Loading...
HomeMy WebLinkAboutWHITE KNUCKLE HEIGHTS LT 1White Knuckle Heights Lot 1 #021-022-58 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page ( of I— www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: Sti1 06p -501 PID Number: oZ( _ 022 —'S % Name: V� r, uvl atICOM&I Wastewater System: ElNew P, Upgrade Adtlress: Lam, • LrS�j2Q SVYL ABSORPTION FIELD Phone: Number of Betlrooms: .Z_ ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other: LEGAL DESCRIPTION Soil Rating Total Depth from original grade: GPD/Ft?Ft. Block: Lot: 1- , r 3u1divisio�nl: /1 el Depth to pipe bottom from original grade: Gravel depth beneath pipe: f Ft. Township: Range: Section: Fill added above original grade: Gravel Length' Ft. Ft. Well: El New ❑ Upgra Gravel width: Number of lines: Distance between lines: FL Ft. Classification (Private, A, B, C): Total DepUr: Cased to: Total absorption area Pipe Material: Ft. FL Ft' Driller: Date Drilled: Static Water Level: Installer I Date Date Installed. V-4 Ft. ncH fY Y �/ i Qy PumpSatatCasing Height Above Ground. GPM Ft. FL TANKSEPARATION DISTANCES ff—IS Septic ❑ Holding ❑ S.T.E.P. ❑ Other: eptic Absorption Lift Holding w (Private Manu/f�acturer. Capacity: ank Field Station Tank Sewer/Line AKA T"np�/()0p Gat0 t1/ * Material: =I�C('• Number of Compartments. 2L Surface Water r oo tf•, LIFT. STATION - .. Lot Line 7-0 '4- Size: Manufacturer Cal Foundation fir 20 'Pump on' level at: "Pump ofr level High water—alarm at: f inj in. in. Curtain Orain N Pump Make & M Electrical Inspections performed by: Remarks: / C.// BENCH MARK SOu'iN (4 nceJ Location antl Descriptio¢ F r„ u'%o .�• ror„ter /D r �� i/ Assumed Elevation' • Ft (CD.pp Inspections performed by: Dates: 1St 9 Engineer's Stamp 0110 OF 2nd 9 Z e 6 �t Xk$ l@ � Development Services Department Approval �p �. ' • ! Conditional ApprovalDate: • �, f *' 49TH .gid ..... j� •tel ill.! . . 0- MICHAEL N. ANDERSON .'Cl - 'ClCE- CE -46 Reviewed and approved b PP Y Date: 3/ (Rev. W/06) pRn/�f[[fpc _Permit No. SW060308 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 1 WHITE KNUCKLE HEIGHTS MAR AB GRND. ELEV. PIPE ELEV. col 62 165 96.1 93 7 TC01 6��( 67 96.2 TCO2 7 69 96.2 02 �' 75 95.5 93.1 03 6 � 72 95.5 93.1 PID No.: 021-022-58 �I I I I I I BENCH, CONCRETE SLA I \ J y B A \ C01 \ � 2 \ CO3 1 � 1 OPEN WATER OPEN WATERI AREA 3' SQUARE ASBUILT SCALE: 1"=30' 4 -v vi SL( a 4 r, . I I Lo'' 1.000 GA LM STEEL TPNH SEPTIC SECTION N.T.S. 499 T/H�.l� ....... MICHAEL N. ANDERSON. 6. No. C 9 9 ���� r+�J R...1Y`�..� 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 Permit Number: SW060308 Legal Description: WHITE KNUCKLE HEIGHTS LOT 1 Design Engineer: 0088 ANDERSON CONSTRUCTION & E Owner Name: RONALD BRENNAN Owner Address: 13520 SUNSHINE LOOP ANCHORAGE , AK 99516 - Date Issued: Sep 21, 2006 Expiration Date: Sep 21, 2007 Parcel ID: 021-022-58 Site Address: 13520 SUNSHINE LOOP Lot Size: 135739 SQ. FT. Total Bedrooms: 2 Permit Bedrooms: 2 This permit is for the construction of: ❑ Disposal Field [?] Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 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:--6�/al `J°�—� Date: Issued By: U� LZLL_ nye Date: q10-110-6 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. C-9 'Z i—(92 Z- S �(� Property owner(s) PO VI 0 N "0 y) Yt a Mailing Day phone 3 Z_T`� 2 S i DbP f iP Zip Code 9951 Site address / Zip Code Legal description (Sub'd, Block & Lot) W LI 1-T_' �V_ rl14 (e, 4 L!J' ii co Legal description (Township, Section & Range) Lot Size I 35, 31a - Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial ❑ Upgrade 9 Renewal ❑ 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. (Signature of property owner or authorized agent) Permit/Rush Fees: g6o' B, e. Waiver Fees: n Date of Payment: 7/OV/Dr� Date of Payment: Receipt Number: 86 Receipt Number: (Rev. 11/05) Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4640 Shoshone Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 Sept 20, 2006 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: White Knuckle Heights S/D Lot 1 (T12N R2W Section 30 W1/2, SETA, SWIM, NEIA, SE 1/4) To Whom it may concern: This is a request for a new septic tank permit. The current tank has caved -in and needs replacement now to keep effluent from spilling out on the ground. The other building shown on the plan is a garage with no plumbing facilities provided. Nothing will be changed except a new 1000 gallon tank will be installed. The neighboring lots wi not be impacted by this new construction. If you have any question please call me at 345-3377 Since✓ Michael N. Anderson, P.E. EXISTING GARAGE NO PLUMBING EXISTING WELL, - S 0 100' RADIUS L 0`B\P w / EXISTING HOUSE WELL z i ¢ EXISTING HOUSE EXISTING SEPTIC EXISTING SEPTIC - GLEN �ON N� 1 ♦ynF kN�Ok`e hF��HTs PROPERTY LINE A C H R 0 A D - - B Septic Design Prepared For RON BRENNAN ♦ �� OF / tit LOT 1, WHITE KNUCKLE HEIGHTS SUBDIVISION ��Gj�:''♦♦♦ Anchorage, Alaska 49TH ';'� ♦/ •••••. •• • • • ................ Prepared By MICHAEL N. ANDERSON, P.E. 4640 SHOSHONI DRIVE .i............................ .•••••.............••••:• • i N. ANDERSON; = ♦ :MICHAEL o. CE 9469 � (907) 345-3377 / FAX (907) 345-1391 ♦♦♦,E�.����•• SCALE: 1"=100' SEPTEMBER 20, 2006 i i \\ % -SUNSH�Ne\ i \\OOP` % O \ i r \ I I \ I 1 I 1 I PROPERTY WELL j II 1 LINE 1 I 1 I \ v, FXiST i \\ E o /106, F SEXISTING!SEWER LINE\��TO REMAIN 3 \\ REPLACE EXISTING 1,000 GALLON EPTIC TANK WAIVER GRANTED w 3/11/86 --, •--�e_� _____ EXISTING DOUBLE C.O. - -- --- EXISTING DRAINFIELD \ \� TO REMAIN S o ` \ ri NEAREST SURFACE FLOW \ s—EXISTING SURFACE WATER Septic Design Prepared For RON BRENNAN �' ♦���. LOT 1, WHITE KNUCKLE HEIGHTS SUBDIVISION : Anchorage, Alaska � : i �;' 49TH ..,. ... ..%. .............. Prepared By MICHAEL N. ANDERSON P.E. •••.•.. �• jjjj.����.: 0 4640 SHOSHONI DRIVE ♦'.MICHAEL N. ANDERSON ��� No. (907) 345-3377 / FAX (907) 345-1391 CE 9469 . ••,E \.����•• SCALE: 1"=40' SEPTEMBER 20, 2006 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROAON �..t ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME - PHONE tl' —(SS"z ,❑,-.,,.,, NEW ER1 PGRADE MAILING ADDRESS SP- �2 -L LEGAL DESCRIPTION TO Sho_l C 2 w(/ sF-'IqA)wllq se l!4 L LOCATION NO. OF BEDROOMS 3 a7 Y DISTANCE TO: Well Absorption area Dwelling PERMLT �&3O83f� _ iL G wF Manufacturer Material No. of compartments rn Liq. capacity in gallons IF H ENIADE: Inside length Width Liquid depth O Y JWZ DISTANCE TO: Well Dwelling PERMIT NO. 2 F Manufacturer Material Liquid capacity in gallons a w= DISTANCE TO: Well too Foundation- ] r Nearest lot line > Or PERMIT NO. 083 � u- z F w No. of lines Length of each line -r Total length of lines $— Trench width .3 {cinches Distance between lines ¢ F O Top of the to finish grade 1 W % / Material beneath tile i0 inches Total effective absorption area f 'V'so 4 w C7 Length Width Depth - PERMIT NO. Q F- wa Type of crib Crib diameter Crib depth Total effective absorption area H DI STANCE TO: Well Building foundation Nearest lot line J J C 1 y Dept Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foqdation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING /S0 INSTALLER I w 3r REMARKS E .S 'T W 70' 0 F k r of 4+1 APPROVED DATE_ LEGAL A'3 7-aAJ 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE 8/e3 Department Health and Environment rotection 825 Street, Anchorage, AK.501 3- 264-4720 HANDWRITTEN PERMIT # # * q.31-�3 /.:3 Permit # - -0 ON-SITE SEWER PERMIT Applicant: /�/ ���M�S Mailing Address:5e)9 ANS, Location: Phone Number: t .Z N .?cy S w/� tb /i✓.vu. �y Legal Description: .¢c30 Lott Size: Type of Soil Absorption System s: Trench: Drainfield: A _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: 3 Soil Rating(sq.ft/br) /SV The Required Size of the Soil Absorption j7S�ystem Is: 1 , 6 ylisc�f!/: / DEPTH _0� LENGTH �s0 GRAVEL DEPTH ANOuWN WIDTH 3 The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in 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 feet). cC /00a * * REQUIRED SEPTIC(HOLDING) TANK SIZE = CXif�N� GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. ' # # # TWO(Z) INSPECTIONS ARE REQUIRED # # # Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fef for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required andmust be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. # # # PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I un stand that the on-site sewer system may require enlargement if tiTe� sidence is remodeled to include more that oms Ssgned: Issued by: App icant pj �z? Date: O � J SWP/024(1/81) 8-1 �--1983 ----�------ -----S�R)AL_DISTR.I�UTI�N_�€L•'T1c--S�T�r�--�- �r�ss€L _- FOP- NE11. THOMAS R4M # 351141 PA6F- I OF i - INVERT OUT OF TR"CR SkALL Be fe" A6ovE THAT 122' MIN. UNDI5TVAbrD 501L 4boVE DRAJOAGE 6AnYEL, TYP, OF DISTKI ON MOYNO To PROVIDE MINIMUM i8" SOIL . OVE{L DISTRIBUTION o:: _NEw" TReNCIt INSVLATIoN,TYP 2" EXTRVDED NEW ' POLYSTYA , 6 MIN. (� 6' M IN, f ExIsnNG , NEk/ / I !��% BepRotK 6' MIN.—ij — FILTER FA6kjC i -T°221 Wg5kED ROCK flflRRIEE A@oYE �/ MIN• d a BELOW PIPE wA5HE6 kocK PAIN, Z AbOVE PIPE 4SotiD PVC 5fgln p15TmemoN PIPe ° PLAce 4' mor LAYek of z" TIIIC?r FATP-M-4 P'LYSTVRENE IN5ULAT1oN CANT44CV OVf-k PIPE RIVA COVER WITH M1N. )i",,501L TYP, CR,os S 5 E CT)o N A -A 1. SEWU DI5TRI6UTt0PI TRErICrIEs SHi?LL GoNTA1N A LRy[R. OF W19SHF-D GAAVEL AT LEAN IV' OF-F.P. TNG A65CAL710PI PREA FOR. 514ni.10%,d sNALL BE 6115EA arl TNF TR.ENCII BOTTO?LA kkEA WITH T14E 37 t*? i, ApF-A :NcRElISE k1=4UiR.I-,D 0Vf& TNkT RE?v!r? -0 Fop_ D:EP TrFNCH 51>?FWFLL5. T)WE FELT wlOf- TAtNCNFS ',/ILL PRoV10E TILL F-QVIVALFEFdT OF 2 5Qv4Ac FFF-T of 965oAeTlotl flAFF- Prit, LINEAL. Foal OF Tf-4-KCH, A TOT6L- OF 150 L1NF,9L PFFT OF 3 FfE.�' WlaE TRt"NGN WILL Br- RF-QVIPF-G. Z F©F 3C0fPfiF,T1G LPj0VT SEI -TVI NIPAlfrzo UP A5-EVILTDkf)WIN6 �mGF3) M�TUTAL 5 It WR58Ep GbgVF-L (),go' X 3' x i I /2-7 = '17 Como YPkV5 �•x, Z4 -PN5) 2, PIPE : 4-f` PEFFOPAITC-0 PVC = 15-> FFF-T 4" SOLID (SVG 5o FF.FT 2 Eli. 45" ELBowj B-12-83 --- -'. _.----- - - 61L_TO MAR5 -- R-tM # 351181 - ----- -_6LA55EL TEI<s 3 EF;. PAGE i of 3 CAPS Crap 1N5PECTIOR p1Pe5) PPOPoSeb TRF-NC1} LAYOUT — X 2" THICK .y 4' EXISTING X a,l TMCK �pkoP CO"ImErTCeMS)="'>2O BOFRIJ FCi INSPECTION PIPE SEPTIC .YQVPiRE FE r -T OF 2 "TA/Ck 12.20 BOARD FU �- TANK F-ATkLIDEp P005YReN1= 1MlSULATION LIMITS (pow MPOFogn4 H 3-1) c>~ \0A E4VAL 4, 1N5PECTION PIPS I i 6, MIN. 3 a ti -' ��•' N 3 - A: i 4, EX15TING FAILED �Y57t rA-- I /-10PECTioN PIPE a9 �a- M�TUTAL 5 It WR58Ep GbgVF-L (),go' X 3' x i I /2-7 = '17 Como YPkV5 �•x, Z4 -PN5) 2, PIPE : 4-f` PEFFOPAITC-0 PVC = 15-> FFF-T 4" SOLID (SVG 5o FF.FT 2 Eli. 45" ELBowj 6 EA V-tJ0 CAPS & EA, TEI<s 3 EF;. v Ir -A CAPS Crap 1N5PECTIOR p1Pe5) 3, IN,5ULPTtoN 3' X 1'30' X 2" THICK TRE-NCNF,5) = 9010A°1)ff FF6 4' X 4o X a,l TMCK �pkoP CO"ImErTCeMS)="'>2O BOFRIJ FCi � aI4 .YQVPiRE FE r -T OF 2 "TA/Ck 12.20 BOARD FU �- 9r'!C —,.45s 54vrkt fff. f Q'A- 50 5Qu)IP-9 YITAD5 i —119.5 O - croperty and that no en the premises r;orcther visible ., -,n. - o =. 2x2 huh9 tack recovered •._=5/8"x 3d��rebar set this survey X 7,4 3c^ia /N ✓ jI: Gci- _ /J —=F CO0 Preporedby: -. (907)279-.6200 W 5f 5W �a A'. JO T /Z /U, ®fy?�'�••..»... �0 V , /I CAd' 1 �JQ'Vo S:J�F�ct waT�=.2 x - croperty and that no en the premises r;orcther visible ., -,n. - o =. 2x2 huh9 tack recovered •._=5/8"x 3d��rebar set this survey X 7,4 3c^ia /N ✓ jI: Gci- _ /J —=F Preporedby: -. (907)279-.6200 W 5f 5W �a A'. JO T /Z /U, ®fy?�'�••..»... Anchorage Recording Precinct, Aiaskrc V , /I CAd' 1 �JQ'Vo LOT SURVEY CERTIFICATION — F:>I is [; 5'1> Tr- r✓; F-ht5TtNG TKFUCH' /64.57 ti 89.54 0 w C YRGE 36F-- I TAX LOT iib - croperty and that no en the premises r;orcther visible ., -,n. - o =. 2x2 huh9 tack recovered •._=5/8"x 3d��rebar set this survey sT . L. Bu on J�,4 ® Eq'°•, oQ's FOP•'••...,.••'P�aO� 3c^ia /N ✓ jI: Gci- _ /J —=F Preporedby: -. (907)279-.6200 W 5f 5W �a A'. JO T /Z /U, ®fy?�'�••..»... Anchorage Recording Precinct, Aiaskrc V , /I CAd' 1 �JQ'Vo LOT SURVEY CERTIFICATION LEGEND se I hareby certify that I have surveyed the propert,, . wn and described 1j6 = Brass capped monument recover • •• • ••• .� hereon and that the improvements situated there^i :ra within the prop- o = Iron pipe and/or rebar recovered a arty lin as and do not overlap orencroach on ad;ec:. ;mprovements on adjacent property overlap or ec::-�h inq'vesrlon and that there are no roadways, uti:ity: ec3aments on said property except as indicated L - croperty and that no en the premises r;orcther visible ., -,n. - o =. 2x2 huh9 tack recovered •._=5/8"x 3d��rebar set this survey sT . L. Bu on J�,4 ® Eq'°•, oQ's FOP•'••...,.••'P�aO� 3c^ia /N ✓ jI: Gci- _ /J —=F Preporedby: -. (907)279-.6200 R.L.BUT'-u ' Registered LaIV 5!9 W. E/ghth Ave: Ancbo, ag.., A 7s8o 9950/ F. B. No. 4-51 Property of: r- x GREOR ANCHORAGE AREA BOF40GH Department of Environment Quality 3500 Tudor Road Anchorage, Alaska 99507 c)a I - Caa -4Co INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME MAILING ADDRESS S',PHONE3��-�/9�r7 Lo - s�z• 30 !vi z� fF`!� rti`f� �' g LOCATION � � 47-'�--r LEGAL DESCRIPTION -r%fl% SEPTIC TANK: DISTANCE .��i'/'<sr�' NUMBER OF FROM WELC��D MANUFACTURER MATERIAL COMPARTMENTS — INSIDE LENGTH INSIDE WIDTH - LIQUID DEPTH LIQUID CAPACITW_ �®� GALLONS. TILE DRAIN FIELD: TOTAL LENGTHL� DISTANCE FROM WELI�� FOUNDATION NEAREST LOT LINED �� OF LINES NUMBER OF LINES / DISTANCE. BETWEEN LINES ABSORPTION AREA `3� DEPTH: TOP OF TILE TO FINISH TRENCH WIDTIii IN. TOTAL EFFECTIVE . FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TIL&- IN. ABOVE TILEIN. WELL: TYPE CONSTRUCTION BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM_ CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED .REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL; !�/�°fT_/l0p� LOT SLOPE: REMARKS: /�/�/✓!�/��i� �®!lam Form PW -027 q✓ I DISTANCE. FROM: DIAGRAM OF SYSTEM G.A.A.B. 0 GREATER ANCHORAGE AREA BOROUGH r v� DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT No. 3330"C"STREET ANCHORAGE, ALASKA 99503 3 f TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT J scyUST�Z/s/1e57 3� 3Y5� NAME OF APPLICANT MAILING ADDRESS PHONE O 9 INSTALLATION LOCATION✓ LEGAL DESCRIPTION LOr �6 s�z..�0, l vp2 .fE-i///" sl�/`y /�c� y!�/ f !y TjZ/✓�Z/.rJ INSTALLATION OF: SEPTIC TANK SEEPAGE PIT—, DRAIN FIELD 4— OTHER TYPE AND SIZE OF FACILITY TO BE SERVED ��� /���//�/I/G����,✓`y/�'-I- �O�✓1T FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS 4 ��L�� 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 DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPEZ OZ/ SEEPAGE AREA SIZE GF TYPE dVii/CR�T>� .d�j.�/T/Ger/N y ' u/io�Ti2r�+vi ref/ 3 � oG GiJ/�-utL/3e SYSTEM a p MINIMUM DISTANCES, REQUIREMENTS D11"7�CCGSYSTEM RAM OF T/ter i FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PITA, DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL XJ SEPTIC TANK SEEPAGE PIT DRAIN FIELD /0 TO NEAREST LOT LINE. WELL TO SEPTIC TANK /y SEEPAGE PIT DRAIN FIELD -�l / ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK ✓D / SEEPAGE PIT DRAIN FIELD /% / O / SEPTIC TANK, /�, SEEPAGE PIT DRAIN FIELD/y , 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. �+ C G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT 1 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. DATE 1� �� APPLICANT'S SIGNATURE FORM NO. EQ -616 r13 os - R&M ENGIREERING & GEOLOGIA CONSULTANTS 229 EAST 51st. AVE. — P.O. BOX 6087 — ANCHORAGE, ALASKA 99503 TELEPHONE 907-279-0483 TELEX 090-35419 Civil Engineers Geologists Land Surveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P.E., L.S. JAMES H. WELLMAN, P.E. May 7, 1974 R & M No. 462019 Mr. E. J. Schuster SRA Box 393R Anchorage, Alaska 99509 Re: Test Hole and Soil Log Report for Sanitary System, Lot 46, Section 30 W 1/2, SE 1/4, SW 1/4, NE 1/4, SE 1/4, T12N, R2W, S.M. Dear Mr. Schuster: RALPH R. MIGLIACCIO Engineering Geologist We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of May 6, 1974, and those procedures outlined in a letter dated September 13, 1971 by Mr. Rolf Strickland of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 46 area for the purpose of defining general subsurface soil conditions for the proposed sani- tary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 10.0 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. 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. Very truly yours, R & M ENGINE/EERIINNG & GEOLOGICAL CONSULTANTS, INC. J�/v �t Rooney JWR:ph ANCHORAGE FAIRBANKS JUNEAU T. H. 1 5-6-74 ~ ORGANICS ORGANIC SILT Gravelly Sand Trace to Some Silt (SP) Bedrock Refusal No Water Table NOTE: Test hole extended with auger type drilling unit. R Engineering 81 Geological Consultants Inc. yA ANCHORAGE FAIRBANKS ALASKA JUNEAU DATE 5-7-74 SCALE I"=5' DwN BY JRS CHKD BY WED D42273 0.0' 1.5' 2.0' 9.0' 10.0' T. D. E. J. SCHUSTER PROPERTY LOG OF TEST BORING Anchorage Alaska PROJ. No. 462019 1DwG No. A-01 Well • M -W DPJWNG, Inc, •' �5� %62w Location (address of Township, Range, Section, if known; or distance main road L469 K�p.Sri SYi4, hE�L SES, Sec. 30 T1St R2K, len AIps 6 10 75 f t Cased to 10 feet Size of casing Depth of Hole__7 ee Static water level 17 ft (abutre _ low) land surface. Finish of well (check one) open end( - i -7C. Screen ( ) ; Perforated one - " Describe screen or perforatio Describer for--L-1---hours with Well pumping test at 10 "gall�pe - sF. (minute) of drawdown from static e w 9� yr+' Date of completio 3 an WELL LOG Depth in feet from color and hardness ground surface Grvae _ f ormations penetrated, size of material, 5 TO 10 10 TO F0 b5 TO 7r, TO- O -TO- TO TO- TO TO TO - TO TO �Se.!)`t e4 Anr Arrlllitr, tinrl. rr►or snyN� o Rb Ky.. _ -_3—CONTRACTOR 1 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 I.D. # - LtLo — HAA# 0 Q92DQ 3-Q1-1 1. GENERAL INFORMATION (/� SE /H Sw� NEIN SE 1�Y Sec30 Complete legal description W r � �,� i—r— / 12 N. RZw Sr`t Location (site address or directions) 13SZo SunSh'ne Loan Property owner /- 1/7 dcL Go (b„ —I Aa-LLq 6Y1 Day phone Zs7 - 13 2 y Mailing address P U GO x23 09 & 2 Lending agency C' �r Morf-g ave Day phone 563-0706 Mailing address I? I w- r,,rebl eed /-,ane,fMw /4-k 99507 Agent N&'Jc? - hDude_ �'dgrSold Zv ocunor Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 \' 3. TYPE OF WATER SUPPLY: Individual well 'l� 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. 72-925(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. Waver /c sur-rr c we, tee- mycA ire o(, Name of Firm Ftafk4n 71echni[ar Sarvk>i Phone 3NS-13Ss- Address 1HS 3o C—cho ArAcboCc=9P, Al -c 99Slz Engineer's signature - Date 0 F ACza4�� ��, SO.." �J............• n..^ / 4 ip I ➢•THEODO,:E F.. -1002E ,• rf` r,.• C., 35'.9 M 6. DHHS SIGNATURE" X Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments 0 UITIC bedrooms, with the following stipulations: Date -7-28-93 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 orderto 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(Ru.1/91) Beck MOAN21 Municipality of Anchorage lak Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: W Y2 SE 114 SWY* NE Ya SEY4 SEC 3o Parcel l.D, A. WELL DATA Well type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed 6-3-74 Driller M 4 W Total depth 75 Cased to to r Casing height 12" Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y FROM WELL LOG., AT INSPECTION .' Date of test { {, ><3 �71it G �1 (i�1G A 't1 Static water level ) 7 14 Ind' { � � - Well flow 1 n g.p.m. > '7.5 9•p• Pump level SEPARATION DISTANCES FROM WELL TO:- Z Septic/holding tank on lot 125, qq ; On adjacent lots >/Oo i Absorption field on lot Or 3 J% wAwER oN F14E) ; On adjacent lots >100' Public sewer main >too1 Public sewer manhole/cleanout Sloop Sewer service line y Ifor Petroleum tank No.(E a65ERvED WATER SAMPLE RESULTS: Coliform O cc,1 !fc'Ofit Nitrate 1'S n- -e_ Other bacteria A00 e- �°or� Date of sample: 411113 Collected by: FL 477x!' TCCY SVCS B. SEPTIC/HOLDING TANK DATA Date installed -5 /Q. 174 Tank size 10M 641 Compartments 2 Cleanouts (Y/N) y Foundation cleanout (Y/N) Depression (Y/N) N High water alarm (Y/N) Nr A. Alarm tested (Y/N) NA, Date of pumping 57 (7 ! 9 3 Pumper Den a1! S ewer t Or)a"A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)onlot , 125 Onadjacentlots > loor Foundation 771 r Topropertyline a5D Absorptionfield 7 Water main/service line Surface water/drainage* 90 * $¢@ Psc161eo(_ cewaiue� ecpf 14^/76n 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at - Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump Off" level at Cycles tested Surface water _ Date installed '11,183 Soil rating 150 018DRM System type SNAceOw TRENCH r r r Lengtb.170 f45 Width 3 Gravel thickness 0• S Total depth j• S r Total absorption area Cleanouts present (Y/N) Depression over field (Y/N) Date of adequacy test /I/T3 Results (pass/fail) Pass for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) N09E Kkawu OF If yes, give date t4,A. SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot D rr'86 aA1vER On adjacent lots i'/0°1 Propertyline To building foundation r To existing or abandoned system on lot - 7 On adjacent lots 95ot Cutbank KA Water main/service line %� 701 Surface water* 53 Driveway, parking/vehicle storage area > qO r Curtain drain NONE OBSERVED E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature �-�- �r Engineer's Name %%T &0dam F r'taooP . R Date June THEODORE E. L500RE • 0 •.� E-3589 : st' �Af HAA Fee $ C b`� Waiver Fee: $ �D Date of Payment - p/� Date of Payment Receipt Number ���( ��Receipt Number 72-026 (Bev. 3/91) Back MOA 21 WR# WR930034 Date Received *MUNICIPALITY OF ANCHORAGEO Department of Health and Human Services On-site Services Section Waiver Review Worksheet PID# 021-022-46 HA# HA930324 Permit # June 21, 1993 Legal Description: T12N R2W Section 30 Wz SEk SW; NE; SE; Engineer: Ted Moore, P.E., Flattop Technical Services 14530 Echo Street, Anchorage, Alaska 99516 Applicant: Linda Bowlby-Layton Waiver Requested: Leach field to surface water of 53 feet. Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: X Waiver is NOT Granted: List Conditions or Reasons for above: SEE A)TR CHFP Date: 7- 26 -93 By: Rec #: 24820/8553 Amount: $ 590.00 Date Paid: June 21, 1993 MunApality of Anc0brage Department of Health and Human Services Cih Tom Fink, 825 "L" Street Mayor P.O. Bax 196650 Anchorage, Alaska 99519-6650 343-4744 July 28, 1993 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for T12N R2W Section 30 W2 SEq SW; NEa SE; Waiver Request #WR930034, PID #021-022-46, HA930324 Dear Mr. Moore: Your request for a waiver(s) of the required 100 foot horizontal separation of a septic system to the surface water has been approved. The approved separation distance(s) are the leach field to the surface water of 53 feet. This waiver approval applies to the existing septic system to surface water separation only. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. Should the operation of the subject wastewater disposal system cause any contamination or degradation of the subject surface water, this waiver will become void. Sincerely, � Daniel J. Roth Civil Engineer On-site Services ljm:#5 Co cur: J hn Smi/anager P.E. rogram On-site Services /-,2 Qoo 0 0 wA/vER I?F_Quffs r Fob W%z SE V4 5wY4 Alf % SE /4 SEL770,v ,3O 7-/2N R2 WA/vER RF4aESr Ivi4"off/? wR93oo 34 WRIvEn RFgaEsr FoR ON L cT IARSORPTIOA. rRENCH TO SAWA4CE Gv OF S3 '. 5fOTl6 H1,17 -CRI" %HE SG BJEcr W,45TF_u.,4rbR SYJrB,u L-hS f041s7RWC7-6"to /N SEPr. 1993. THE SURFACE a,47,ER wgsNor 0/ScovF)?Ev qr rRIf 71 AAE, TKF 5-liRF,4CE c,14TER Ml► K A,vT HI3v£ fzlsreD RT r TIMI_. THF ANA4r,vE FvtIA6E /u rH1, RR4,9 IS TNICk f T/9LL. Aue06e0 l4 51TE VISIT OA., ]-22-C(y /?EUEAIF0 7-1464 fr?r4m W1gS vl?%4 V0A'-FxIS TENT F. TIIC SrRE19M FLOi,5 PeST rMff A05'Oefr/o,v F/bLD A4 v0 n/sA/�PE/4�'J OuRIA,& 7-1-1E OYEIp,rkP rl,Ke Of YgE4gR SL/6fsrL PowN 6efiP1EA,T FI?Om 71 -IE Lot --&.5r Po✓?T Janes of TGtF 1030.5,419prioA rRENCrf. YAN THE EvEn,T OF A P07-EuTI6L n/3Y4/611F PROAl THE FIof09PROA, TRF—RF-/ Iti �uEST,Ou� TL(E EfFCkE.vT UouLP TRAVEL 190 .ov6 e,A-,PiewT NEIMLjy P19-1?RgL6EL To 7-1tE SulPF'ICE wATen 1A, QUFSTIoA/. THE S1+K'FAfF 1,14rER THEAi YJ/Sf1l'PL-fIRS gh-Clz /Pro THE 6Rau,,,p 4ov6 19A`F0RE 211YE OOTEA✓TIRG QlIyL/GKr pF EFFLuEA,T FROM rltE #g_rol?ppo. 7Rr-A,CA-/ COULV IA�r6/eCFP7 [~17"1-( T/4E fURFFICF L-/4r5e, THE CA,6/,vECR u'/9Lk'En THE strq� 4R15F4 THAT r/{E Sul?FfILE + /4TEI? TVW51?SFS IeA.T/L IT 015x7 /}A,p CojAj_ii Ivor F/PD R 7R,*CE OF T1-fF I—PITE/e RE,9FFFy�/NG Pow, SL OPE FOR MORE 7-KA3 Ar 2 00 FEET Fl?o� 77aE CL of Fxr OF r14E t9f50f?1°r1041 TPEIu61-e IN qu ssT/Oa. OV CLt(:r/oN — r14 falPFHCE 1„./4rER /v Qu6xr/oAi /f FREE FRO�c R/SM eF 1007FA. 'uRFA6/N(9 SEPT/C r#AIR EFFLaE,vr F,fcA4 /wTrRSECT/v,� 7 -we Sk?FAjCE! 7 8,9,v r w,,wE1? ! T.ER r S M.O.A. DHHSn L P.O. Box 19-6650 l_ �.� too J Anchorage, AK 99519 RE: Waiver - field to surface water - w2, SE4, SW4, NE4, SE 4' Sec 30, T12N, R2W, S.M. Dear Sirs: By means of this letter we are requesting a HAA certificate and a waiver of the normally required 100 foot separation distance between a soil absorption system and surface water down to 53 feet for the subject lot. A site plan and other relevant backup documents along with a description of our adequacy test procedure and results are included to assist you in your review. According to the driller's log, the well serving the residence on this lot was completed in June of 1974 and has a total depth of 75 feet and a yield of 10 gpm. On June 1, 1993 we conducted a yield test of the well. At the start of our test the static water level stood at 14 feet below the top of the casing. Steady pumping of 782 gallons of water from the well at the maximum pump output of 7.8 gpm caused the water level inside the casing to be drawn down to 28 feet, but no further. Based on our test data we determined that the total yield of the well is in excess of 7.8 gpm, which exceeds Municipal requirements for a single family residence and also exceeds the FHA lending criteria that a well be able to supply 720 gallons of water within a 4 hour period. Water samples collected on June 1 were satisfactory, showing no coliform or other bacteria and 1.5 mg/1 of nitrate -N. According to inspection documents on file at DHHS, the original wastewater disposal system serving this residence was installed in 1974 and consisted of a 1000 gallon septic tank followed by a single 48 foot long soil absorption trench. In 1973 the original soil absorption trench was abandoned and replaced by two parallel 3 foot wide drainfields with a total length of 155 feet having 6 inches of gravel beneath the horizontal distribution pipes. The installation was inspected by a municipal inspector. In February of 1986 the system was tested by AECS and found to be adequate for a three bedroom residence, however the well was found to be 90 feet from the drainfield. On 3/11/86 DHHS issued a waiver allowing the existing drainfield to be 90 feet from the well. The records do not give any indication that surface water was observed within 100 feet of the system. On June 1, we conducted an adequacy test of the wastewater disposal system. Measured quantities of water were added, first into the septic tank and later into the standpipe at the east end of the upper drainfield, while fluid levels were monitored in the septic tank and soil absorption system standpipes before, during and after the flow of water was stopped. The line between the septic tank and the upper drainfield was found to be obstructed, but the line has since been repaired by Carl's Excavating and a double cleanout installed. The standpipes in the upper drainfield initially had 6 and 7 inches of fluid in them, and these levels rose only 1 inch during the course of the test before the fluid overflowed into the lower drainfield. The standpipes in the lower drainfield initially had 0 and 3 inches of fluid in them, and these increased to 11 and 8 inches, respectively as water was being added. A total of 782 gallons of water were added to the system, and within 1 hour after the flow of water was stopped all the fluid levels were back within 1/2 inch of their original position. Based on this observed behavior, we concluded that the system continues to be able to accept water at an adequate rate for a 3 bedroom residence. In conjunction with our adequacy test we noted the presence of a small stream flowing in the approximate location shown on the site plan. We measured the surface water to be 55 feet from the standpipe at the east end of the lower drainfield at its closest point. The requested waiver distance of 53 feet is to allow for slope correction and/or possible underground protrusion of the drainfield gravel a little closer to the stream. The stream had an estimated flow rate of 5 gpm in the area where it is closest to the drainfield, with a somewhat higher flow rate further upstream. All surface flow of this stream ended within approximately 20 feet downstream of the point of it's closest approach to the drainfield, and surface flow did not reappear within the next couple of hundred feet further down the swale. The elevation of the steam at it's closest point to the drainfield is approximately 10 feet lower than the ground elevation at the standpipe at the east end of the lower drainfield. The slope of the topography in the area, however, is such that surface flow of effluent, which might conceivably daylight from the drainfield, would never reach the stream, as it would have to cut obliquely across the slope to do so. The fact that the surface flow disappears below ground and remains there should eliminate concern as to the possibility that surface water contamination could pollute other receiving water bodies. Due to the slope of the topography, no residential development exists or is likely to br built in the near future for approximately 1/2 mile downhill of the subject lot. Surface water separation distance waivers do not lend themselves to the quantitative application of DEC waiver analysis points, as is done for well waivers, so it is necessary to make a qualitative assessment of the potential public health hazard associated with granting the waiver. In this case, particularly considering the small volume of the stream and the fact that the system was inspected and tested several years ago without concern as to surface water proximity, it is our opinion that issuance of the requested waiver will not result in surface water contamination. Please feel free to give me a call if you have any questions on this waiver request. Sincerely, Ted Moore, P.E. cc: Linda Bowlby WELL VAr—PrN 7— I -OT, b.vr w Lo O vAC AN I t,o T Hous wAlvEk .,I��Is�, GRANTEn Sly t X000 6AL � 5EPT tC TANK MBw Doc 7o,+$S' ABsoRP. TRfi� �v Oop HousE SEPTIC e'S SYSTEM F�o�✓ (0 GPM F.ow WEST %,. EAST %s p Flattop Technical Services j(.S' 14530 Echo Street VACANT l.0% Anchorage, Alaska 99516 W %, SE y4, SW'/4, NE %., SE Y4 OFA SEC 30, T 12.N, R2Vq .........p'4 0 AK "''' '•.'�.,°� WASTEWATER SOIL ABSORPTION SYSTEM •49LH '1 • SITE PLAN t. vv.�ays�...........e n. 3. .... ... ......o.., �� No -TF.. THIS is NoT A •s THEODORE E. WIOORF. SC A L E '. I =50 CE. -35p9s SVRVE`(EA FLAT. p'�^�' • .......•� DATE : io /q3 L LOCAT OKS DWN RY� CA ARE APPRoxIMATE. mEAREST 53I 5uRFAC 6P� 5 J�END of 5 FLOW �RiIPI F Oop HousE SEPTIC e'S SYSTEM F�o�✓ (0 GPM F.ow WEST %,. EAST %s p Flattop Technical Services j(.S' 14530 Echo Street VACANT l.0% Anchorage, Alaska 99516 W %, SE y4, SW'/4, NE %., SE Y4 OFA SEC 30, T 12.N, R2Vq .........p'4 0 AK "''' '•.'�.,°� WASTEWATER SOIL ABSORPTION SYSTEM •49LH '1 • SITE PLAN t. vv.�ays�...........e n. 3. .... ... ......o.., �� No -TF.. THIS is NoT A •s THEODORE E. WIOORF. SC A L E '. I =50 CE. -35p9s SVRVE`(EA FLAT. p'�^�' • .......•� DATE : io /q3 L LOCAT OKS DWN RY� CA ARE APPRoxIMATE. 0 MUNICIPALITY OF ANCHORAGE 0 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ( , ,`} OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date �� d$'_____ 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 7rjznj ,t' zi.J SCG j0 Location (address or directions) (b) Applicant Name -774y/il Telephone: Home P j`�5 f�� 6Z-- 53 Business Applicant Address �erov f"l- 3<• fcriTc /ui /%i% �j� (c) Applicant is (check one): Lending institution[]; Owner/builder; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family( Multi -Family ❑ Other Number of Bedrooms -3 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Telephone t:441rilfrJtfltUlTPry2ff n,,,�-. ....,. ;G DETIT. RECEIv..) Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDIINSPECTIONS, TESTS, FILE SEARCH, DOAND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. I Name of Firms Telephone Address Date Lz%�lt5a'1ie�/diz $'�/fat�� SeFai� >�. Nib J' -z7- sr� AL E A � 6. DHEP APPROVAL Approved for yilr2r� 3 bedrooms by (S=3 -c �--�i-�'� Date Approved x Disapproved Conditional Terms of Conditional Approval CAUTION y9so3 ®eeeeoee�y_Qw� iieJJ�y a TH a eo�ese6 OYec. R"ct JR.: CE -2251 Q,4� Ftoiesstot�a��®®®� lrli— /— Pb The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/04) 0 w MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 MUNICIPALITY OF ANCHCRAG2 DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 0 5 9986 Legal Description :r /j z' � I� J� E12V� D A. WELL DATA Well Classification k/('/� �-� If A, B, C, D.E.C./Approved (Y/N) Well Log Present(Y/N) Date Completed 3 -- `f� Yield �� �= �•`%`� Total Depth i Static Water Level Cased to Depth of Grouting 4; i) P S t At Casing Height Above Ground Electrical Wiring in Conduit 6/N) Separation Distances from Well: Pum e p Sanitary Seal on Casing 61/N) Depression Around Wellhead (Y6)'! To Septic/Holding Tank on Lot / On Adjoining Lots To Nearest Edge of Absorption Field onL/A/Z '�_ ; On Adjoining Lots r To Nearest Public Sewer Line To Nearest Public Sewer r Cleanout/Manhole To Nearest Sewer Service Line on Loth Water Sample Collected by Date Water Sample Test Results ?i%i='ii','C, �`A! Comments x/''` � /11(6,4'T icjs<✓C �+/ii9v��P py )e1�i7XAlan� )i17/*eL: ,_f5A-eV 3Yr tieA, - B. SEPTIC/HOLDING TANK DATA Date Installed 4 Size ���� �/� No. of Compartments Stand pi pes((Y/N) Air -tight Cap(Y/N) Foundation Cleanout (Y N) Depression over Tank (YJ) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) �/� for > �/ Holding Tank High -Water Alarm (Y/N) ��,!'' Temporary Holding Tank Permit (Y/N)'- .f Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line To Water Main/Service Line Course To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments /` 21M-3ia`6 *7;i?W69 AbW4& 'T 6�+T 'T Te 3aHP i s Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA W+D� DRR+moi' Soils Rating in Absorption Strata IDLE � Type of System Design Date Installed Length of Field 7a' Width of Field • Depth of Field %• Square Feet of Absorption Area Depression over Field (Y6) Results of Last Adequacy Test Gravel Bed Thickness a•� ^ Standpipes Present (Y ) AA `` Date of Last Adequacy Test Z= Separation Distance from Absorption Field: To Water -Supply Well % ) ?el To Property Line To Building Foundation V %' ' To Existing or Abandoned System on s , Lot '•J On Adjoining Lots 5-o 'r To Cutbank (if present) f To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area X53 '7— Comments 6 AIM 70 Ze?i6401P AVIWE'74 vF k17Jh eA , i h; -P& -tire per/ 1-7o D. LIFT STATION Size in Gallo "Pump On Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access(Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I hav ec d, v rified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection aBF�rR^F cct * Signed '.G�. f---' Date�-aa fir, Company MOA NO. 07 -�'�] Receipt No. ' �%<yy II Y ,4 W C� PIC o Date of Payment. Amount: $ meer s Se NQ. 2257-E Page 2 of 2 72-026 (11/84) 72-026 (11/84) 60069 ALASKA 6 1ROWnTRL COnTROL BARS, If1C. Engineering & Enulronmental Studies 03/03/86 NIEL & JUDIE THOMAS SELLER—NIEL & JUDIE THOMAS NIEL & JUDIE THOMAS 3000 A STREET/SUITE 101 3000 A STREET/SUITE 101 ANCHORAGE ALASKA 99503 ANCHORAGE ALASKA 99503 LEGAL:TI2N R2W SEC30 W1/2 SEI/4 SWI/4 NE1/4 SE 1/4 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE -2/21/86 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 465 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 678 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC 'TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT HAS NOT BEEN PUMPED WITHIN THE PAST YEAR. THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. FLOW TEST ON WELL WELL FLOW DATE -2/21/86 A FLOW TEST WAS PERFORMED ON THE WELL. 678 GALLONS OF WATER WAS PUMPED AT A RATE OF 6.8 GPM OVER A DURATION OF 1.6 HOURS. THE DRAWDOWN WAS 23.7 ' WITH A RECOVERY TIME OF 120 MINUTES AND THE STATIC WATER LEVEL WAS 36.8 FEET. THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME. Ga UN E T� pF�4m-1 &RAON RC1. �a G b 1200 West 33rd Auenue, Suite Q 9 Anchorage, Alaska 99503. 907) 561-5040 Mlicipality of Anchorage MEMORANDUM DATE: March 11, 1986 TO: File FROM: Civil Engineer, On-site Services SUBJECT: T12N R2W Section 30 W-, SE-, SWI -4 NE-, SE4 Waiver, WR86-032; 90 feet well to absorption trench A risk analysis on the subject property indicated that there was very little possibility of contamination of the well from the septic system. A waiver of the 100 foot separation distance required by 18 AAC 72.021 was waived to 90 feet. This waiver is valid for the existing three bedroom single family dwelling only. Stephen S. Morris Civil Engineer On-site Services SSM/ljw cc: Alan Wien, A.E.C.S., Inc. 1200 West 33 Avenue, Suite B 99503 ALASKA ENVIRON,NTAL CONTROL SWUM, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 JOB SHEET N0. OF— CALCULATED BV �' DATE CHECKED BY DATE SCALE i r t, 'N_. �1 106 L -7-1 _1 Ali /t ___ _.... _. DAUN�cpE �, �N�px,� PROTEC't10N _ PS:�?N'"�/. ". 1.![^ Man 0111' Time APPLIONT FILLS OUT UPPER HAI+ONLY Property Owner Time Phone Mailing Address /,' 'q 1_?, G Zip Code Buyer Date i Address Inspector Zip Code Lending Institution Inspector Phone Address Zip Code Realty Co. & Agent Phone Address Zip Code Legal Description (..) �' �yi l �.� ��/ y.YIL" �✓ �. ' i y J... / > i✓ AI i. 1 i'✓� Street Location i ( APPROVED BEDROOMS �) Type of Residence *CONDITIONS OF APPROVAL ( DISAPPROVED G Single Family -: Multiple Family No. of Bedrooms _ Other Water Supply Lg' Individual DATE . v - ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. C Community BY: r For wells drilled prior to that dale, give well depth (attach log if available). ❑ Public Utility Soils Rating _ Sewer Disposals Ei"'Individual -',. '— Year Individual Installed: ❑ Public Utility Well Log Received When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date i Inspector Inspector Inspector Inspector Field Notes: (r ;4. ,,,.vr-2 ( APPROVED BEDROOMS �) *CONDITIONS OF APPROVAL ( DISAPPROVED ( ) CONDITIONA -APPROVAL� ! �- DATE . v BY: r Soils Rating _ Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size :,;> WeiI to Tank ".:fs p.) 0 0 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 5. Type of facility to be inspected—�i��!��° >,:�,% No. of bedrooms 6. Well Data: A. Type _— C. Construction 7. Sewage Disposal System: A. Installed.. B. Depth - D. Bacterial Analysis B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Date Received / i Time of Inspection Date of Inspection '- REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: Phone:2. Property Owner:r Phone: Mailing Address: 1�<"�^ �� :� 3. Legal Description: 4. Location: 5. Type of facility to be inspected—�i��!��° >,:�,% No. of bedrooms 6. Well Data: A. Type _— C. Construction 7. Sewage Disposal System: A. Installed.. B. Depth - D. Bacterial Analysis B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages 0 0 GREATER ANCHORAGE ARC;, BOROUGH Department o 1 Env irormen"aI Ouaiity 3330 "C" St., Anchor^aye, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER. & WATER FACILITIES 1. Type of Inspection: CMRG VA F'r'A CONV x 2. Property Owner: Schuster Edmund J.E. Mailing Address SRA box 393 R Day Phone 344-0967 3. Fame of Buyer: n.a. Mailing Address: Day Phone 4. Name of Lending institution: N. 3. of A. Mortgage & Loan T nailing Address: 5th & Gambell Picone 279-2506 5. dame of Realtor or Agent: n.a. Mailing Address: Prone 6. Legal Description W 1/2 SE 1/4 SW 1/4 NE 1/4 SE 1/4 S 30 ---- Location: City of Glen Alpp, via Upper Huffmann 7. Type of Facility to be inspected: single family No. Bdrms, 2 8. Water Supply Type of Supply: Public Utility Individual x If Individual, number of djraellings presently served 1 If Individual, depth of well 75' 9. Sewage Disposal Systej.,j Type o -ii System: Public Utility Individual ) X -- {on -s to _ Ii Individual, date of installation May, 1974 Page 2 of two pages - Re* t for Approval of Individual &r & Water Facilities Legal Description Comments Approved Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date