 Name: Wastewater System: ❑ New ■ Upgrade & SARAH HARLAMERT Y Address: 5621 EAST 99TH AVENUE * ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 349-7538 3 ❑Deep Trench 0 Shallow Trench 0 Bed 0 Mound 0 Other Soil Rating: Total Depth from original g LEGAL DESCRIPTION CPD/Sq. Ft. Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: •el dept eneath pipe: - 4 RAMPART #1 \\ j Ft Township: • — Range: — Section: — Fill added above original gra \C3 • Grovel length: Ft. Ft. Gravel width: Number of lines: Distance between lines: WELL: ❑ New ❑ Upgrade Ft. Ft. Classification (Private, A,B,C): Total De• •• Cased To: Total .....rption area: Pipe material: Ft. Ft. SQ. Ft. Driller: Date Drilled: Static Water Level: Installer. Date installed: Ft. DENALI SEWER 10/5/2002 Yield: Pump Set At: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ■Septic ❑Holding ❑S.T.E.P. ❑Other To Septic Absorption Lift Holding Public/Private Manufacturer. Capacity In gallons: From Tank Field Station Tank Sewer Lines ANCHORAGE TANK 1000 Material: Number of compartments: Well 100'+ — — — 25'+ STEEL 2 Surface Water 100'+ — — — — LIFT STATION Lot Line I — — — — Size in gallons: Manufacturer. 5'+ "Pump on" level at: 'Pump off' • at: High water alarm at: Foundation 5'+ — — — — Curtain Drain Pump Make . ode/: Electrical Inspections performed by: NONE KNOWN Remarks: BENCH MARK Location and Description: EXISTING SEPTIC TANK COMPLETELY ABANDONED TOP OF CONCRETE SLAB NEAR POINT "B" Assumed Elevation: 100.00 Ft. ENGINEER'S S • OF il ‘44d ,,,,.... .... . .....,„ Inspections performed by: AKWWC, INC. Dates: 1st 10/5/2002 i4'' T� % .. * 2nd — ,. ) vA .. 3rd — QD Jie f -y °. Cants.' �O Development Services Department Approval �iih C' • •3 o4.� Qf �\o Reviewed and approved by: Date: /o ..>'i/A 0.,ea • •,, o` 0 (Rev. 12/01) / essl.,*;,., V SWR NUMBER: AS-BUILT DRAWING PARCEL ID —1 7R: SW020385 015-071-17 X N / FOUNDATION CLEANOUT \ _ / \ \ IN CRAWLSPACE — / _ _ �_ — ' CAREA DBL3 — — \ 'BL4 DBL2 N DBL1 10' UTILRY EASMENT ........_, fir ---- SHED \ -- I / EXISTING CRIB. S / t i I EXACT LOCATION OF PERIMETER OF CRIB NEW 1000 GALLON \ UNKNOWN. / / SEPTIC TANK / / o A / \ / rr ^ I 3 g ROOM / HOUSE \ \, / G. A B / ST1 46.82 55.45 ST2 43.89 59.42 / DBL1 48.10 52.78 I DBL2 48.16 53.41 INSULATIONo F918.35 G - DBL3 40.60 61.22 - TOP OF TANK ATOP OF TANK AT DLB4 39.37 60.89 INLET - 95.20 OUTLET - 95,19 410111 111111111b / 1 I 4114,0.5". am / NEW 1000 GALLON / INVERT OF BUNG. SEPTIC TANK \\\ AT INLET - 94.87 INVERT OF BUNG AT EAST 99TH AVENUE/ _ OUTLET - 94.45 DATE: oo6O.P• 10/10/2002 ' ''a OF F o 4 , ( r,• .'� �r.. _ DRAWN BY: Qap 4i ../ •.4. 04 ALASKA WATER & WASTEWATER SCALE: C.J.G. ff T .000 CONSULTANTS, INC. 1„ 30, O i . * OQ 6901 DEBARR ROAD.SUITE 2B •ANCHORAGE,AK 99501.•PHONE(907)337-6179•FAX(907)338-3246 = o PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARK & SARAH HARLAMERT (907) 349-7538 2 OF 2 0 Je 're A. . - . 4 LEGAL DESCRIPTION: O o C 7 &O RAMPART SUBDIVISION #1• LOT 4, 04 \cP0 TYPE OF WORK: 44s f ess10��\0o� AS-BUILT DRAWING AND DETAIL OF SEPTIC TANK UPGRADE ��O000' --- MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water&Wastewater Program 4700 South Bragaw Street P.O. Box 196650,Anchorage,AK 99519-6650 (907)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 03, 2002 Expiration Date: Oct 03, 2003 Permit Number: SW020385 Parcel ID: 015-071-17 Legal Description: RAMPART#1 LT 4 Design Engineer: 0041 AK Water&Wastewater Consultant Site Address: 005621 99TH AVE E Owner Name: Mark&Sarah Harlamert Lot Size: 16200 SQ. FT. Owner Address: 5621 E. 99th Ave. Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99516-6425 This permit is for the construction of: Disposal Field I✓I Septic Tank [] Holding Tank I I Privy ❑ Private Well ( I Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 )and Drinking Water Regulations( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907)343-7904 (24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: /[ 0_'0_ -�� _ Date: l0[3/02---- Issued By: it/ ' / Date: /0 3' 0 Municipality of Anchorage • p 4W1)!fL�ll'I: j_ Development Services Department Building Safety Division SA ETY On-Site Water&Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage,AK 99519-6650 www.ci.anchorage.ak.us 34 -7904 k.us (907)343-7904 4%, 11S440, ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-071-17 Permit Number ! VIS 0 3 Property owner(s) MARK & SARAH HARLAMERT Day phone 349-7538 Mailing address (1) 5621 EAST 99TH AVENUE * ANCHORAGE. AK Mailing address (2) Zip Code 99516 Legal description (Lot, Block& Sub'd.) LOT 4: RAMPART SUBDIVISION #1: Legal description (Section, Township & Range) N/A Lot Size /b ,V6r3 Acre S Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS, INC. _ 5501 ' (f +4 Permit Fees: /"V i"'60 Waiver Fees; Date of Payment: __ 0/3/O Date of Payment: Receipt Number: a164475 S-4 Receipt Number: ALASKA WATER & WASTEWATER CONSULTANTS, INC. October 2, 2002 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water& Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Tank Upgrade for Lot 4, Rampart Subdivision#1 To whom it may concern: The existing 3 bedroom house is currently served by an on-site well and septic system. The existing septic system consists of a 1000 gallon septic tank and a crib type drainfield. The septic tank is collapsed and needs to be replaced. We are proposing that the existing 1000 gallon septic tank be replaced with a new 1000 gallon septic tank. 1. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. I S.- erel 1, 1i Jeff : 4 a - '.E., M.S. Pre.'.e NOTE: Attached is a site plan drawing, a design drawing„ and a 5 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B *Anchorage,AK 99504 Ph: (907)337-6179*Fax:(907)338-3246*Website: akwwc.com /-- ``5_5 —/---tel\-\ \\ / /' \}\ �"S EAST 98TH AVENUE -_ / /' \, __-_ \\ \\ ,-/- N—\ ------ - ---- / / / \\ \ \\ I � I 11 1 I 1 I 1 . i I 1 \ 1 1 / / \ \ \ / / / SUMMIT EST. S/D; PROPOSED SEPTIC UPGRADE SUMMIT EST./S/D; SUMMIT EST. S/D;/ LOT 2, BLOCK 3, (SEE DESIGN PAGE 2 OF 2) LOT 4, BLOCK 3, LOT 3, BLOCK 3, Al2.Et PTIC \�� PEA •-•-_ L PI1C/ ARP TIC —_- --- — ��---��— A� -- AR-i---- — / •\ ----- —G - r --'mac----•- I / •„�S4ERPEFC � .-1 1 -' SEPTIC NG�__. SEPTIC AREAS� / \ / \ • \ .� \ a ISTIYS SEPTIC \ \ SUMMIT EST. S/D; • \ / SYSTEM \ / LOT 12, BLOCK 3, / EXISTING • RAMPART 3/D1; '.3-..' BEDROOM �. 1 \ \ HOUSE / ��� iEAST 99TH AVENUE ,\ miami %` :RADIUS. ` ' — --- — ---�� A---- /1�— — ------� ---L--- / /• \ /• / •� /i AR • \�\ -ice -7// / \ /RAMPART S/D #1; \\ RAMPART S/D #1; SUMMIT EST. S/D; pA� VD #1; LOT 7, RAMPART S/D #1;RAMLOT 9, LOT 8, BLOCK 4, LOT 6, LOT 8, I : ` 1 'I '� I \ / \ ',1-, \ / 4 / \ i DATE: �cc.•, \ 10/2/2002 0F ,�, / A\ aasFT DRAWN BY: ,-''` �(• 4st4,1t, ALASKA WATER & WASTEWATER C.J.G. '� .• 1 , ..11,t) CONSULTANTS, INC..„.., ." 0.' SCALE: ;5 49i pi' 37� +,,i 6901 DEBARR ROAD.SUITE 28•ANCHORAGE.AK 99501.• PHONE(907)337-6179•FAX(907)338-321.6 1” - 100' �/� PREPARED FOR PHONE NUMBER: PAGE NUMBER: ii �� MARK & SARAH HARLAMERT 349-7538 1 OF 2 (,. '•,J! fr= •. ,em ss.- p LEGAL DESCRIPTION: 4i�0 / : 7953 • 0`.� RAMPART SUBDIVISION #1; LOT 4, Ike tS, �o``�>� TYPE OF WORK: 4AToeaprofesslo�d ..-t.;”" SITE PLAN FOR SEPTIC TANK UPGRADE ���`,�0f e <<�- \ \/ \ / \ / � N / N N N ` INSTALL DOUBLE ! -SEPTIC \A •--._ _ --__ CLEANOUTs ARE / GAOONK N 10' UTILITY EASMENT v _J / / i SHED \ -- o EXISTING DRAINFIELD / \ j'4 TO REMAIN IN USE / EXISTING SEPTIC TANK \ *" TO BE COMPLETELY -"Nola \ / ABANDONED AND REMOVED. FILL HOLE INSTALL WITH PLATE COMPACTEDEXISTING FOUNDATION / N.F.S. SOILS OR I 3 BEDROOM CLEANOUT \ / DRAINROCK. I HOUSE 0 I \ / S I ,� n / Il / I I 1-1 / V NOTE: THE CONTRACTOR SHALL HAVE THE 100 FOOT /WELL RADIUS ON THE REFERENCED PROPERTY AND THE / NORTH LOT LINE FLAGGED PRIOR TO CONSTRUCTION. / 1.1 ALSO THE CONTRACTOR SHALL FIELD VERIFY ALL OF EAST 99TH AVENUE THE 100' WELL RADII PRIOR TO CONSTRUCTION. DATE: op '''''•N N� 10/2/2002 o OF '' X44 i .r. DRAWN BY: C�. . .,111.6Ab ' ' WASTEWATER c.J.G. ` •,.�- 0 ALASKA WATER rLR & SCALE: :". .r).-: 4„ p.:4 %-..-7:00D CONSULTANTS, INC. 1" = 30' g...... ...I..ii PREPARED FOR: PHONE NUMBER: PAGE NUMBER: Q 907 - 8 2 OF 2 a` ' A MARK & SARAH HARLAMERT ( ) 349 753 Oh e e A ess. Og LEGAL DESCRIPTION: Q g. I '- , e• � RAMPART SUBDIVISION #1; LOT 4, OP'. . ....•- •‹°0 TYPE OF WORK: VP fess. oma SITE PLAN FOR SEPTIC TANK UPGRADE �O0000�� GAAB-HD-1 GR' TER ANCHORAGE AREA BOROV- 1 • Dc.NRTMENT OF ENVIRONMENTAL QUALU I . 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING 3 .1 NAME A 4- !�• GO/yJ�s ADDRESS 4‘,:y..5.-- 9/ `'`J �`� PHONE-3'- LOCATION 3V7 7/4/f �% LEGAL DESCRIPTION X07-y /7!/�.4r-7--1vr. SEPTIC TANK: DISTANCE FROM WELL 7.c MATERIALr-1-7--- NUMBER OF Z COMPARTMENTS �� /y7z- -$77,1 ,mss./. w--�i7�/l 7d- LIQUID CAPACITY e.) _GALLONS. INSIDE LENGTH '..----- INSIDE WIDTH "----- DEEPTHD SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER `� X..?OR WIDTH � , LENGTH / 7 /, DEPTH / , / / , LINING MATERIALLd �.Q r�� ,X , DISTANCE FROM WELL ,r47‘',r47‘' , BUILDING FOUNDATION -2G / NEAREST LOT LINE /'!le./7D ,yam• . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 4..‘"-- e-00 SQ. FT. TILE DRAIN FIELD: /j//z TOTAL LENGTH DISTANCE FROM WELL • • -- : , , ' - • T LOT LINE , OF LINES , NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH IDTH •. •TAL EFFECTIVE ABSORPTION •EA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN, ABOVE TILE WELL: /,,f4fD!/d 0044,- �`%yT0— i DISTANCE FROM / WATER / TYPF.. Z c ' , DEPTH 60 ,BUILDING FOUNDATION. /D �` SAMPLE �� - NEAREST LOT LINE o,G / SEWERSLINE �� TANK ��/ SYSTEM SEEPAGE ��� / OTHER /��/y� CESSPOOL./�v/3/�, SOURCES"-10"//1/ DIAGRAM OF SYSTEM DISTANCES: 1 /970 r/G' i9Toa= 7s"' --14---- i' /9 7V#-..7.-ZOO 1 i017.0a= ..3.5---7q A t 0 .t-rod.-.:- /O ' 1 k. .� -4444,7 , t. t t‘s . .c' . ,i, ? it S' i< TEST �_ U _t t \if \ffs) 1\1 ‘,;70111r,; ., I� CL 'A'X:33 e I Av,arosiG-7 1 DATE 1Z7- .72- . APPROVED e• ��-- 161;11 .A. .B. GRE/ , ER ANCHORAGE AREA BOR UGH �1,3� DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE. ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT z 4' MAILING ADDRESS 9i .•/./r/ / "" PHONE -""•'="›.6" INSTALLATION LOCATION LEGAL DESCRIPTION .4673/ � oy INSTALLATION OF: SEPTIC TANK SEEPAGE� lPIT , DRAIN RR/A IINy�FI/ELDD ��. OTHER TYPE AND SIZE OF FACILITY TO BE SERVED 1 f ' ` _ /"i�`;-7J'r "�i��� FINANCED THROUGH TO BE INSTALLED BY -7.1 -ire���'�� SOIL TEST RESULTS .�� 1if/�G --_ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY/`� WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE/ �'7 TYPE,..-.17.27;7"-- SEEPAGE AREA SIZE 7/4/,‘" Y1 ' TYPE MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK -� FOUNDATION TO SEEPAGE PIT --'"26,2��--77 U / . DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL ,""J �1 / SEPTIC TANK - ✓ _ . SEEPAGE PIT . DRAIN FIELD ,// 1 TO NEAREST LOT LINE. WELL TO SEPTIC TANK . SEEPAGE PIT /226' DRAIN FIELD /D D ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK /D . SEEPAGE PIT VZ-2 DRAIN FIELD l U l SEPTIC TANK. ` SEEPAGE PIT /7/7Z2,/7/7Z2, SU , DRAIN FIELD , TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH U ITY OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. �J/J DATE �`�LY,2"2--- APPLICANT'S SIGNATURE / U/• �' � 11 • R&M ENGE EERING & GEOLOGIC CONSULTANTS i f' '' 229 EAST 51st. AVE. — P.O. BOX 6087— ANCHORAGE, ALASKA 99503 r TELEPHONE 907-279-0483 TELEX 090-35419 Civil Engineers Geologists Land Surveyors JAMES W. ROONEY,P.E. RALPH R.MIGLIACCIO MALCOLM A.MENZIES,P.E.,L.S. Engineering Geologist JAMES H.WELLMAN,P.E. May 26, 1972 R & M No. 26512 Mr. Don Combs 4915 West 84th Avenue Anchorage, Alaska 99502 RE: Test Hole and Soil Log Report, Rampart Subdivision No. 1, Lot 4, Anchorage, Alaska Dear Mr. Combs: We are submitting herewith the test boring results and our comments re- garding soil conditions encountered at the subject site. This investigation was performed in accordance with your verbal instruction of May 26, 1972 and those procedures outlined in a letter dated September 13, 1971 by Mr. Rolf Strickland of the Greater Anchorage Area Borough Department of En- vironmental Quality. A single test hole was put down within the Lot 4 area for the purpose of defining general subsurface soil conditions. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extended to a total depth of 10. 0 feet. One sample was recovered from the bottom of the test hole and retained for grain size analysis. The final log prepared for the test hole has been included in Drawing A-01. The test hole is considered to represent the material lying within the lot boundaries. The soil profile disclosed by the test hole indicated six inches of organic material overlying a brownish red organic silt which extended to a depth of 2. 5 feet below ground surface. At this depth, a light brown silt with some gravel (ML) was encountered and extended to a depth of 6. 0 feet below ground surface. At this depth, a gray coarse sand (SP) was encountered and extended to a depth of 10. 0 feet. The soils were visually classified in accordance with the Unified Classified System. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. ANCHORAGE FAIRBANKS JUNEAU • • T.H. I 5-26-72 00' `_- ORGANICS 0.51 ORGANIC SILT Brownish Red 2.0' 0 SILT - ML 0, W/SOME GRAVEL Light Brown Slightly Moist 6.0 :.' ::".0 COARSE SAND -S P Gray , slightly moist 10.0 T.D. No water table Note: Test Hole excavated with tractor-mounted backhoe DON COMBS PROPERTY LOG OF TEST HOLE t Engineering a Geological Consultants ivi • ANCHORAGE FAlR®ANKS ALASKA JUNEAU Anchorage Alaska 1 DATE 5-50-72 SCALE I" ❑2DWN BY B.D. ICHKO BY PROJ. NO. 26512 DWG NO. /a-01 LI- MUNICIPALITY OF ANCHORAGE .� ( •-1 �' DEPARTMENT OF HEALTH & HUMAN SERVICES j1 ichrort. Division of Environmental Services �,�; = On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ��ll Parcel t.D. # I '� C I—I HAA # /`f>1l��zw 1. GENERAL INFORMATION Complete legal description Lift t t4, v A ( I= � # /�vt_ Location (site address or directions) { � 1.t.- , Property owner t�;'-r - Day phone r t- - I`1 Mailing address -11 fit- . A Lending agency Day phone Mailing address Agent 1� .� �r, t <.- Day phone .7")�= - i Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: =� 3. TYPE OF WATER SUPPLY: / Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev vsn Front MOA x21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm I c 16,oy--e Sp I V,,1[tvcr'x' L Phone 9-r7- 3 41 Address ;2_c. 3 /O J—Gr '(2 Ll Engineer's signature s Date 5/3) t'-e) • • . 1 • 6. DHHS SIGNATURE 17 Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: (1} • ac'— ( Date -7 - O d CAUTION • The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska.The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements.Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 Rev 11911 3acx MOA rf21 • Municipality of Anchorage Adik •���'� Department of Health and Human Services i Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 cirihs P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoT y k TAK-( (2-`l Parcel I.D.: 0/5-0 1/-/7 A. WELL DATA Well type j2, If A, B, or C provide PWSID # '//-\ Well Log 4�( Date completed V(72- Sanitary seal Wires properly protected Total depth 1( ft Cased to // ft Casing height (above ground) '`iin. FROM WELL LOG AT INSPECTION Date of test N- 7- Dt.--, Static water level ft 3 L ft Well production g.p.m g.p.m WATER SAMPLE RESULTS: Coliform /0 colonies/100 ml Nitrate . 7/ mg/I Other bacteria �� colonies/100 ml Date of sample: i/ 9 /)- ) Collected by: I 5 B. SEPTIC/HOLDING TANK DATA II Tank Type/Material )-er 1.1:c_ , S t e Date installed 'Iz ''7 L Tank size bo-&O gal Number of Compartments %Z- Cleanouts s Foundation cleanout 11 Depression over tank N\ High water alarm 1/ Date of pumping /4- g —DU Pumper A c' Lr - Le-55/90,1 C. ABSORPTION FIELD DATA Date installed c/L/77-- Soil rating (g.p�i./ft2 or ft2/bdrm) / /.> System type Li,,t-`j Cr; b Length l 7 ft Width 13 ft Gravel below pipe ft Total depth 1 1 ft Effective absorption area 7 yv ft2 Monitoring tube "/ Depression over field f"-1 Date of adequacy test V/740 Results (Pass/Fail) / For 3 bedrooms Fluid depth in absorption field before test in Water added 5v 0 gal. New depth :5'••5?' in. Elapsed Time: min Final fluid depth (`'7 in Absorption rate >= (ASa g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N-1 If yes, give date 72-026(Rev.01,00)* D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in ''Pump off" lev: at _ in High water alarm level at in Datum Cycles - ted Meets alarm & circuit requirements E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 7 MUNICIPALITY OF ANCHORAGE 1 . ••/ —' DEPARTMENT OF HEALTH & HUMAN SERVICES > Division of Environmental Services T_ On-Site Services Section Yt,Ll CV P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ° lam' U7 i ' l HAA # (PCCC..(S 1. GENERAL INFORMATION - Complete legal description LO i 14 R V _' 17 Location (site address or directions) Tl E N- A ti- Property owner D-e. S Day phone `S " & t 11 Mailing address 5 co E 9 ct Lending agency Day phone Mailing address Agent 1-? r `,1 -r- t c\ -R (f_7L,0(..)z Day phone a 7(L: - ,'t.,76 J• Address o-d' Co ckO Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 4Rev.1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. �1 Name of Firm I a bb€ yr - e �1.�LaIAd P. t✓ Phone 2 7-( 3 l Address a c :AL1 .a 0 3 Engineer's signature 7 L-c_LADate /7/06 • • 6. DHHS SIGNATURE • . Approved for 3_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: I / Date ' 2 6-n 0 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska.The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements.Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025;Rev.1/91) Back MOA 1121 RECEIVED • Municipality of Anchorage Department of Health and Human Services APR 1 2000 Division of Environmental Services On-Site Services Section 825 "L Street Room 502 MUNICIPALITYL OFSERVICFc ANCH P.O. Box 196650 Anchorage, AK 99519-6650 LAI ml r' www.ci.anchorage.ak.us (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT L} , A sAppi.PT SLD Parcel l.D.: L/1; -471-l7 A. WELL DATA Well type R If A. B, or C provide PWSID # /a Well Log N Date completed i 912. Sanitary seal y Wires properly protected `f Total depth &O ft Cased to LD ft Casing height (above ground) 15 in. FROM WELL LOG AT INSPECTION Date of test H- 7- O U Static water level ft 32 ft Well production g.p.m g.p.m WATER SAMPLE RESULTS: tt Coliform 7) colonies/100 ml Nitrate 3 `i mg/I Other bacteria colonies/100 ml r Date of sample: H 7 "00 Collected by: j rr `- B. SEPTIC/HOLDING TANK DATA Tank Type/Material S ep L c t e Date installed 63/'217.Z Tank size I a-rY0 gal Number of Compartments Cleanouts `/ Foundation cleanout NI Depression over tank NI High water alarm 1•I Date of pumping - c" Pumper A i e (-e S s e f c. C. ABSORPTION FIELD DATA Date installed q9-17)-- Soil rating .(4.4a.d.,/it.2 or ft2/bdrm) /75" System type 1-.0 C-r I Length / 7 ft Width /3 ft Gravel below pipe ' ft Total depth / 1 ft Effective absorption area:'/b ft2 Monitoring tube ), Depression over field IQ1 Date of adequacy test 4"7"W9 Results (Pass/Fail) )- For bedrooms Fluid depth in absorption field before test 75 in Water added 6V gal. New depth Q, S in. Elapsed Time: .30 min Final fluid depth ' I in Absorption rate >= 4/60 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date 72-026(Rev.01;00)' D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in "Pumprpff' level at in High water alarm level at in Datum C les tested Meets alarm & circuit requirements E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 7_ On adjacent lots > ! Absorption field on lot 110 ( lha L ,,/3)On adjacent lots 8 8 `O b' 13�' a {,to Public sewer main N/A Public sewer manhole/cleanout N/Ac Sewer/septic service line > 50 Holding tank N A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation •,S, I I Property line > 1 0 Absorption field I Water main N�A Water service line >a 5 Surface water j\1 0'‘•11--t Drainage Ni Jo Wells on adjacent lots > /1,-0 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I Building foundation ,2 L Water main Water Service line > u Surface water NA c Driveway, parking/vehicle storage j 5 0 Curtain drain f`f/0 Wells on adjacent lots > i at) F. COMMENTS • w4 OF A`'▪ � •l.�t.L G. ENGINEER'S CERTIFICATION jco .c,.,• "` I certify that I have determined through field inspections and i GINE R' review of Municipal records that the above systems are in te' •N..' _ _ TAMP, Lc „ 'r conformance with MOA HAA guidelines in effect on this date. �,... . 444 e� n, Cc-222$ .' • "sM Engineer's Printed Name • 1 o h/D—e S u r h la K� • F'• � �J -D 7 - 41, �• :o r Date 2'40 FESSP HAA Fee $ ' LZ Waiver Fee $ Date of Payment 211/ 10-2, Date of Payment Receipt Number 5679 CI)i Receipt Number 72-026(Rev.01/00)' 00 0 1 �,aete tl6. 9hA �.Ur . late+ 41+1 r �. ��t«laa+rr $er na`t. A1..ika. ft"Oi tMI W 1 i4l6tM K M'��tjo®a4w &i®W�Y�68}1_1 nu�4�bige b�'y19r.MAU 4. !•4• .i*sa9. i 114 not 1s:wr ;;dIA—i loon fe%. 9;1`1 9..t %:t'a't'gWow "'A e'4 i t city lrani:: d. •t•#i1 YiWlklia 4 crr®+atAun thpin eUe.%.►i!•' !t Y�Q'1! find® t[.a 2 {e4.96 R, St .40+a t�4md8 lf.:o•i, smt a1.N ffilaffi;t� 4Yf6et64ras 1;m11t a8 AlmLacou.4 1.rfgsid4. at Arriidw&i ° ki1:k�1a'i �' �:L"•..1.<i4°� Vie. � ''ae�m� t 907ev a� NINETY 4� f m 4V Ir 11 1 �•W oYmi .°'a ..ono. • •®• „ Ord i �yPey,► t.s•tE �•,a 4v 16 a 1 �,aete tl6. 9hA �.Ur . late+ 41+1 r �. ��t«laa+rr $er na`t. A1..ika. ft"Oi tMI W 1 i4l6tM K M'��tjo®a4w &i®W�Y�68}1_1 nu�4�bige b�'y19r.MAU 4. !•4• .i*sa9. i 114 not 1s:wr ;;dIA—i loon fe%. 9;1`1 9..t %:t'a't'gWow "'A e'4 i t city lrani:: d. •t•#i1 YiWlklia 4 crr®+atAun thpin eUe.%.►i!•' !t Y�Q'1! find® t[.a 2 {e4.96 R, St .40+a t�4md8 lf.:o•i, smt a1.N ffilaffi;t� 4Yf6et64ras 1;m11t a8 AlmLacou.4 1.rfgsid4. at Arriidw&i ° ki1:k�1a'i �' �:L"•..1.<i4°� Vie. � ''ae�m� t MUNICIPALITY OF ANCHORAGE ••t DEPARTMENT OF HEALTH & HUMAN SERVICES irtio Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # j LC-- C''71 I - HAA# 1 i 9" C, r-,"? 4 1. GENERAL INFORMATION Complete legal description L^' q A.A,iPt fa+ 5; Location (site address or directions) - T(:.•"ZI c� • '� } Property owner k" ? `�? I ' I`�, Day phone -.?& R._ :.. Mailing address - (- ?- 1 ti.' (lI i1 .� ,; ' /--(2 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe,functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm -% JL-k) AA) )c'.t./ TP. La, Phone 2-:?-2---1:3`0/ Address `- C) 0 i '.tZn 7_c1 )lk'c0 AK. c-47 �%g Engineer's signature,---- --AM Date Z ---17—':-.)7- ' k,i``.1 ,.. i7.. : ..1c:3 6. DHHS SIGNATURE ,61c-40:- Approved for 771/2• ('> bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments I il ( I 1 / By: 4 '(0r el_ ► (10 ;11(.41/11 - Date 02P4,/( I CAUTION - The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska.The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements.Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev.1/91) Back MOA#21 �, Municipality of Anchorage RECEIVE o � t• il j DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division FEB 3 1997;--T=, 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907�f43,� 47of Anchorage Dept.Health&Human Services Health Authority Approval Checklist Legal Description: 1- 44 ¶v .-vi i,A 2 `171-r) Parcel I.D.: C')1.5--c,-1— 17 A. WELL DATA Well type ?'J.rc-: If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed ')'F.' Total depth C c'` Cased to etc- r Casing height (above ground) /,`, Sanitary seal (Y/N) i Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test �%t k-,CcwnJ z--1 _ C". Static water level U i.J i`.1fd,,.fAd 3) Well production )A) is 0,11 AI• g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform ,. - Nitrate ,_' Y- i Other bacteria Date of sample: 2.- :/ Collected by: 5i • R ?A.).A.)c,�, c. B. SEPTIC/HOLDING TANK DATA Date installed 'C' / ?Z- Tank size /c=c1c-, Number of Compartments_ / Cleanouts (Y/N) - i,►3�c_ c.ce Av-t,•r. -T+/_;rdati.a-.0 t;aru.:t;.JTjaa:r t !~u:-a Foundation cleanout (Y/N) 14 .- Depression (Y/N) It Me High water alarm (Y/N) Date of Pumping I -I S-' -F- Pumper A`t- C-I•-t^encaZvic±= C. ABSORPTION FIELD DATA Date installed !c l"?Z Soil rating (g.p.d./ft2 or ft2/bdrm) 1 7 S System type J t 'f- Length c& LS Width L_i Gravel thickness below pipe El Total depth t I • c( Effective absorption area S'12 Monitoring Tube present (Y/N) `z Depression over field (Y/N) 4 Date of adequacy test 2 -1- 4 4 Results (Pass/Fail) �A S_s For bedrooms Fluid depth in absorption field before test (in.); i `1 1 Immediately after'i 9J'gal.water added (in.): 'i Fluid depth 1<<<!L' (ins) Minutes later: '-/2.' Absorption rate = at 4_.C) g.p.d. Peroxide treatment (past 12 months) (Y/N) — --- - If yes, give date ' - 72-026 (Rev. 3/96)" D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump n" - - "Pump off" level at* High water alarm level a * *I m C ested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot `<(z) --.2 CM) On adjacent lots /C�c' See (e1t�ST Absorption field on lot /C'c 47 On adjacent lots Ovegg oat L-/ Public sewer main Public sewer manhole/cleanout "4-4 Sewer/septic service line S Lift station t c'o --(- SEPARATION SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation I11c. -ZZ`(('-‘) Property line /c-' Absorption field 75/CR) 15'(.r ) Water main/service line "Z Si 4- Surface water/drainage /nc-t- Wells on adjacent lots /cot SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /`i� Building foundation ( Water main/service line 2 S t Surface water c"c� r Driveway, parking/vehicle storage area .� Curtain drain Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that/have determined thru field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Signature. _ - Engineer's Name nA,u ck e,. >• -. le)!3 =5tev t :t t�none Date vas , CE-8i, . HAA Fee $ . (MCI CL: Waiver Fee $ Date of Payment A :3)-91 Date of Payment Receipt Number t(n` _l0 1\ Receipt Number 72-026 (Rev. 3/96)* I MUNICIPALITY OF ANCHORAGE 4-1"..a1 • \ DEPARTMENT OF HEALTH& ENVIRONMENTUMF (ifi F ANCHORAGE 0./10 T"1 / r 825 L Street.Anchorage,Alaska 99501 DEPT. OF ; -;'.o ;' '< t ENVIRONME,;I _CTIOt' ENVIRONMENTAL ENGINEERING DIVISION eic9-) Telephone 264-4720 APR 1 1 1980 luaAD - - REQUEST FOR APPROVAL OF INDIVIDUAL WATER II�Ii.n( Y fAILITI DIRECTIONS: Complete all parts on page 1.Incomplete requests will not be processed.Please allow ten (10)J(days forprocessing.processing. 1. PROPERTY OWNER PHONE Charles L. Johnson MAILING ADDRESS P.O. Box 5486 - Lake Charles, La. 70606 PROPERTY RESIDENT(If different from above) His Wk. 279-2448 PHONE Richard & Nora Palinko Her Wk. 279-7511 349-6947-Home 2. BUYER PHONE Richard & Nora Palinko " to 349-6947-Home MAILING ADDRESS 5675 East 99th - Anchorage, Alaska 99507 3. LENDING INSTITUTION PHONE Peoples Bank & Trust Co. 279-7511 MAILING ADDRESS Pouch 7-007 - Anchorage, Alaska 99510 4. REALTOR/AGENT PHONE N/A MAILING ADDRESS N/A 5. LEGAL DESCRIPTION — Lot 4, Rampart Subdivision No. 1 STREET LOCATION 5675 East 99th Ave. - Anchorage, Ak. 99507 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ® SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ® Three ❑ Six 7. WATER SUPPLY O INDIVIDUAL* •ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date,give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ® INDIVIDUAL/ON-SITE** "If individual/on-site,give installation date If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) 1-4,0 %(\iS1-49 not.c) eto:A...111.2.<161- 1 - ,t5-14-1:41°r4,0 QTHIS SIDE FOR OFFICIAL USE ONLY 0 DATE RECEIVED INSPECTION APPOINTMENTS • TIME TIME ------ TIME • DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE El THREE ❑ FIVE ❑ OTHER MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX PERMIT NUMBER 2. WATER SUPPLY ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER El INDIVIDUAL/ON -SITE DATE INSTALLED C1 PUBLIC UTILITY — "7 2— Connection Verified INSTALLER ❑Septic Tank or ElHolding Tank Size:_LW& If Tank is homemade SOILS RATING r give dimensions: _ / — t!y —Jo TYPE OF TANK MANUFACTURER ji2ii,e TOTAL ABSORPTION AREA MATERIAL ^ C)itdr 4. DISTANCES Septic/Holding Tank(,Absorption Area Sewer Line Nearest Lot Line WELL TO: �S 1 00 Absorption Area to nearest Lot Line 5. COMMENTS V APPROVED FOR .2 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompan certificate) ❑ DISAPPROVED DATE BV) } LEGAL DESCRIPTION 72-010(Rev.3/78) 0 MUNICIPALITY OF ANCHORAGE DEPT. OF i RK�A� REID ENVIRONMENTAL ENGINEERING ' xu-~� SRA BOX lso4n � ��08Y n AmcHonAos. ALASKA e9507 MAY " .""° (907) 344-1205 276-1361 RECEIVED ECEIVED APRIL 30 1980 RICHARD PALINKO SRA BOX 81F ANCHORAGE AK 99507 SELLER CHARLES JOHNSON SUBDIVISION-RAMPART *1 BLOCK- LOT-4 THE TYPE OF ABSONBTION SYSTEM IS A PIT WITH AN AREA OF 540 SOFT^ THE QUANTITY OF WATER ABSORBED DURING THE TEST WAS 330 CALLONS, THE SOILS RATING OF THE SYSTEM AT CONSTRUCTION WAS 180 AND NOW IS 164 SOFT/ BEDROOM. THE REQUIRED AREA FOR A 3 BEDROOM HOUSE IS 492 SOFT. THIS HOME HAS 540 SOFT. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM 49 ••.0•••• .• •- . ••••17, ~� r Ir `ur2EATE0. ANCHORAGE AREA BOO`JGH p/� Department of Environmental Oilality Ws' 3500 Tudor Road, Anchorage, Alaska 99507 270-96B6 ( C 1,/p� Time of Inspection /0.640401 I `/ Date of Inspection RErvP.sT FOR AIDE--?0`1.41, OF 7- ad- 7? INDIVIDUAL SE6ER & WATER FACI-ITIY FO? ev A . 1. Approval Requested '3',': SLA Address: 49/ ,S-- of id-11-72:124,4.-4.-.:7) Phone: 2. Property Owner: (3 0.1b-}j/L__4_1_LPhone: 3. Legal Description: / Pt Ad..Pati .A ' `L,, _ . _/ 4�—.4eil 411 / 4. Location: - - 5. Tyne of Facility to he Insrectea._ Number of Bedrooms:_� 6. Well Data: A. Tyne -Tr , /fie d B. Depth 4U _ _ _ C. Construction 4,p ,-o /e e( D. Bacterial Analysis 7. Sewage Disposal System: A. Installed (, /2112- B. Installeryo rt q /d Cc7 pr)hS C. Septic Tank: 1. Size /000712. Manufacturer /q 7 Z -Crew%.574o / D. Seepage Pit: I . Size /3g/7,...g 2. Material. Log_ Cr; 6 / ,-a,J&'/ E. Disposal Field: Total Length of Lines AM- 8. 8. Distances: A. Well To: Septic Tank 7,s / , Absorption Area /00 / , Sewer Lines /d/f" , Nearest Lot, Line 20 / , Other Contamination AD 4 . B. Foundation to Septic Tank 27' - , Absorption Area Z6 C. Absorption Area to Nearest Lot Line /4/ Request for Approval of Ir v dual Sewer & 'Nater raci.litier Vage Two 9. Comments: ,,e..y k.-e,IY 4i1.- et„-01__W ,V- 4.- ,�0 Annrove. / y�y;a^moved Date 4/ 24 /y%�' Apr,roval Valid for One Year Fon Date 5i"Tned Greater Anchorane Area lorounh. Department .;f Ervironrrani.al Quality JIAO: AM OF SYSTP.V.. I certify that the information contained in this request for approval to he a true and accurate representation of the suhiect sewer and water facilities located at : /Y1f Signed Date