HomeMy WebLinkAboutKARIANNE HEIGHTS LT 1AKarianne
Heights
Lot 1 A
#017-091-98
Municipality of Anchorage Page I of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519=6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SLS 1600 51 PID Number: ot'► - og t' - 63
Name: SLer PAr
13Wastewater System: New J4 Upgrade
q
Address: bA,7TLAC,COJrJ0, wA
23 696614fJGe'er
ABSORPTION FIELD
20 IJ. E. -Pat.
Phone:No. of Bedrooms:
(BGO) 666 - g7703
W Deep Trench O Shallow Trench O god O Mound O Other
LEGAL DESCRIPTION
3o11 R°""°: 0 6
Total Depth from original grade:
PD F
0 fet[T
Lot: Block: Subdivision:
Depth to pipe bottom from original grads:
Gravel depth beneath pipe
IA049 NEmci
5 F.
5 Ft
Township:
Range:
Section: _
Fill added above original grade:
Ore el length:
O. t
2 301) (-Ga FI
WELL: New ❑ Upgrade
Gravel width: 5
Numb"4 linos:
OBuncs;12 RFs:
a
Ft
Ft
Class,llcatlon (Private, A,B.C): Total Depth:
9_8 300-1-0:
Total absorption area:
Pipe materiel:
Pat I JA
Ft.
SO Ft
Asrnn D-3054
Driller, aDrilled:
Static Water Level'
Installer.
'7�W@EO EicAdAtu1
Date Installed:
Ft.
Yield:Pump
Set at:
Casing Height Above ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
54 septic ❑Holding ❑S.T.E.P.
To
Septic
Absorption
Let
Hold.ng
ubllcvPdvole
Manufacturer.
Capacity In gallons:
From
Tank
Field
Station
Tank
Sow*,Llnu
11110Ae Fr TAaIL
/000
Well-
1001+
loo'
'�
—
Material:
STE& L_
Number of Compartments:
Z
s°"°`°LIFT
Water
6014
no
—
-'
STATION
Lot
II
i'
""
Size in gallons:
Manufacturer:
Line
10 4-
l0
�'
Foundation30
s
+
L+S1+
..Pump on- level at: 'Pump olPl
High water alarm at:
Curtain
Id
e L
Pump Msk et
Electrical inspection performed by:
Drain
�•
h
04
Remarks: S00ertgrrar OErwji..v S4Arac 74,.Jr/
BENCH MARK
d Ju,tyarra,"
A prrt-o �No wi��r o� Noano��>
Location and Description:
Tgly� � 1.4e
Lo r r 1 w )Do -F" ,
geTTeM eP 0.04 Sia... BAGS OF'
GARAGE .
Assumed Elevation:
1 DO. 0 Ft
Et s�
0..
S & S ENGINEERING
Inspections performed by: 17 o.gdjyes: 1st
""""'"
�, ..........
Eagle River, Alaska 97577 2nd 5 /it
....... ...............
ROBERT a COWAN f4C
f�+ts�if;.. cE•eeol ,�
Department of Healt and Human Services app oval�C
t'I rt.1 y:r. ': �'� •gin%yw^
Reviewed and approved by: Date
Permit No.
SW960051
Page 2 of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Description; LOT 1, KARIANNE HEIGHTS S/D
017-091-63
72-013 A (Rev. "I) MOA iS
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM
?ERMIT NUMBER:SW960051
DESIGN ENGINEER:S & S ENGINEERING
DWNER NAME:LAIRD SCOTT
7WNER ADDRESS:14721 PRATOR ST
ANCHORAGE, ALASKA 99516
PARCEL ID:01709163
LEGAL DESCRIPTION:
KARIANNE HEIGHTS LT 1
LOT SIZE: 40525 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
(UPGRADE) PERMIT
DATE ISSUED: 4/18/96 !%i._Y�
EXPIRATION DATE: 4/18/97
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
2
DATE: /,b /or(
S & S\ ROBERT C.COWAN, RE.
Sin epinG ROBERTA.SHAFER.PE.
April 16, 1996
CIVIL ENGINEERS
(907)694.2979
FAX(907)694-1211
AP�ALSSTpRIry
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
SEWERLWATER
L"UTMI01.5
REFERENCE: Lot 1, Karianne Heights S/D
Request you issue a permit to upgrade the septic system
SEWWSPECrlaTIM ER
serving the existing three bedroom house on the referenced
sPi
property. Also request a Conditional Health Authority
Approval. Septic system to be upgraded by June 16, 1996,
due to the high coat to install the system in frozen ground
at this time. There are no health or environmental hazards
ENOnEPORTERING $STUO:ES
observed, such as surfacing effluent.
A test hole was excavated and percolation test performed.
The approximate location of the test hole is located on the
attached site plan.
WELLINSPECTI@,
SFLOWTEST
At the time of excavation no water was encountered and
after seven day ground water monitoring, the monitoring
tube was found to be dry.
SITE PLANS
Attached is the proposed upgrade design.
We do not anticipate any adverse effects on neighboring
RW OES:GN
wells, septic systems or drainage patterns by the
installation of the proposed septic system.
The proposed 1000 gallon septic tank is to be placed
SIXTEST
outside the well protective radius. Attached is a site
plan which depicts the location of the proposed tank.
If you require additional information, please contact us.
PERCOLATM
TEST
Sincere
Robert C. Cowan, P.E.
STRUCTURALS
RCC/gk
MEOMICAL
WSPECTICNS
Enclosure
ONSITE
WASTEWATER
DRPOSALSYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RNER, ALASKA 99577
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Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: SCOTT f"Imt) DATE
LEGAL DESCRIPTION: Lo-rKA0,1ANNG I+rS. Township, Range, Section:
� ORUANICs
1 _ � '1'ILoZ@N 'SEAT
11
12
13
14
SNi - ottAN6E SILTt S4WD
tAr/TRALF VgAvat-
6M - sm-1ye SANDya 6QPgEL
a1 / C068.a5'Zv 0'
15
16-M %.O.H. Ifi7
17
18
18
20
COMMENTS
WAS GROUND WATER
ENCOUNTERED? N0
IF YES, AT WHAT
DEPTH?
Oepm to W71tf After nr 31av�yl
Monilorin07—_Oale:
1i
Reading Date Gross
Time
Net
Time
Depth to
Wator
Net
Drop
's ar- SO aL -Psmt
8- 1-96 S%30
_.-
p
r,
r „
Vast
a
g!u
/- n
PERCOLATION RATE Iminutesnnchl PERC HOLE DIAMETER to
TEST RUN BETWEEN FT AND 7 FT
PERFORMED 8Y: 17�9,,34pT-*04� ARiv�at,l'� pG�OP-Read No -'184_ t-1%.A_,� / (�,r e�� CERTIFY THAT TPIS TES WAS PERFORMED IN
ACCOnDANCE Wt N1-*Al9%1'EIAAkIsX47JPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 3 /� ; 179
4+
72-000 (nev. 4/85)
ROBERTO. COWAN. P.E.
ROBERTA. SHAFER, P.E.
o ON-SITE WASTEWATER DISPOSAL SYSTEM CMLENGINEERS
CONSTRUCTION PRACTICES (907)694.2979
FAX (907) 694-1211
and
MATERIAL SPECIFICATIONS
FIEALTHAZWHORNY
APPROVALS
REFERENCE: Lot 1, Karianne Heights S/D
April 16, 1996
SEWERAWATER
GENERAL:
LWNECTENSIONS
1. The scope of this project includes the installation of
a 1000 gallon septic tank and leachfield trench to
serve the three bedroom residence located on the
SEWER&WATER
referenced property. The existing 1000 gal septic
WSPECTIO.N
tank is to be excavated, pumped, crushed, and
abandoned in place.
2. Construction shall be in accordance with the approved
EINICINEEnING STUDIES
ANDRETORTS
site plan and design drawings, Municipal permit with
any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal
Regulations.
WELLINSPECTION
&FLOWTEST
3. The contractor shall be responsible for obtaining any
necessary underground utility locates.
4. Unless specifically agreed otherwise, the property
SITEPUIM
owner shall be responsible for final grading areas
subsequently depressed from soil settling.
5. Contractors installing wastewater disposal systems
ROADDESIGN
must be certified by the Municipal Health Department
for system installations. Owners installing their own
systems must also receive prior approval from the
Municipal Health Department.
SOLTEST
SEPTIC TANK INSTALLATIONS
PERCCUT10N
1. A septic tank is to be constructed by a certified
TEST
septic tank manufacturer. Construction shall include
two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to
STRUCTURAL&
prevent settling or shifting of the tank.
VECKANCAL
INSPEcraNS
3. All standpipes on the septic tank shall extend a
minimum of 12 inches above final grade.
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER. ALASKA 90577
Page Two
Lot 1, Karianne Heights SID
April 16, 1996
4. Septic tanks installed with less than 4 ft. of cover shall
be insulated.
5. A foundation cleanout shall be installed one to four feet
from the building foundation. In the line between the tank
and the leachfield there shall be two adjacent cleanouts
(unless an effluent pumping system exists within the septic
tank). These cleanouts shall be located on undisturbed
soil not more than 10 ft. from the tank. The first
cleanout, in line, shall be to clean toward the leachfield.
The second cleanout shall be to clean toward the septic
tank.
6. Final grading over the septic tank shall be such that a
positive slope exists away from the septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the
design. The bottom of the excavation shall be within 2
inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (ruffed -up) before
gravel (sewer rock) placement.
2. Once the gravel is installed, the distribution pipe is to
be installed level with the perforations faced downward.
Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel
layer and the native soil backfill. Ensure the silt
barrier covers the entire gravel surface before placing
backfill.
4. Monitor tubes shall be of four (4) inch diameter,
installed approximately in the locations shown on the
design, and extend a minimum of 12 inches above final
grade. The portion of the monitoring tube extending
through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This is
equivalent to the effective depth of the gravel as noted on
the design.
Page Three
Lot 1, Karianne Heights S/D
April 16, 1996
5. Backfill over the final gravel layer must not be less than
twenty-four (24) inches. Insulation must be installed when
the backfill depth is less than thirty-six (36) inches.
The finish grade over the trench must be mounded to prevent
the formation of a depression after settling.
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be
constructed by a Municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Tvpe
of Pipe
Perforated
Solid
Cast
Iron
Yes
Yes
ASTM
D3034
(PVC)
Yes
Yes
ASTM
F810
(HDPE)
Yes
No
ASTM
D2662
(ABS)
Yes
Yes
Use of a type of pipe other than listed above must be
approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct
burial polystyrene (Dow Chemical Company Styrofoam HI or
equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N,
or equal) must be installed between the final leachfield
gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5"
screened gravel with less than 3% passing the #200 sieve.
7. When sand is being used as a filter material, its gradation
specifications must conform to current M.O.A. or D.E.C.
requirements.
Page Four
Lot 1, Karianne Heights SID
April 16, 1996
INSPECTIONS:
Typically there will be a minimum of three (3) inspections
required during the installation of the wastewater disposal
system. These inspections will occur as follows:
1. The first inspection must be conducted after the
excavation of ditches, pits, trenches, or beds and
before the installation of any gravel. A septic tank
may be set in place, but may not be backfilled before
this inspection.
2. The second inspection must be conducted after the
placement of the silt barrier, gravel, distribution
lines, standpipes, cleanouts, and insulation, but
before the placement of any other backfill.
3. The final inspection is to occur upon final grading of
the property.
Often there will be more than these 3 inspections required.
Especially with the installation of multiple trenches, sand
filters, pressurized distribution systems, etc. Thus, the
inspecting engineer is to be contacted at least 24 hours prior
to the start of construction. If necessary, a pre -construction
meeting will take place on-site. The inspecting engineer will
not coordinate, direct or control in any way the contractors
activities.
The owner shall contract with the contractor to perform the work
outlined in these specifications and plans and in accordance
with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S
Engineering. S & S Engineering shall be the owner's
representative and will inspect the work as stated above to
document the contractors activities. Final acceptance of the
contractors work rests with the owner and the M.O.A.
Page Five
Lot 1, Karianne Heights S/D
April 16, 1996
S & S Engineering shall have no liability to the owner or to
others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the
contractor to carry out the work in accordance with these
construction documents. S & S Engineering's inspecting engineer
will not be responsible for the construction means, methods,
techniques, sequence, procedures or the safety precautions
incident to this project.
CONTRACTOR/INSTALLER
MUNICIPALITY OF ANCHORAGE
I( u+ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
\ i 825 L Street • Anchorage, Alaska 99501 Telephone 264.4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
tME
PH NE
+ �r c - -j\ Lq lY?�
ILINGADDRESS --
L
Y
DISTANCE TO:
�it
Manufacturer
N ~
Dlftance to lot
r line
Liy. c81laG 1Y in paln
1
d D i
DISTANCE TO:
gzla,
Manufacturer
S
DISTANCE TO:
of linos
H ?I
¢ H
iop of tilu to finish
D
Lengdl
W
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c.
Wa
Type of erlU
W
N
DISTANCE T//T
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J
Class
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IF HOMEMADE:
b_
It
diameter
.__.... ....-_ L: !t •. `,� filo
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Y A._, • JTY
�! •a• u••aiarr�,
�i •uv .•J'••oaraa•••yr
�.v/itv!ra•r rr• i<t�r �
7/
E
0
NO. OF
mllinp Q PEHMII
depth
Total elfective
ling foundation
Nearestlotlin
f
Dlftance to lot
r line
Septic tank
aroa
UPGRADE
October 12, 1981
S & S Engineers
5610 Silverado - Suite A7
Anchorage, Alaska 99502
.I.. i :.' . . . . 2 '. '.11 ! ! -o I P" 1 i 17 - -f,:q
Subject: On-site Sewer Inspections
This department requests a more detailed report on the
inspection reports. See example below.
If there are a3
office at 264
Sincerely,
Les N. Buchhol
Senior Environ
LNB/ljw
t/V,
R, C, efcociljdy
r'-
(MUNICIPALITY OF ANCHORAGE
a w& DEPARTMENT OF HEALTH & ENVIRONMENTAL PIIOTF.CTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street AnclwraEq
- Alaska 09501 Telephone 264.4720
- - ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME --- ----_ __
✓-Lr-�.r1. _... __._ . _.. _...._. Z q -S - 65.17 ❑ UPGRADE
fv1A1LIN GADDRESS - --••-• ---_.. -• _._._...___._.
LEGAL DESCNIPTIONd__S"-"'"'-'-"--"_' _�••----�•�-------. -_—
LOCATION
NO. OF•BED3R00MS
Wull Abxogrhun Oren Usnrlhn'1 PCHMII NO.
U DISTANCE TO: p Q
x __
Mmwlxlurcr s-'-"
W Q MJtCnal-
No. of Cdnl,Jrtnlenl3
1 I V In g011onSImult Ian to
IF HOMEMADE: ) Witllh LigmJtlepth
b s[
Buz
DISTANCC TO: WCy Dwelling PEHIdI E NO.
--...----_..._._
0za---
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Matin rat L.qultl COI ,.n:ilY in µ�IlOnx
j
DISTANCE TO: Well ,, `` FOuntlabmt Numryt Int hmi PERM(l NO
No. Hoes
_ 2 W
~
ul Length of ewln line,
TOlal Ienglll8f linty T7nnrh wnlN DislJnte howrvn lines
-`."�__-__.
a I-
O
Toil ul lite Iii linish gra0o�'•+_____ .�L, -_inches
a'Q. MatenJl l�,u.lh lino ToCul eltecuw sogiiina area
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or
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mQHM1
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DISTANCE TO: Well .. _- 6niltlinq IotoMalion Wiliest Ins line ---_— __.—
J
CIJ:a
D01301
Dnller
Uysonco tp lot Sinn
PERMIT NO.
W-
.._ __._.�_. _� _•
Sewer lion
---__—__ ..._...
SCI)hC IaeE
_ _
Absorption emalsl
DISTANCE TO:
••___... _—_.
ueiltlinq Inuurlatiorl
OTHER
I
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PII'F MATEli f, ----- ��•- --'-'—
-
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INSTALLf.R
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REMARKS
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LEGAL
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04, F 46-1-1-461
FlF�� f• -r k.: I=u G F.
DEPARTMENT HEALTH AND ENVIRONME4!NTAL .ROTECTION
825 'L' STREET, ANCHORAGE, AK. 99504,
264-4720
!•1EL_L_ I -'1r•! ur•J—_.I-FE-.- f3fot!E-=kms•: F'E=FTV11 T'
PERMIT NO. f 011011 )
"PLICAN7 SCOTT LAIRD 8620 JADE ST. ?.
)CATION 43-5547
EGAt_ LOT 1 KARIANNE S/D LOT SIZE 54400 SQUARE FEET
&E OF SOIL ABSORPTION SYSTEM IS: TRENCH
3XIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING CSQ FTIOR)" 85
1E REQUIRED SIZE OF TIME SOIL ABSORPTION SYSTEM IS:
F.Er,lmZji'F-fr= r L3Fz`(-i%- E= L_ L�L'F 74 -1: --
THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT 15 THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIF! 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 {IN F•EETX
:Ci'tilJi x F?F=4�+ �ICE� -F I C -r n- r,lK. I: ?f`= 2.10 CEO 17J f F IL_L_ C)I'A
ERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
4STAI_LATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
JMBER OF RESIDENCES THAT THE; WELL WILL SERVE.
--- 104CA C .^' :1 I P4 to F" E7 CTI- I CtiVAi3 pfF?F IRE=- 0 L-1 R 1--.'_F_I1
TCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION! AND APPROVAL BY THIS —
EPARTMENT WILL BE SUBJECT TO PROSECUTION.
ENIMUM DISTANCE BETWEEN A WELL AND ANY ON• -SITE SEWAGE DISPOSAL SYSTEM IS
30 FEET FOR A PRIVATE WELL OR 1.50 TO 200 FEET FROM A PUBLIC WELL DEPENDING
°ON! THE TYPE OF PUBLIC WELL.
ENIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
) A COMMUNITY SEWER LINE IS 70 FEET.
:L.L LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
- THE WELL COMPLETION.
FHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
JAILABLE TO INSURE PROPER INSTALLATION.
F I EE F I tI Z -F I^ }^. F" J F c f-= S F E C F'r�11[� � FZ � L AL nA ED n -
CERTIFY THAT
I AM FAMILIAR WITH THE RE=QUIREMENTS FOR ON-SITE SEWERS AND HELLS AS SET
)RTH BY THE MUNICIPALITY OF ANCHORAGE.
I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
ESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. D
I GNED : - 6
----------- - G
APPLICANT SCOTT LAIRD
SSUED E3Y4-4--zewiIz-C/-------------- ._- V4. 0
V SOILS LOG
MUNICIPALITY OFANCHORAGE
• �; DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 1"O
PERCOLATION
825 L. Street, Anchorage, Alaska 89501 204-4720 TEST
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: �� A L i� I t'�PI DATE PERFORMEO: •57: I
LEGAL DESCRI
f
1C
11
12
13
14
16
16
17
18
19
20
PERFORMED
72008 (6/79(
V/V\
ML
G AA
...�' f i•
r
WAS GROUND WATER
ENCOUNTERED? iV p
IF YES, AT WHAT
DEPTH?
PLAN
nm
Imolmom MMIN
�MENNENMMM
riN■iii�i�
Reading Date Gress Net
Depth to
Net
Time Time
Water
Drop
1-1�••3l
.77'
O
7'
wSer.
.Q
d
77'
SU�r�
C'7
0 '
l
7'
O..O
�
s r, ee
7'
_ _
0.. 1'
it e
n 0
t PER ATI N RATE " J
.
s/in0j) Z'-"
TEST RUN BETWEEN FT AND <— I
FT
rj
CERTIFIEDBY:_ /Pi ee(d DATE: I/"- /6-e
,py
�'cl� i ann 1-{•e�l�•{s
�I
WELL LOG
Date Drilled: /6— 3 - 87
Static Water Level 70 feet
Draw Down feet
Type Material Drilled:
0 feet to
MUNICIPALITY OF ANCHORAGE
DEPT. OF H::,LF;i d
ENVIRONMENTAL rdC.TLCIION
OR 2 2 1991
RECEIVED
Gallons Per Minute " 8"
Total Feet of Casing" 1 —35
> o roc,,
-- _ ,C tooYY1 Pa17�N
to /3S SGn
t0
to
�45� `rya ac�•
Certificate of On -Site Systems Approval
Parcel I.D. 017-091-98
1. GENERAL INFORMATION
Complete legal description KARIANNE HEIGHTS LOT 1A
Expiration Date: I V o d � q 11 'A' 0A �, I
Location (site address) 14701 PRATOR STREET ANCHORAGE AK 99516
Current property owner(s) DANIEL & JUDITH MOOSE Day phone
Mailing address
Real estate agent
14701 PRATOR STREET ANCHORAGE AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
'Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ 5 5 d Waiver Fee $
Date of Payment
p a Date of Payment
Receipt Number. / 0 9 % rJ Receipt Number
COSA # 0 .S G 1 __� g Waiver #
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, based
on procedures outlined in the Certificate of On -Site Systems 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. 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 (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY ANCHORAGE AK 99516
Engineer's Printed Name CURTIS HUFFMAN PE
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting & FtaC 5 .
6. DSD
SIGNATURE
System #1 Approved for 3
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms
Date 8/18/2021
bedrooms, with the following stipulations:
OF �A*Z It,,,
Q �G
Or4-
�- � RAND
Z z
a W PS.�'-y,, PT
J�"9 TSE
By: Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory _ Arsenic Advisory
Well Flow Advisory Other ToA Gig- a;W. SarH X
COSA Checklist
Legal Description: KARIANNE HEIGHTS LOT 1A Parcel ID: 017-091-98
If more than 1 septic system on lot: COSA Checklist #
of
Structure served by this system
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 10/31/1981
Total depth 135 ft
Cased to 135 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 8/10/2021
Static water level at beginning of test 80 ft.
Well production at time of test 2.1 gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date of Sample 8/10/2021
Comments __________________________________________________________________________________
B. TANK DATA
Age of tank(s) 25 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 48”
Standpipes/foundation cleanout per record drawing
Date of pumping 8/10/21
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/7/1981
ALL standpipes present per record drawing
Total measured depth from grade *9.1 ft (max)
Measured depth to pipe invert from grade *4.9 ft (min)
N/A – pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective **2.5’ of 5’ ED
Code-required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced 2000 gallons
Adequacy test date 8/17/21
Results Pass For 3 bedrooms
Fluid depth prior to test 7 in
Water added 500 gal
New depth 23 in
Elapsed time 1260 min
Final fluid depth 3 in
Absorption rate 450+ gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Comments/Deficiencies: Tested 1996 field first = 300 GPD absorption rate & near / at capacity.
*MEASURED DEPTH AT GRADE OF THE MT & TANK DCO INVERT. THE MT GRADE IS AT A HIGHER ELVATION THAN THE DCO INVERT. ELEVATIONS WERE TAKEN & SHOWED THE DCO INVERT TO BE 2.69' HIGHER THAN THE BOTTOM OF THE MT. ASSUME **2.5' ED TO ACCOUNT FOR RUN FROM DCO TO ORIGINAL FIELD.
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100’
Yes if No
ft
Neighboring Tank > 100’ Yes if No
ft
Absorption Field on Lot > 100’ Yes if No
ft
Neighboring Absorption Fields > 100’
Yes if No
ft
Community Sewer Main > 75’ Yes if No
ft
Community Sewer Manhole/Cleanout > 100’
Yes if No
ft
Private Sewer/Septic Line > 25’ Yes if No
ft
Holding Tank > 100’ Yes if No
ft
Animal Containment > 50’ Yes if No
ft
Manure/Animal Excreta Storage > 100’
Yes if No
ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Property Line > 5’ Yes if No
ft
Absorption Field > 5’ Yes if No
ft
Water Main > 10’ Yes if No
ft
Water Service Line > 10’ Yes if No
ft
Surface Water > 100’ Yes if No
ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No
ft
Community Wells > 200’ Yes if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10’ Yes if No
ft
Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No
ft
Water Service Line > 10’ Yes if No
ft
Surface Water > 100’ Yes if No
ft
If absorption field is under driveway comment below
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No
F. ENGINEER’S COMMENTS
G. ENGINEER’S CERTIFICATION
I certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date.
8/18/2021
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904
On‐Site Water and Wastewater Section Fax: 343‐7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Septic Tank Advisory
Certificate of On‐Site Systems Approval # OSC211498
Subdivision: Karianne Heights Lot: 1A
The septic tank for this property is 25 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $7,000 to $11,000.
This advisory must be attached to all copies of the subject Certificate of On‐Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
Municipality of Anchorage
Development Services Department
° T44-4-%
Building Safety Division
•'
On -Site Water & Wastewater Program
ttt�(,`Oi
4700 South Bragaw St.
❑
P.O. Box 196650 Anchorage, AK 99519-6650
❑
www.ci.anchorage.ak.us
❑
(907)343-7904
❑
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. nig-MI-CIS HAA# 05btV j
1. GENERAL INFORMATION Expiration Dater [9 — 0 AC
Complete legal description KARIANNE HEIGHTS SUBDIVISION: LOT to
Location (site address or directions) 14701 PRATOR ST. • ANCHORAGE. AK 99516
Current Property owner(s) ROBERT do MARGARET RUSSELL Day phone 265-5723
Mailing address 14701 PRATOR ST. • ANCHORAGE AK 99516
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 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. 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(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily Identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate ofhow long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will It confer any legal right whatsoever.
S. DSD SIGNATURE
�G Approved for _�3 bedrooms.
Disapproved.
Phone 337-6179
Date )I/ II /oS
Conditional approval for bedrooms, with the following stipulations: tt W(Wiltt,
,tett: 1.1 OF q�j
WNICUM LIQ
��• oRf1GRAM
Attachments: JJ���J�(o• • ' • ••'too
HAA Checklist l� Maintenance Agreements �iiq • • ��
111111
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: Original Certificate Date: I I 16-0-5-
(R".
n-0S(R". 79M1(
.. Municipality of Anchorage
Development Services Department
7 Bulklhp Safety Division
On.Ske Water 6 Wastewater Program • , °
4700 South Brsgaw SL
P.O. Box 196850 Anchorage, AK 995198850
www.d.androrege.akus
(907)343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: _ KARIIWNE HEIGHTS SUBDIVISION, LOT IA. pared ID: 0 17- d 4 (' ci$
A. WELL DATA
Well IV" MATE If X 8, or C provide PWSID# N/A
Date completed 10/31/1981 Sanitary Seel (y/N) YES
Total depth 135 R. Cased to 135 R.
FROM WELL L.00
Date of test 10/31/1981
Static water level 70 R.
Well production 8 G.P.M.
WATER SAMPLE RESULTS:
Colitom colonies/100 ml. Nitrate o' I mgJL.
Well Log (Y/N) Y
Wires Property Protected (YM) YES
Casing height (above ground) 17 k1.
AT INSPECTION
10/5/2005
79 R,
1.24 9—
p.m-
Other bacteria -A—Lcolonies/100 ml.
Arsenic: N/A mgJL. Date of sample: 10/5/2005 Collected by: GEG. LtD.
B. SEPTIC/HOLDING TANK DATA
Tank TYPe/Matedel STEEL Date installed 5/8/1996
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation deanlout (Y/N) YES Depression over tank (YM) NO High water alarm (Y/N) N/A
Date of pumping 10/5/2005 pumper MCDONALDS PUMPING
Date installed 6/0/199s Soo rating .p.d lt%dmn) .8 System We DEEP TRENCH
Length 2030 ft. Width 5 R. Gravel below pipe 5 R.
10.5/
Total depth 10.1 R. Eft. absorption area 600 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 10/7/2005 4Results (Pass/Fal) PASS For 3 bedroom ms
�
Fluid depth h absorption Held before test 3 h. Water added 500 get. New depth �55�4 h.
Elapsed Time: 189 min. Final fluid depMVL!25in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN 6 type) NONE KNOWN If yes, give date -
D. uFT STATION
Date installed Size in gallons
'Pump on' level at _Jn.
E. SEPARATION DISTANCES
High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?.
SEPARATION DISTANCES FROM WE N LOT TO:
Septic tanknift station on lot I toff On adjacent kits 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sower /septic service line Holding tank N/A
SEPARATION DISTANCES FROM SEPTICIHOLDINO TANK ON LOT TO:
Building foundation 5'+ Property line 10'+ Absorption field 50+
Water main N/A Water service One 10'+ Surface water 1001+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
10'+
Building foundation
10'+
Water main N/A
Water service line
10'+
Surface water
100'+
Driveway, parkingNehide storage 50'+
Curtain Grain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
0. ENGINEER'S CERTIFICATION �.kx 1:..
1 campy that I have determined through Held inspections and `cl !'� •*
review of Munidpal records that the above systems ere in
cmlbrmanca wHb MOA HAA guidelines in eNed on this date.
Engineer's Printed Name JEFFREY A GARNESS
Date till, Jox-
HAA Fee S (AV
Date of Payment \k- \,\-K
Receipt Number
(Rev. W"),
Waiver Fee $
Date of Payment
Receipt Number
KARIANNE
2001-114
HEIGHTS
LOT 1 A
65.333 S.F.
S RQ°5R!•{R•ir ora ore
SUBDIVISION
n
W
O
O
Z
10' T.
& E. & UT1L ESMT.
I
�I
WI
.J
�I
1i I
•
WI
•
43
SEPTIC SYSTEM
SHED
I
•
1
I WPo E
A. C.
•
1
1
I yA.S•
EXISTING
1
BUILDING
(SEE DETAL)
1
I
i wm
i
E
I
I
I
I
131.0•
1
I
I
I
I
I
a
"
I
I
r�
i
I-10' X 30' ELEC.
I
I I UTTL ESMT.
.00-
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI. R.L.S.
4726 WEST 88TH AVENUE
ANCHORAGE. ALASKA 99502
PHONE 248-5454
1 GRID 3039 11ATE
1/10/2005 I
F.B.
00-15 I JOB N0.
KHS1A
a
O
FERNWOOD AVENUE
BUILDING DETAIL
SCALE: 1"-20'
J big cm,
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
R IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE
1 11=40'
OF 44
AV
■ Tt : 49LH ': * ♦
0...... ..............■
♦ . Jeffery A. G°sl°Idi : c
♦% : i
♦"g • LS-6091�� •
r°je»lonol foo 'd6
MUNICIPALITY OF ANCHORAGE
• ^' DEPARTMENT OF HEALTH & HUMAN SERVICES
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 l.D.# 017-0 el -G3 --:'HAA#-i1A 960111
1. 'GENERAL INFORMATION
Complete legal description Lot 1; Kari6nna+Heiahts%i+(:+15
Location (site address or directions) 14701 Prator Street
Mli�1
Anchorage, AK
Property. owner Scott Laird Day phone
Malling address:" 2342�s91clnuaget Drive Battlenround, WA gnrna
Lending agency Day phone
,. r . 1 •x: i
Malting address
Agent =- "'earbsra Baud n/ ERA Professional Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. `' NUMBER OF BEDROOMS: "" ° 3 1( -
'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 ev
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 (Ftw. 1/91( F'Ont MOA 821
S. STATEMENT,OF INSPECTION BY ENGINEER'_ '. •: ""'s t. s. w..', " �i
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. If u rther verify that based on the informatlon obtained from
the Municipality of Anchorage files and from my investigation and Inspection, the on-slte water
supply and/or wastewater disposal system Is in compliance with all Municipal and State codes,
ordinances, and regulations In effect on the data of this inspection.':
Name of Firm S d S ENGINEERING Phone • G9 `f �9 7 `I
eg a River Loop Road No. 204
_ Address Eagle River, Alaska 99577
Engineer's signature Date
6. DHHS. SIGNATURE :.:.?.,• .__ w
. _.. --X—
Approved for,.. ,.......... _... ...._..+tit,:_,•`=-``;.�,',�;:' .
.bedrooms. Z�
Disapproved.
Conditional approval for
Additional Comments
Ely:
,
bedrooms, with the following stipulations:
Date !F4 :., -
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.
72aa(M+.wl) Beet MOAe71
S&
nG
May 13, 1996
ROBERT C. COWAN. P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907)694.2979
FAX(907)694.1211
RECEIVED
IEALTHALITHORTY
APPROVALS
MUNICIPALITY OF ANCHORAGE MAY 141996
Department of Health and Human Services
P.O. Box 196650 Municipality of Anchorage
Dept. Health & Human Services
Anchorage, AK 99519
sEwERawATT:n
MAMEXTENSIONS
REFERENCE: Lot 1; Karianne Heights Subdivision
iEWERSWATER
A Conditional Health Authority Approval (HAA) was issued on 4/18/96
NSPECCON
for the referenced property. All work required for the Conditional
HAA has been completed.
Please issue a full Health Authority Approval at this time.
_NGINEERWG STLIDIES
ANDIIEPonn
If you require additional information, please contact us.
sincerely,
YELLINSPECTION
LPLOVVTEST
/ •, /Z
Robert C. Cowan, P.E.
UTE PLANS
RCC/gk
IDADDP.SIGN
XXTEST
'ERCOIATION
EST
RRUCTU AL&
AECHANw'AL
`RPECTIONS
7NSITE
YASTEWATER
ISP(SALSYSTEM
KSIGN
17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577
MUNICIPALITY OFANCHORAGE
' DEPARTMENT OF HEALTH & HUMAN SERVICES
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 l.D.q C17-onI —63
HAA q 'n\���11 • L � t \
1. GENERAL INFORMATION
Complete legal description Lot 1: Kaua7tr o Ifu.ght6
Location (site address or directions) 14701 pi taa
Property owner Scott S Pat La Ad
Day phone 345-2546
Mailing address 14701 Avalon Avenue, Anch04a : AK 99516
Lending agency
Mailing address.
Day phone
Agent- Bowden/ ERABowdenlERA P`o��e3aLondt Real E4�tRea. Ea�teOay phone
Address _33sa orn et...* .•,1T,.ti,,,., . .v
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: It community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(A".1/9n r,OM MOAI21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verity 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 furtherverify 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.
5 d 5 ENGINEERING
Name of Firm Loopa. g04_ Phone E cl y' q�/
Address Eagle Rlv'r, Afaska 99577„
Engineer's signature _74- 'f L. Qtw-- Date 3 3 1 q (
S10r1c- Sysrtm T 0 rt V)1L..A01.1) ),y TVA•E /6, /99 G AS
A- GJe 0, /)on. or rN, f Al EAt raj 'u T/f".4 i, -y 4,0P.0•V'AL•
p.�.. •i'. 7...y. -
Ito- ERT C. CO•N.AN • •)
6. DHHS SIGNATURE rl�'c y Ce•c�01 ;.'
Approved for bedrooms.
By:
Disapproved.
_X Conditional approval for bedrooms, with the following stipulations:
MONEY
110 ED Pur )N Pledew
r0 &'eoriettirej rNr
Agoy frn?Ey CoND)rION PGRfuAmr
i0 PFRH)r
Numseg Stvg4oar/
NY .00 )area
rue • ne ).f /996
MU,vfY ),V W)tow Split[ Nor OE get rarfy VAIM f/A.0 9PPRCygL NAf Oeew
Additional Comments -61VEN 8Y rHU Orryr,
0000000
NUTIr
Date d —19—q6
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. Em ployees 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.
72425IRw.w1) e.n MOA121
NUNICIPALI I Y Lir tiN..rr j k2t
ENVIRONMENTAL SERVICES DIVISION
Municipality of Anchorage AI'Ft 1996
DEPARTMENT OF HEALTH & HUMAN SERVICES l
Environmental Services Division
825" V Street, Room 502 • Anchorage, Alaska 99501 • (907) 34AWT] VED 44
Health Authority Approval Checklist
Legal Description: ).or / IcoAlANNE f/LT J Parcel I.D.: 01 7 — 0 0)/ — G -T
A. WELL DATA
Well type N OV 4 7 C. If A. B. or C. attach ADEC letter. ADEC water sysicat number
Log present (0/N) YE._S Dale completed /0 13 / S /
Total depth ) 3 S Cased to / 3 S" Casing height (above ground) 4 r v
Sanitary seal(VN) YE J
FROM WELL LOG
Date of test /e / 3/ is /
Static water level 70 1
Well production Is g.p.m.
WATER SAMPLE RESULTS:
Coliform o
Nitrate 0'/
Wires properly protected (ON) YL S
ATINSPECTION
3%s/4G
g C/ e
.2 • 7 g.p.in.
Other bacteria O
/ S 8 S ENGINEERING
Date of s uuplc: 3 1 #1 I % G Collected by: ,.._ j7934Xe((t"Ivac.L00pRo4d gp f—
B. SEPfIClIIOLDINGTANK DATA Eagle River, Alaska 99377
Date installed Sc r7 /S/ Tank sivc /000 NumbcrofCotnpartmcnts :2 Clcnnouts®/N) Yt_t
Foundation cleanout (YA& 00 Depression (YIS Ir 0 High water alarm (YAD) t,10
DnteorPumping 311 /1(1 Putnper AwcM'RAcL cftsisrr p.nP�rG�(
C. -ABSORPTION FIELD DATA
Date installed 01 IV Soil rating (g.p.dJll' or Eliim q S System type TAGc.H
Length d- 01 Width Y Gravel thickness below pipe S Total depth 10
s 04,G)Effective absorption arca —a'10fl Monitoring Tube present((!�/N) Yt i' Depression over field (Y& N 0
Dalc oradeAnaey test 3/0 -AG Results (Pass/Fill) r-411- For 3 bedrooms
Fluid depth in absorption field before test (in.);
Fluid depth (ins.) M
Immediately
Absorption rate a _ g.p.d.
(past 12 Irtonths) (YIN) If yes, give date
SognntN ldpoo11
watuAm )o oleo
g D3� �3n! eM
oop'7lAceeq :SSO S6/8 'AZU
LoG 7J/7//-/ 33qumN 1dpovd
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N0I1VOI3 IN30 S61133NIDN3 •3
� a•�d�U wit+teSNl IA/.[/i y1J x
Dull XImdatd ..p 01 00 / slol lumurpt+, Ito sINM .�•+o v 7000 u. mL1m0
WIM oclLiols opnpA/`dul>lied '6Lmonpa f„ 0 o / . �31em D3LpnS
-F/ 0.9
.SC Dill[ 33[A33s/inemSDleM trap no!lepun0j2u[pling
:O.L,LO'I NO O'1313 NOLI.d110SSV W011d 30NVJSIO NOLLV11Vd3S
jp. o o / slot 1U33L fpe UO 91I3M d 1,o/ o1Luluippolm o3L,pnS f S C om[ ootAl3s�ltrut 331LA1
i
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P. IOU aopdiosgV t o/ 3u![ (13odad d S 1 uo!lepnno[ 1u[p[tng
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• �'�, an/J InjoyU ++aM yo -Aoef g nq rr3*•VC17y 7U OLbl K
N uottLis U!7 i g Du!I wimas opd3s/ iom3S
b�N lnoue3lop[oquctu tomos olignd N lnttut JOWS 3llgnd
i slot p133efpL u0 : P o to! uo p[3U uondlosgV
pool
00% slot lttoorfpe u0 : £ b lot Ito IIuc11u!p[oq t
' '01.3 LCrl N0713M W0113 S33NVMCI N0LLV11Vd3S
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NOI.LV.LS.I.d1'l •a
March 29, 1996
ROB ERT C. COWAN, P.E.
ROBERT A. SHAFER, P.E.
CIVILENGINEERS
(907)694.2979
FAX(907)694.1211
"PPROVA nM0`"r
�PRovAtis
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
SEWER & WATER
wuNExTENSIONS
REFERENCE: Lot 1, Karianne Heights SID
Request you issue a permit to upgrade the septic system
SEWER&WATER
serving the existing three bedroom house on the referenced
INSPECTION
property, A1IF0 N11,111-117'C.ONON 71ONAl Nf4�t•N RN/yNOA/Ty 010041v4&.
d&,T7/L tyf)4.n T• 44L vPC.140EJ by .7 VNC /6//4 y6. T'HIA.E A4t. wO
M94170 4A cN..•41r.( ' ,Ly LA4l: VOSSAv40Asv ON 41 9v,LC4c•w6 dorA. e` r.
A test hole was excavated and percolation test performed.
The approximate location of the test hole is located on the
ENGINEERING STVDIES
attached site plan.
ANDREPORTS
At the time of excavation no water was encountered and
after seven day ground water monitoring, the monitoring
tube was found to be dry.
WELLWSPECTION
& FLOW TEST
Attached is the proposed upgrade design.
We do not anticipate any adverse effects on neighboring
,ITEP,ANS
wells, septic systems or drainage patterns by the
installation of the proposed septic system.
There are no protective well radii which encroach upon the
ROADDESIGN
proposed Septic system.
If you require additional information, please contact us.
SOIL TEST
$1)a12'4,
'Robert C. Cowan, P.E.
RCC/gk
PERCOLATION
TEST
Enclosure
STRUCTURAL&
AECIVHICAL
INSPECTIONS
ONSITE
WASTEWATER
DSPOSALS`rSTEII
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RNER. ALASKA 99577
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MUNICIPALITY OFANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
On-Slte Services Transmittal Sheet
TO: r&6 awAN LEGAL: LT (1 KF}RIANNr
S 6 S Ft4QFl#4r-r-i1Nfr
The attached paperwork has been reviewed and is being returned
for the following reason(s):
Discrepancy in legal description and/or owner name.
Discrepancy in number of bedrooms.
Signature and/or stamp missing on
Show measured distances to sewers/wells, curtain drains
and streams within 200 feet of proposed system .-9s� N`a;HTo>
Replacement disposal site not shown and/or tested. puposro ti -17&".
Calculation error in design.
Show locations of all soils, percolation or water table
tests.
Proposed system too deep for soil test submitted.
Topographic information missing or inadequate.
Narrative missing or inadequate.
Additional soil/pert test needed.
Sand filter requirements not satisfied.
Water monitoring results missing or inadequate because
_G1'iECL, F12ST C/. Ty TRnIK WAS TNI$ P'Qmpeo IZEcB�+T�)/(3•��96)
Incomplete; missing
Well log required.
Water sample unacceptable becaus
Y Other __SRSW P.o c FdZ SEPTIC.TAm Loc+71oNi
Oi t`FIILAA J06' C>=?AaA-7(oni 1 s We SEPTiC TANK /^.. CUT)
-r
SMAT 42 UN O Ai CF+r=cr- C4e45-:,/'
Please supply the necessary information and re -submit your
request. YO r coopslation is appreciated.
Reviewe
Date 'i-12-96
LEAVE THIS FORM ATTACHED TO PAPERWORK
/203 -rev. 9/93
r
r
C,
•1 Time, •
Time .1e
Date
Date
Date
�— .41
Inspector
Inspector
Inspector
Comments
Conditional Approval
o..
Date Sewer Installed
Permit No.
Septic Tank Size
Holding Tank Size
Soils Rating
Well To Absorption Area
Well Log Received
Wall to Tank
APPLICANT FILLS OUT LOWER HALF ONLY
Property owner
K�/ N .0Melling
Phone
,,,
Address,/ f� /G���
v"
�j4X d,'%%
Buyer
Address S
Lending Institution.
Phone
Address
r ,
Really Co. d Agent '
Phone
Address _
Legal Description .SP i•�� I /I
Street Location t v'� S
ti Typo of Rosldenco 3
*Single Family '
'CIMultiplo
Family No. of Bodrooms
0 Other
Water Supply -
>C Individual -ATTACH WELL LOG. A wall log Is required for all wells drilled since Juno
0 Communityy 1875. For wells drilled prior to that date, give wall depth (attach log If
0 Public Utlilr available.
Sowspa Disposal
A Individual Year Individual Installed:
0 Public Utility When Connected to Public Utility*
—
0 Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
;lnnunry A, 19n.1
:'tnhert I'. 7fiurlhn
^1� 11r, J.t.nn n
Anrhorn•tn, n"
^ul,'tnr.t: in l: 1, rar.innne rle!inhtn
Annrovn.l. for the individual raewer end wntnr tncilitter, cnnnni:
he 'rrrult:r.•1 until thn f:010"09 iterss hnve hnnn connlntet:
° N +icl.l. l.ng nuhrlittctl to this of:f-lcn folr our files and
review.
^!In :rntnr. rutnl.vtlin renor•t nnorlc, to hn zuhrli.tl:nA t:n i:hirl
MEMO f:ron thn C.hnn Lnh, 5633 n nt:rnnt„ for Our review.
° "Mio atnnApipo to the ne"nr nystem Ilnerl cnno on them.
nlen!lo notify t:hir. •la»flr.t:nnnt for n reinsnrlcztfoil whe!7 Che
ng1:r 1 At3crnn,?nri.^7 IMVfI hnnn correcett?(1. U• there nre filly
further nuentio'l^r pl.entlr. call. thin nff:ice nt 26n-A72n.
Sincrrn.ly,
Robert l;. rratt
nnrlor.i to Cnvilronrtnntnl. Spocinl.int:
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