HomeMy WebLinkAboutHAROLD MILLER LT 20 0Il- tklaw " Lo
Municipality of Anchorage I I Page 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: -SW 9!00091 PID Number: 017-4137,-11-&
Name:Nlrr.,,,2
Wastewater System: (New ❑ Upgrade
Address:
12,550 fl/��Sid� !)� , ANCtf r�`���
ABSORPTION FIELD
Phone: No. of Bedrooms:
9u 51 wrs� :Zj�
/Deep Trench 13Shallow Trench ❑ Bed ❑ Mound El Other
LEGAL DESCRIPTION
Soil Rating:
�'
Total Depth from original grade:
�� 6 /
GPD/S . Ft.
Lot: Block: Subdivision:
2
Depth to pipe bottom from original grade:
a,
Gravel depth bene pipe
- 2GLD Mi��Ei2
(� Ft.
Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length: 7
6
m...i a — 3 Ft.
/ Ft.
WELL: l New ❑Upgrade
Gravel width:
NumbT flines:
Distance between lines:
Ft.
Classification (Private, A,S,C):
Total Depth: I
Cased To:
8
Total absorption area:
/j 02
Pipe material:
P3034 F 210
P/zj VAT
-391 Ft.
Ft.
6 So. Ft.
Driller:
�f/M GNA fa %
Date Drilled:
07 9(0
Static Water Level:
/i0' Ft.
Installer: �n/'�r/� n
�I[ li A/,q//j/q&
Date
Yield:
5 GPM
I Pump Set at:
9L/ Ft.
Casing Height Above Ground:
a Ft.
TANK
SEPARATION
DISTANCES
aSeptic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
HoldingPublic/Private
Manufacturer:NC y
Capacity in gallons:
D0 Q
From
Tank
Field
Station
Tank
Linn
Sewer Lin
0
Welh
/ lo�)
.o�
/I
fel/A
J/�s}
9�1
Material /
5 f�
Number of Compartments:
Surface
�' 100T!
,LIFT STATION
Water
/,1/A
Lot
G
!
I ` /
/
Size in gallons:
Manufacturer.
Line
l
Foundation
�
�
"Pump on" level at:
"Pump off' IgyeLet�""—�
High water alarm at:
8
�
�/�A
Curtain
N 7A
!!
Pump Make &
lectrical Inspections performed by:
Drain
BENCH MARK
Remarks:
-
Location and Description:
C j11e-REZ- 4711-qG,C
Assumed Elevation:
Ft
ENGINEEg'S SEAGL.
SSaa� F
ffi
Inspections performed by: Dates: 1 st
2nd L04 ZI 9b
NiMTEAGVGwU tlO P3J b68i
Department of Health Hum r rvices appro al
;C fVf ed
�P "�
�i� -� r z� `
Reviewed and approved by: Date:
72-013 (Rev. 9/91) MOA 25
Permit No. SW960091
Page' I 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: HAROLD MILLER LOT 2 PID No.: 017-432-46
N 89°53'19' E
279.58 i
I CD
TH2 ®TH3 _
to ® THl Mf I
r
1c:
r r � d
Cfl
CD LOT 2 #`HELL D
mjy TH4 A < I
I�' A
3 I ® m F9 /
/ A
� a 'I00'
Z
1 ` i C .ie' TO WELL \ I
I /i 10
N 89053'19' E
i 279.62
SWINGTIES:
A - C = 18.9' SCALE V = 60'
B - C = 52.9'
® - TEST HOLE
B - D = 215' • - MONITOR TUBE
o - SEWER CLEANOUT
- WELL
- NEW LEACHFIELD
- — - - EASEMENT
ELEVATI❑NS CDNC�PAD OF GARAGE
(NOT TO SCALE) ABED ELEv = IDD.DDm 1018/96
N
ENGINEER'S SEAL
ORIGINAL op0o00
GROUND
L ATS Ov�/JGP�
. O ' •
LF.y/q
DDRONAL MATERUL 95.8
7
77.9 49 TJ
ING GVT .�(•....�..p5..�U.
TANK
09293.3 7 �4
.r.
0D
92.7
.................................�
VA
\e3'7 Q LOUIS A. BUTERA. � O
0o J ''•, CE -6716
04��p0� ROFESSo Po�?�O
40poo
FROM : Panasonic FAX SYSTEM PHONE 110. Mar. 12 1996 03.54PM P2
Q 09
DRILLING LOG
Well Owner f y![ YO rd A`11yf Use of Well
Location (addre=ss, legal deseriPtion.. etc.) '404 DY -'&e
N } f
Size Of Coming 46 iDchm. Depth of hole � f __ tca C amd to 3 tea
Static water level7� o ---ft. {afteesl belga} land surface -
Finish of wdl (cho & one): Open End Screen ( ) Perforated ( } Liner ( }
Description: T to se. -I-_ ad— ~29Y.e0
Well leunping test at /� >;allous per (l~/ minute) for J -]Z' hours with 70 0 ft. of draw&%vn
from static level.
Date of completion'. --1 1 y Z3- L Drilter.
WELL LOG
Depth In feet fnFn
grmmd surfane ri C details of farmatimiS penetrated, sue of RwCfiol, Color anal .bm1neas
Q 'to - /I '
l5 'to 22. '
:?—z to 34$ ,
33
to 74j '
LY
•tam
2 6° '
26a
to 269 ,
2P
to a
Wo
to >
, to ,
,to
W
OCT PS, 19916
untcgl sv�
D2pt. iwln r; Sgry nag
-4-
Due), Due), $lcr.d
4- 38o-
k
L -AQ -? F 7 G r
OCT PS, 19916
untcgl sv�
D2pt. iwln r; Sgry nag
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 WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW960091 DATE ISSUED: 5/29/96
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE: 5/29/97
OWNER NAME:MILLER HAROLD R &
OWNER ADDRESS:12550 HILLSIDE DRIVE
ANCHORAGE, ALASKA 99516
PARCEL ID:01743246
LEGAL DESCRIPTION:
HAROLD MILLER LT 2
LOT SIZE: 46134 (SQ. FT.)
NUMBER OF BEDROOMS: THIS PERMIT: �(`✓
3 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY 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 ]
ISSUED BY
¢ 13t_�nuort�
Fu 3 lixOn oQAa S.
� l
SLe G v0NB,6R'S 'VITOCHF-0 Rf✓190 DESt6p
sYsrem FRoM TELE. MORTKE9sr CORNER of Lor To
DATE:- 2q -
DATE:
q'
DATE: �' Z �' O6
M o viMb 774 PM Golf f7d ,..rq,7eg
7-140 S a u rite*s 3- !a►Qn.g+Y
e___
Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
June 17, 1996
Dan Roth
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Harold Miller Lot 2
SW960091 Revision #2
Dear Mr. Roth:
RECEIVED
JUN 18 1996
Municipality of Anchorage
Dept. Health & Human Services
We are requesting a revision of the above referenced well and septic permit issued May 29,
1996, and revised on May 31, 1996. The number of bedrooms remains at three, but the house
location has changed, necessitating the excavation of an additional test hole and relocation of
the leachfields.
If you have any questions please call our office at 694-5195.
Sincerely,
i
Louis Butera, P.E.
\ 1996\96-013c-NAR.Doc
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Harold Miller, Lot 2
06/17/96 - REVISED
A. GENERAL
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health
requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the
contractor to meet Municipality of Anchorage requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements
and to locate any adjacent multi -family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
8. It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
9. Any remaining open test hole excavations shall be filled.
B. SEPTIC TANK
1. Septic tank shall be 1,000 gallon MOA approved.
2. If a lift station is required, a receipt from certified electrician stating the lift
station was wired to applicable codes to be supplied to Engineer.
C. TRENCH
1. The trench is to follow the natural land contour to maintain uniform total depth
of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
3. The total depth of the trench excavation is not to exceed 12' at any point.
4. The effluent line within the trench shall be laid level within 0.03'.
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or
equivalent is to be placed over the leachfield.
7. The area over the trench is to be finish graded to prevent ponding of surface
water runoff.
8. The septic tank and leachfield must not be closer than 100' to any existing
private well, 150' to any Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH= 12' GRAVEL DEPTH = 9' under pipe, 2" over pipe
TRENCH LENGTH = 56' TRENCH WIDTH= 3'
SOIL RATING = 0.45 GPD/ft2 BEDROOM CAPACITY = 3
SEPTIC TANK = 1,000gallons minimum
Twenty-four (24) hours notice required for all inspections.
\ 1996\96-013c-spc.doc
i
CUORDS (X,Y) I
A = 5000,500)VACANT
B = 4720.37 1,499.4564
C = 4720.09 8,5164.4562
D = 4999.6792, 64.9997
LOT 3
GARRETSON
LOT 3
I
N 89053'19" E 4
279.58
PROP WELLo Tp WELL
(I,
TH2 z F---1 ®TH3
I ® i15 -20i J TH1 (rI F-
r
o I i0-27. I DRIVEWAY
X d
I
APPROXCP I `(L I
SEPTIC AREA pO LOT 2 I F �0-22 I
15-20% ¢ I I
I P
HSE IRUP. m
GARRETSON I L I 0-22 N TH4 G
LOT 4
I m
1000 GAL
SEPTIC TANK
N 89°53'19" E j0-zi
2 I 279.62
_I
o I FOUND CO
C7 1
SOpSIG PREP 0 I
� ER
17' 33'
OWNER
DI
F9
I LOT 1
FrI
zI
�I ® - TEST HOLE
• - MONITOR TUBE
o - SEWER CLEANOUT
NO SURFACE WATER - WELL
PROPOSED LEACHFIELD
NO KNOWN CURTAIN DRAINS - — - - EASEMENT
WELL/SEPTC SATE 'F�'LAN -w-•aOF'��
LEGAL: HAROLD MILLER LOT 2 Aw • A4 9 10
OWNER: N/A , AV,,AV
CONTRACTOR: HAGMEIER i* ;49TH
JOB 96-013A DATE: 06/17/961 SCALE 1" = 60' •Ff ••.• .%
EAGLE RIVER ENGINEERING SERVICES OA •'• LOUIS A.•BUTERA• 4v0
AP.O. Box 773294 I#s •. CE -6736 .• ��_f
EAGLE RIVER, AK. 99577 �#jeo ""' • �AV
(907 694-5995 FAX: (907 694-3297 ���%%`ES=0:�w'
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 96-013
Calculated By: LB
Date: 6/13/96
Legal: HAROLD MILLER LOT 2 TEST HOLE 4
Single Family 3 Bedroom Dwelling
Deep Trench Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom = 450 gallons
Percolation rate = 48 minutes per inch
Wastewater application rate = 0.45 gallons per day per square foot
Required absorption area = 1000 square feet
Trench width (W) = 3 feet
Gravel depth (D) = 9 feet
Required length = Required absorption area / 2 / D
Required length = 1000 / 2 / 9
Required length = 56 feet
Total Excavation Depth = 12.0 feet
49 TH ��
.... ..................
..
q� LOUIS A. BUTERA,
J 'n CE -6736
04��� � PROFESSIONP���d�G
SINGLE FAMILY ON-SITE WORKSHEET
ERES PROJECT NUMBER: 96-013
CALCULATED BY: LB
LEGAL DESCRIPTION: HAROLD MILLER
LOT 2
NUMBER OF BEDROOMS: 3
LENGTH (FT)
WATER USE PER BEDROOM: 150
GALLONS
PERCOLATION RATE: 48
MINUTES PER INCH
DEPTH TO GROUNDWATER: 18
FEET
DEPTH TO IMPERMEABLE LAYER: 18
FEET USABLE SOIL STRATA
ANTICIPATED DEPTH OF COVER: 3
FEET TOTAL USABLE DEPTH: 12
MOUND OR BED SYSTEM
USABLE SOIL STRATA DEPTH: 9
WASTEWATER APPLICATION RATE:
0.3 GAL/SQ.FT
ABSORPTION AREA REQUIREMENT:
1500 SQ.FT
MINIMUM BED LENGTH
12 FEET WIDE BED
125 FEET
15 FEET WIDE BED
100 FEET
TRENCH SYSTEM
WASTEWATER APPLICATION RATE:
ABSORPTION AREA REQUIREMENT:
SHALLOW TRENCH OPTIONS
5 FEET WIDE TRENCH
EFFECTIVE REQUIRED TRENCH
DEPTH (FT) LENGTH (FT)
1 175
2 140
2.5 127
3 117
3.5 108
4 100
DESIGN SPECIFICS
FIELD SYSTEM:
GRAVEL DEPTH:
TRENCH OR BED WIDTH:
LENGTH:
TOTAL
EXCAVATION
DEPTH:
0.45 GAUSQ.FT
1000 SQ.FT
DEEP TRENCH OPTIONS
3 FEET WIDE TRENCH
EFFECTIVE
REQUIRED TRENCH
DEPTH (FT)
LENGTH (FT)
4
125
4.5
111
5
100
5.5
91
6
83
7
71
8
63
9
56
D (B=BED, S=SHALLOW TRENCH & D=DEEP TRENCH)
9 FEET
3 FEET
56 FEET
12.0 FEET
➢ e �. Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
A i
4e➢O L.j� y➢i]R�ibiS�AR➢303 q2u n q
'w.e ligq➢eq�e"Seas. a•air�ne aia:
e :f'
tl^ Louis A. °mtera � 4J
o
ce-:;ria
WA�.�➢'ei E3�s"'S"�a�rd
PERFORMED FOR: -1-1#6N51/15-4 DATE PERFORMED: e zA1' &
Lof Z --
LEGAL DESCRIPTION: 4-64-- Township, Range, Section:
(-1—r; = SLOPE SITE PLAN
C/� L
2
3-
4
5
6
7
8-
9-
10-
11 91011
12
13 V�—
14
15
19
COMMENTS
SOt+tE CONGSION/SM��G�S
1301%rvm 0t iaOLe
WAS GROUND WATER , /
ENCOUNTERED? /`/ o
S
L
IF YES, AT WHAT 0
DEPTH? P
Depth to Water Attej)p,/ /� 1
Monitoring? LLL_ Date
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
/
1
2: -33
/ L9
7-
7-
:03
301419
Z 7-
7z// "
319
/
:p
317
/ /!n"
/D 1p'
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND 2_ FT
PERFORMED BY: /' NI CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4185)
I
COURDS (X,Y) I
1= 5000,5000VACANT
r 2= 4720.3781, 991.4564 \I
3= 4720.0998, il61.4562
4= 4999.6792 516M.9997
LOT 3
GARRETSUN I
LOT 3
I
N 89053'19" E 4
279.58 s
—r -100,
i 04X TO WELL\
1000 GAL y
SEPTIC TANK z
TH2 Li =
I ® iIs-zoz J TH1 H3 F
I
oI Ll i0-2z PROP.
X PROP DRIVE a
LOT 2 �
APPROX CHSE cil
o
II I Q' -
SEPTIC AREA po � I C-
i0-2Z O
/Is-20X ¢ PROP WELL d
m I GROG NSE Loc
H
GARRETSON I NEW NSE. Loc
LOT 4 I Fq
I
I
N 89°53'19" E
279.62 1
_I
o I FOUND CO
I sEPAIC aREP
NER 17' 33'
R �W
mi Ps PE
DI
V)
3I LOT 1
m
zl
® — TEST HOLE
• — MONITOR TUBE
0 — SEWER CLEANOUT
NO SURFACE WATER - WELL
— PROPOSED LEACHFIELD
NO KNOWN CURTAIN DRAINS - — - - EASEMENT
WELL= SEPI C SITE PLAN
LEGAL: HAROLD MILLER LOT 2 Aw
P�� OF•
OWNER: N/AAV
1�
CONTRACTOR: HAGMEIER 0* ;49TH
JOB 96-013A DATE: 5/30/96 SCALE 1" = 60' `: - i
......
EA GLE RIVER ENGINEERING SERVICES �A f� ' • LOUIS A. •BUTERA ;
P. 0. Box 773294 1�`T•.. CE-6736 •. ==
EAGLE RIVER, AK.
(90 ) 694 5195 FAX 99577
(907) 694-3297 ,11�%P�F� �0:�''�
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Harold Miller, Lot 2
05/30/96 - REVISED
A. GENERAL
1.
The well and septic plan are for a single family residence only.
2.
The drawing and or site plan shall be a part of this specification.
3.
All materials and workmanship shall meet the Anchorage Department of Health
requirements.
4.
All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
5.
All excavations and depths are advisory and are to be verified in the field by the
contractor to meet Municipality of Anchorage requirements.
6.
It is the responsibility of the owner to obtain all necessary permits or easements
and to locate any adjacent multi -family wells.
7.
The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
8.
It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
9.
Any remaining open test hole excavations shall be filled.
B. SEPTIC TANK
1. Septic tank shall be 1,000 gallon MOA approved.
2. If a lift station is required, a receipt from certified electrician stating the lift
station was wired to applicable codes to be supplied to Engineer.
C. TRENCH
1. The trench is to follow the natural land contour to maintain uniform total depth
of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
3. The total depth of the trench excavation is not to exceed 12' at any point.
4. The effluent line within the trench shall be laid level within 0.03'.
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or
equivalent is to be placed over the leachfield.
7. The area over the trench is to be finish graded to prevent ponding of surface
water runoff.
8. The septic tank and leachfield must not be closer than 100' to any existing
private well, 150' to any Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH = 12' GRAVEL DEPTH = 9' under pipe, 2" over pipe
TRENCH LENGTH = 42' TRENCH WIDTH = 3'
SOIL RATING= 0.6 GPD/ft2 BEDROOM CAPACITY = 3
SEPTIC TANK = 1,000 gallons
Twenty-four (24) hours notice required for all inspections.
\1996\96-013b-spc.doc
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907)694-5195
ERES Project No.: 96-013
Calculated By: LB
Date: 5/24/96
Legal: HAROLD MILLER LOT 2
Single Family 3 Bedroom Dwelling
TEST HOLE 3
Deep Trench Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom = 450 gallons
Percolation rate = 26.6 minutes per inch
Wastewater application rate = 0.6 gallons per day per square foot
Required absorption area = 750 square feet
Trench width (W) = 3 feet
Gravel depth (D) = 9 feet
Required length = Required absorption area / 2 / D
Required length = 750 / 2 / 9
Required length = 42 feet
Total Excavation Depth = 12.0 feet
49 TH
LDUIS A. BUTERA,
S'• CE -6736 ��
04��� � PROFESSIONP�����
SINGLE FAMILY ON-SITE WORKSHEET
i
ERES PROJECT NUMBER: 96-013
CALCULATED BY: LB
LEGAL DESCRIPTION: HAROLD MILLER LOT 2
NUMBER OF BEDROOMS: 3
WATER USE PER BEDROOM: 150
GALLONS
PERCOLATION RATE: 26.6
MINUTES PER INCH
DEPTH TO GROUNDWATER: 18
FEET
DEPTH TO IMPERMEABLE LAYER: 18
FEET USABLE SOIL STRATA
ANTICIPATED DEPTH OF COVER: 3
FEET TOTAL USABLE DEPTH: 12
MOUND OR BED SYSTEM
USABLE SOIL STRATA DEPTH: 9
WASTEWATER APPLICATION RATE:
0.45 GAUSQ.FT
ABSORPTION AREA REQUIREMENT:
1000 SQ.FT
MINIMUM BED LENGTH
12 FEET WIDE BED
83 FEET
15 FEET WIDE BED
67 FEET
TRENCH SYSTEM
WASTEWATER APPLICATION RATE:
ABSORPTION AREA REQUIREMENT:
SHALLOW TRENCH OPTIONS
5 FEET WIDE TRENCH
EFFECTIVE REQUIRED TRENCH
DEPTH (FT) LENGTH (FT)
1 131
2 105
2.5 95
3 88
3.5 81
4 75
DESIGN SPECIFICS
FIELD SYSTEM:
GRAVEL DEPTH:
TRENCH OR BED WIDTH:
LENGTH:
TOTAL
EXCAVATION
DEPTH:
0.6 GAUSQ.FT
750 SQ.FT
DEEP TRENCH OPTIONS
3 FEET WIDE TRENCH
EFFECTIVE REQUIRED TRENCH
DEPTH (FT) LENGTH (FT)
4 94
4.5 83
5 75
5.5 68
6 63
7 54
8 47
9 42
D (B=BED, S=SHALLOW TRENCH & D=DEEP TRENCH)
9 FEET
3 FEET
42 FEET
12.0 FEET
Eagle River Engineering services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
May 14, 1996
Dan Roth
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Harold Miller Lot 2
SW960091 Revision
Dear Mr. Roth:
We are requesting a revision of the above referenced well and septic permit issued May 29,
1996. The number of bedrooms has been decreased from four to three, the trench length
shortened accordingly, and the trenches rotated to accommodate a slightly different house
location.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\1996\96-013s-NAR.Doc
Eagle River Engineering services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
May 14, 1996
Jim Cross, P.E.
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Harold Miller Lot 2
Narrative & Permit Application
Dear Mr. Cross:
The proposed well and septic system will have very limited impact on adjacent properties for
the following reasons:
1. The surrounding lots are large, allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +30' distance.
3. Reserve space is adequate, due to absorption capacity and lot size.
4. Drainage will not be affected and is not a major consideration in our design.
The system is being installed on a lot that was filled with road material that has been in place
for over 10 years. We have excavated several test holes, selected the most favorable area and
performed multiple percolation tests. Test hole 3 was our most favorable test hole, and this is
being utilized for the design.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\1996\96 -013n -NAR
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 96-013
Calculated By: LB
Date: 5/14/96
Legal: HAROLD MILLER LOT 2
Single Family 4 Bedroom Dwelling
TEST HOLE 3
Deep Trench Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom =
Percolation rate =
Wastewater application rate =
Required absorption area
Trench width (W) =
Gravel depth (D) _
600 gallons
26.6 minutes per inch
0.6 gallons per day per square foot
1000 square feet
3 feet
9 feet
Required length = Required absorption area / 2 / D
Required length = 1000 / 2 / 9
Required length = 56 feet
Total Excavation Depth = 12.0 feet
.:'49TH*
. �....................
LOUIS A. BUTERA.
•• CE -6736
F� �'•�........••' FSO
�� PROF ESStoNPo�
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Harold Miller, Lot 2
05/14/96
A. GENERAL
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health
requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the
contractor to meet Municipality of Anchorage requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements
and to locate any adjacent multi -family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
8. It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
9. Any remaining open test hole excavations shall be filled.
B. SEPTIC TANK
1. Septic tank shall be 1,250 gallon MOA approved.
2. If a lift station is required, a receipt from certified electrician stating the lift
station was wired to applicable codes to be supplied to Engineer.
C. TRENCH
1. The trench is to follow the natural land contour to maintain uniform total depth
of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
3. The total depth of the trench excavation is not to exceed 12' at any point.
4. The effluent line within the trench shall be laid level within 0.03'.
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or
equivalent is to be placed over the leachfield.
7. The area over the trench is to be finish graded to prevent ponding of surface
water runoff.
8. The septic tank and leachfield must not be closer than 100' to any existing
private well, 150' to any Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH= 12' GRAVEL DEPTH = 9' under pipe, 2" over pipe
TRENCH LENGTH = 56' TRENCH WIDTH = 3'
SOIL RATING= 0.6 GPD/ft2 BEDROOM CAPACITY = 4
SEPTIC TANK = 1,250 gallons
Twenty-four (24) hours notice required for all inspections.
\1996\96-013a-spc
CDDRDS (X,Y)
A = 5000,5001 VACANT
B = 4720.37 1,4 99.4564 ►I
C = 4720.09 8,5 64.4562 I�
D = 4999.67 )Rt 164.9997
LOT 3
GARRETSON
LOT 3
C N 89°53'19" E D
.58
/0-2% +100•
O WELL
RESERVE AREA
TH2 Z TH1 /o-z% NTH3
3X60' TRENCH H
F—
F-
125D
—
F-
1250 GAL Cn
LL j0-2X SEPTIC TANK
N 0
° p p
APPROX UI LOT 2 IY / 0-2% UI F9
SEPTIC AREA p d o E�'
0
/I5-20% ¢ PROP WELL t7
PROP. F9 7Z7
GARRETSON HSE
L❑ T 4 PROP DRIVE
N 89°53'19" E A
B 27 9.6 2
c� FOUND CO
�
C AREA o
r SEpZI
-<NE 17' 33'
QW R
r1i AS pER
D
In
3 LOT 1
z
N — TEST HOLE
• — MONITOR TUBE
o — SEWER CLEANOUT
NO SURFACE WATER 4 - WELL
PROPOSED LEACHFIELD
NO KNOWN CURTAIN DRAINS - EASEMENT
WELL SEPTI C S0TE PLAN �.•eoF����
LEGAL: HAROLD MILLER LOT 2 Aw -� . • q�q If
OWNER: N A AW,`P..•'' S If,,
CONTRACTOR: HAGMEIER i * ;49TH
JOB 96-013A DATE: 5/13/96 SCALE 1" = 60' /�
.:
EAGLE RIVER ENGINEERING SERVICES ��� • '• LOUIS A. BUTERA ;' 4
� AO
CE-6736
P.O. Box 773294 I�64l4eP'Y0FESSlO0
'•.•••.• AV
(907) 694-5195 FAX.S(907) 694-3297 ��:�
t
Municipality of Anchorage
T DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: C0,9,5 -7
t./ o 'Q
4 11
PD u�b YY i!3�ed9gi.q.d(�306S.P;Ot P
iAsffA3SP8AP 9�1... ....09.9 Piq .F
e
iA Louis A. Butoro W,
CE -6736
040
d _
t� �dA ii re n°• �3 Avti.�
DATE PERFORMED: 3—aq— 96'
LEGAL DESCRIPTION: Peirold Itl12/' L 2 Township, Range, Section:
—rl/r DEPTH SLOPE SITE PLAN
r 77 '(FEET), i
1 �
2 6 SII 5�1- G
3
10 / WAS GROUND WATER
��I f Or9g7/CS/ w�ENCOUNTERED?
S
IF YES, AT WHAT 11/4 L
/� O
12 i00if �Oo12/ DEPTH? P
E
13 �ork 6ra..Pr�laek Depth to Water After AlIv 3-96
Monitoring? Date.
14
15
16--
17
SM. wi Th 0'Y/
' MoisT/ CX7runc/y
18 Lokes; ✓-e
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
/G-
Gc/
6' I): 'L -0
76 "
77 l//6'
77
20 PERCOLATION RATE113 (minutes/inch) PERC HOLE DIAMETER 6
TEST RUN BETWEEN S` FT AND 5K -E FT
COMMENTS
PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: '"
V
• Municipality of Anchorage .f, b�e a�>asD uml A>a:us ...Da •a �e+
DEPARTMENT OF HEALTH & HUMAN SERVICES
�
825 "L:' Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST rti
PERFORMED FOR: rrA9�zie/' Copi7% DATE PERFORMED:
LEGAL DESCRIPTION: 'yardId /"/i%ie/' L z Township, Range, Section:
T11� gEPTIj, SLOPE SITE PLAN
/ /, IFEETI
or hi c_S T_/ces
2
3-
4
5
6
7
8
10--
12-
13-
14-
15-
16
01213141516
17
18
19
20
COMMENTS
WAS GROUND WATER ,I /
ENCOUNTERED?
Pry
/ Va
5M, ✓ reYl Pry
IF YES, AT WHAT O
DEPTH? IVA � P
E
Depth to Water After
1�o 77or -;e %H Monitoring? 0N gate:
PERCOLATION RATE (mmuteslmch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
PERFORMED BY: �' `` _ I �-' '� CERTIFY THAT THIS TEST WAS PERFORMED IN
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L'• Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
F e o 4P
,.
N ER'S S�1SA
aere°aa of �wss=oc¢.;ao sH,.,.�n.r ..
p 313�Eggqq ea'0 8g0'J ex l6ea '+1
CE -6736
ipat
,' t• P
�+���/'ROFI:S5i0��`�
PERFORMED FOR: �Aq�7R /fir Co✓,s7 DATE PERFORMED:
LEGAL DESCRIPTION: ilg/'o/C/ 10i'liQ r L z Township, Range, Section:
—0rzPTH-j SLOPE SITE PLAN
5
6
7 Q.L
8
10-
13-
14-
is -
16
01314 1516
17
18 -i
19
5W/ yrowr7I
loose- Dry
ca he-,11�7n
13°77or V� 7/J
WAS GROUND WATER w/
ENCOUNTERED? O
S
IF YES, AT WHATL
I/A D
DEPTH? P
E
Depth to Water After
Monitoring? Jeri Date:
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
5-13-1 6'
76 " l6
Z
11:3o
$-n,'y
73'h6
"k,",
11•'3/
6 Q//s
y
lJ'y6fs
�,
7'7"/j
16116"
Il •' y
6 '°// �
78 a
20 Lj
PERCOLATION RATE 10-1 CL (minutes/inch) PERC HOLE DIAMETER 6
TEST RUN BETWEEN 5—'1 FTAND 6'S FT
COMMENTS
PERFORMED BY: ' -�`{-� 1"-` tel'"�'' CERTIFY THAT THIS TEST WAS PERFORMED IN
( t�;�
P49
w kER'SS°I£ T
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q A qh I)4A� 79 ?4RtC; eO 02@Ce
Municipality of Anchorage a
DEPARTMENT OF HEALTH & HUMAN SERVICES
-0650
825 "L" Street, Anchorage, Alaska 99502
A°q•Qfl�°:°�� ex
AW
SOILS LOG — PERCOLATION TEST R0cSSt3
PERFORMED FOR: 144 f-7-2/ e./' C-0pS7' DATE PERFORMED:
LEGAL DESCRIPTION: Nardil i /L%/ler• L 2 Township, Range, Section:
DEPTH I SLOPE SITE PLAN
Ty (FEE.TI' 1 IL -1.11 I
1r73�j1
2- 0 :-at
i-/
3 Q
4 `O t
5 -
6
7 Q C7
8
9
'Firow✓!t
10 WAS GROUND WATER /
�aoSe�p 5o,a ENCOUNTERED?
11
C_o HG5/bn IF YES, AT WHAT ,! L
DEPTH? r A P
E
Depth to Water After
13 Manitarinp? 12r�' pate: S"13-96
14-
15
4 15
16-
17
6 17
18
(3o rlo.+ -TH
19
Reading Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
re –iia0o,__.
1 5 -13 6
//'/
) Z3 )Y
)zs qhs
1 2/16
)r.
l23
/23
t Z//6
20
PERCOLATION RATE Z6' 6 (minutesnnch) PERC HOLE DIAMETER 611,
TEST RUN BETWEEN 1— FT AND FT
COMMENTS
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel 1. D. 017-432-46
1. GENERAL INFORMATION
Complete legal description Harold Miller Lot 2
Location (site address) 12500 Hillside Dr. Anchorage, AK
Expiration Date: 1(7 Z�i-20_ 2-
Current Property owner(s) Samual Beatty Day phone
Mailing address
Real Estate Agent
12500 Hillside Dr. Anchorage, AK
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class. Well
❑
Public Water System
❑
Waiver/Variance request for:
3
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ -I Q. 5 0 a V iD
Date of Payment % r21 " Z O
Receipt Number(j 0
COSA # o S ('Z d 1 3 q
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
Distance:
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my sea[ 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.
Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date ?/ 6?/Z.-
I
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. 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,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseen Awl a
encroachments, deficiencies or discrepancies exist. OF AZ Z��
6. DSD SIGNATURE
System #1 Approved for bedrooms.
System #2 Approved for bedrooms.
Disapproved.
71 U~
s
i" .r
Conditional approval for bedrooms, with the following stipulations:
m MsTs �� WATE z
�� ROGF�AM
By: Original Certificate Date:_ 141
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 isory
Well Flow Advisory Other Gtv�L
rncn nu,o r,aA7rtn_� rti_
a
Legal Description: Harold Miller Lot 2
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 7/23/96
Total depth 397 ft
Cased to 38 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 26 in.
Date of flow test for COSA 6/25/20
Static water level at beginning of test 48 ft.
Comments
B. TANK DATA
Age of tank(s) 24 years
Tank type/material S22tiic/Steel
Measured operating fluid level in septic tank 49"
Standpipes/foundation cleanout per record drawing
Date of pumping 7/7/20 r
D. ABSORPTION FIELD DATA
Parcel ID:
Structure served by this system 1
017-432-46
Well production at time of test 4.5 qpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes E Nc
Coliform bacteria is Negative
Nitrate 5.72 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L JJ Arsenic less than MRL (ND)
Collected by A.rcterra Consulting
Date of Sample 6/25/20 —
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Which system tested (date installed) 10/17/96
Adequacy test date 6/25/20
❑ ALL standpipes present per record drawing
Results ® Pass For 3 bedrooms
Total measured depth from grade 17 ft (max)
Fluid depth prior to test 49 in
Measured depth to pipe invert from grade 8 ft (min)
Water added 450 gal
❑ N/A — pressurized field
New depth 57 in
FINMonitor tubes go to bottom of effective. if not, state
Elapsed time 160 min
depth into effective
Code -required soil cover over field
Final fluid depth 49 in
❑ System presoaked
Absorption rate 450+ gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months)-
onths)
date
date of test)
Gallons introduced gallons
If yes, enter date
Comments/Deficiencies:
COSA Checklist yellow sheet
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'
Community Sewer Manhole/Cleanout > 100'
2 Yes
if No
ft
21 Yes
if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' [1 Yes
if No ft
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100''®Yes
if No ft
Neighboring Absorption Fields > 100'
Animal Containment > 50' Yes
if No ft
Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Yes
if No
ft
® 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
Surface Water? 100' ®Yes
if No ft
Property Line > 5' ® Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5' ® Yes
if No
ft
Private Wells > 100' ® Yes
if No ft
Water Main > 10' Yes if No ft Community Wells > 200' Yes if No ft
Water Service Line > 10' 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 If absorption field is under driveway comment below
Property Line > 10'f Yes if No ft Wells on Adjacent Lots:
Water Main > 10' Yes if No ft Private Wells > 100' 21 Yes if No ft
Water Service Line > 10' Yes if No ft Community Wells > 200' ® Yes if No ft
Surface Water > 100' ® Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that 1 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.
COSA Checklist yellow sheet
Septic 'Tank Advisory
Certificate of On -Site Systems Approval #OSC 201346
Subdivision: Harold Miller Lot 2
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 24 years old. Typical replacement costs range from $8,000 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 20 year old steel tank MAY look like.
'{s
;��..
"Box 196650 � Anchorages Alaska 99519 6650 *www rnun��org � �t ��
MUNICIPALITY
DEVELOPMENT SERVICES DEPARTMENT � A 907-343-7904
On-Site water and wastewater Section q Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC 201346
Subdivision: Harold Miller, Lot: 2
A water sample revealed a nitrate concentration of 5.72 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
���p:�� � ���� Ma�l�ng ��dress� P tl O� Box 196650 *NAnchorage,� Alaska 99519 6650 *www mum org � y � � N
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
� �� � $ Mailing Address P ;:O Box 196650`- *Anchorage, Alaska 99519 6650 www muni org ��
On -Site Water and Wastewater Progr APR 0 8 2016 n "
(907) 343-7904
Certificate of On -Site Systems App
Parcel I.D. 017-432-46
1. GENERAL INFORMATION
Complete legal description Harold Miller, Lot 2
Location (site address) 12500 Hillside Dr.
D th R. H Id KA;
Expiration Date:
Current Property owner(s) Oro y aro I er Day phone _
Mailing address
Real Estate Agent
4 Forjador Ln. Hot Spring Vlg. AR 71909
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
F1
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
Waiver/Variance request
Received by: e
vLT�i
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ GJ Waiver Fee $
Date of Payment Date of Payment
Receipt Number bje jA 5G) Receipt Number
COSA#— OSLI i,' 11 � ` 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-Sfte;-Systemg-=approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is (are) safe, fundtiohartrid 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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations. The reported results describe 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 soil
condition, ground water 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 this system- All systems eventually fail and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for bedrooms
Disapproved
Date 4/8/2016
®nm.�
• , Steven R. , NAI
iq ••. CE -8149
Conditional approval for bedrooms, with the following stipulations:
0
The Municipality of Anchorage Development Services
Original Certificate Date: Y = tz'—/ lc�,
(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 grrors or omissionsjh•the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSAbluesheel t c
If more than 1 septic system is on the lot:
COSA Checklist # ? of
Structure served by this system 1
Certificate of On -Site Systerns'Approval Checklist
Legal Description: Harold Miller, Lot 2 Parcel ID: 0.17-432-46
A. WELL DATA
Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y
Date completed 7/23/1996 Sanitaryseal (Y/N) l Wires properly protected (YIN) Y
Total depth 397 ft. Cased to 38 ft. Casing height (above ground) 12+ in.
FROM WELL LOG
Date of test 7/23/1996
Static water level 170 ft
Well production 15 9.p -m.
WATER SAMPLE RESULTS:
Coliform Neg colonies/100 mL Nitrate ND mg/L
Arsenic ND ug/L Date of sample: 3/25/2016
B. SEPTICIHOLDING TANK DATA
AT INSPECTION
4/5/2016
49 ft.
2.9
Collected by PES
g.p.m.
Tank Type/Material Septic/Steel - Date installed 10/17/1996.
Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over
/tank (Y/
N) N High water alarm (Y/N) N
Date of pumping / 1 6Q, G Pumper
C. ABSORPTION FIELD DATA
10/17/1e96 2 0.45 SF/BR Deep Trench
Date installed Soil rating (g.p.d.IFt or ftz/bdrm) System type
Length 57 ft. Width 3 ft. Gravel below pipe 9 ft.
Total depth 16 ft. t �Eff.,abtorption area 1,026 ftz Monitoring tube Y Depression over field N
Dateof adequacy test 4/7/2016 Results (Pass/Fail) Pass FDF -3
bedrooms
Fluid depth in absorption field before test 28 in; Water added 472al _.Nei✓ depth 42 in.
Elapsed Time: 1440 min. Final fluid depth 28 in. - Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo:) (YIN & type) No If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. °Pump off" level at in. High water alarm level at
Datum. Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+
Absorption field on. lot 100+
Public sewer main 75+
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout 100+
Sewer /septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 20�, 0+
ABSORPTION FIELD ON LOT TO:
Property line10+ Building foundation 10+ Water main 10+
Water Service line 0+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+; Wells on adjacent lots 200+
F. ,COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and
review of Municipal records that the above systems are irL.
conformance with MOA COSA`guidelines in effect on this date.
Engineer's Printed Name even Pannone
Date 4/8/2016
COSA canary sheet_2-6-15.doc
in.
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UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUSWNG BOUNDARY OR FENCE LINES.
THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY
AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY,
LISTED DISTANCES PREVAIL OVER SCALING, REPRODUCTION MAY CAUSE ERRORS IN SCALE.
LOT WRSEY SURVEY TYPE
SYMBOLS
FOiNSATION AS -BUILT
> SET REBAR ww ASPHALT
DRAINAGE
0 FINAL MUCTUP.E A5 -BUILT
D POUND REBAR B-.•-t�—e• .WOOD FENCE CONCRETE
0 PLOT PLAN ... AS-SULT ... LOT SURVEY ... TOPOURAPHY
d—..t:-o-:�,.
W R ASSUMED ELEV. n—*—K METAL FENCE 1ts:.LG.7 WOOD DECK
A L^L mas SET RTT aRNEA5 SET
PLOT PLANS & LOT SURVEYS
ROTE
IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO
ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS. DRIVEWAYS,
TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE
ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY, .$NOW
THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS
MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED,
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT,
ALL DISTANCES ARE: RECORD UNLESS OTHERMSE NOTEO. '.
SURVEY CERTIFICATION
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Prepared by
Robert E. Johns, Jr. & Assoc..
PLOT PLAN
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Professional Land Surveyflrs
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FOUNDATION AS -BUILT
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Date Sur"ytd:
03129116
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Date Drawn:
03131116
2839
16-84
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FINAL STRUOTURE AS -GIRT
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Lot 2,„
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HAROLD MILLER
Parcel I.D. #
1
MUNICIPALITY OF ANCHORAGE
• '� DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6MONICIFAL�TY of Aracr+oKAoe
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING a, q
017-432-46 HAA# 0" 1�C)�- `
GENERAL INFORMATION
Complete legal description
Harold Miller
Lot 2
Location (site address or directions)
NHN Hillside Drive, Anchorage
Property owner Harold Miller Day phone 694-5195 msg
Mailing address 12550 Hillside Drive, Anchorage, AK 99516
Lending agency n,/n Day phon
Unilinn nHHracc
Agent N/A Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well X
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 X
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.
12-025 (Rev. 1/91) Front MOA #21
5.
6.
M
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm Eagle River Engineering Services Phone
694-5195
Address P-0- Box 773294 Eagle River Ak 99577
Engineer's signature - Date ���L91Ae
U
DHHS SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for
Additional Comments
bedrooms, with the following stipulations:
Date 31 /'
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Heae kAhority
Approval Certificates based only upon the representations given in paragraph 5 above by an :)endent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchase...4 homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025(Rev.1/91) Back MOA#21
#R•a§ems a I-`$:xef4t t�� 2
}
low A_
Pis'
y e ir; r. •^
bedrooms, with the following stipulations:
Date 31 /'
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Heae kAhority
Approval Certificates based only upon the representations given in paragraph 5 above by an :)endent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchase...4 homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025(Rev.1/91) Back MOA#21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
�\ Environmental Services Division
�I 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
D 10
Health Authority Approval Checklist
Legal Description: /-1/i'eo4z) A4 -t -c -,e 4-07-2-- Parcel I.D.: e7/9- lf3Z' Lib
A. WELL DATA
Well type /-)/Z/ Vyi TE If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) y`S Date completed 7/9(/
Total depth
Cased to 3b L Casing height (above ground) �i l
Sanitary seal (Y/N) YC -5 Wires properly protected (Y/N) YL%s
FROM WELL LOG
Date of test 'o % 910
i
Static water level /20
Well production / 9 -P.M.
WATER SAMPLE RESULTS:
Coliform --a Nitrate / `� !� % C� IL, Other bacteria
Date of sample: �5 9la Collected by: G
B. SEPTICMGLDING TANK DATA
9 -P -111 -
Date installed Tank size 4,900 0 Number of Compartments Z— Cleanouts (Y/N) ti[
Foundation cleanout (Y/N) %S Depression (Y/N) O High water alarm (Y/1) N 1A
Date of Pumping NMW Pumper
C. ABSORPTION FIELD DATA
Date installed d Soil rating (g.p.d./ft2 or-fi2/bdrm) 1�. �iS System type
Length S%Width Gravel thickness below pipe Total depth
'SF ���
Effective absorption area �d� v Monitoring Tube present(Y" V6S Depression over field (Y/N) i v
Date of adequacy test /p/c -/-o Results (Pass/Fail) PA SS For bedrooms
Fluid depth in absorption field before test (in.); Immediately after_ gal. water added (in.):
Fluid depth (ins.) Minutes later: Absorption rate = g.p.d.
Peroxide treatment (past 12 months) (Y/N) If yes, give date
D. LIFT STATION 144
Date installed
Manhole/Access (YN
High water alarm level at*
E. SEPARATION DISTANCES
Size in gallons
*Datum
SEPARATION DISTANCES FROM WELL ON LOT 'TO:
Septic/holding tank on lot
Absorption field on lot
at* "Pump off' level at*
2'
On adjacent lots
)�/DD
i
L ; On adjacent lots 4-/00,
Public sewer main N14 Public sewer manhole/cleanout 1-1,4
-Sewer /septic service line / S Lift station MA
SEPARATION DISTANCES FROM SEPTIC/H'5 NG TANK ON LOT TO:
Building foundation
SQ/
Property line
Absorption field.
Water4nain/service line ) Surface water/drainage "100 / Wells on adjacent lots 711_/O0
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation Property Line S Waterr-mairdservice line _
Surface water - W i
Driveway, parking/vehicle storage area �Q
i
Curtain drain /I ONE A/0P4r���Wells on adjacent lots 74,1D('
F. ENGINEER'S CERTIFICATION
I certify that f have determined thru field inspections and review ofMunicipal records that th"e)above syst&fis or
in conformance with MOA HAA guidelines in effect on this date. }t.
Signatures -�
AAA Fee $_ )QC) , c)U Waiver Fee $
Date of Payment IC)- Q � Date of Payment
Receipt Number C)nS-)ln Receipt Number
Rev. 8/95 OSS: haa.wk.doc