Loading...
HomeMy WebLinkAboutNAVROT LT 2Navrot Lot 2 #015-271-59 Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141277 PID Number: 015-271-59 ❑ New ❑✓ Upgrade Name: Timothy and Barbara Weiss ABSORPTION FIELD ❑ Deep Trench Z Shallow Trench ❑ Bed ❑ Mound Address 11000 Navrot Circle Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.0 GPD/SF 9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5 Ft. Gravel depth beneath pipe 4.OFL Subdivision Block Lot Navrot 2 Fill added above original grade - 0-1 Ft. Gravel length 46 Ft. Township Range Section Gravel width 5Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES TO Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 460 Ft2 One Ft. well >100' >100' N/A N/A >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Gal. Surface Water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain None Noted Pump on level at Pump off level at High water alarm at RemarksTank inspected and verified suitable for in. in. in. continued use. Flow Diverter Valve placed and existing trench connected for future use. Pump make and model Electrical Inspections performed by PIPE MATERIAL Housetotank D3034 Tank to drainfeld D3034 Installer Pomraning Excavation Drainfield HDPE COfMT D3034 Inspector MEA BENCH MARK (Assumed elevation) 100.Oft Inspecilon1g 7/30/14 7/30/14 Location and description 2w Garage Slab. 3" 7/30/14 4'" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL O Conditional Approval: Date�Q'��. ••� 4918 So- .. , .. .... �.... /.NI NW..NY ......•.. . MICHARL E ANDERSON CE-4381 ApprovedDate Inspection Reedit 1-1lf2b1oc Z," FIREWEED HILL SUBDIVISION Pa LOT 11 I LOT 1 LOT 2A PerrmitmitNumber: OSP141277 PID NO.: 015-271-59 o j LOT 2 D M N N w a � a � i ij MICHAEL E� ANDERSON: NO. CE -4381 ti4 F j\\ Fin, UTILITY EASEMENT NAVROT SUB. LOT 2 53,278 s.f. 1 Mew 4Rx ' Wide Long 5 Absorption Trench A B FDV 19.9' 45.1' C4 44.7' 70.4' M1 39.4' 64.5' 05 32.5' 30.3' LOT 3 GAS EASEMENT LOT 1 0 Z �< �I mho � I PLAN AS BU LT SCALE V = 50' LEGEND M1 - Monitor Tube FCO - Foundation Clean Out TH - Test Hole C5 - Clean Out St - Septic Vent 2CO - Double Clean Out Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP141277 1,000 Gallon Septic Tank NOTE: Existing Septic Tank inspected and verified suitable for continued use. Flow Diverter Valve placed and existing absorption trench tied in for future use. PID No. 015-271-59 7-30-14 PROFILE AS -BUILT - No Scale 82.6 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141277 Tax Code Number: 01527159000 Work Type: Septic Upgrade Permit Effective Dates: July 29, 2014 to July 29, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: NAVROT Site Legal Address: NAVROT LT 2 G:2634 Owner/Address: WEISS TIMOTHY J 50% & --/--3 a _/i c 3 WEISS BARBARA J 50% 11000 NAVROT CIR ANCHORAGE AK 995161446 Site Mailing Address: 11000 NAVROT CIR, Anchorage This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 53278 Total Bedrooms: 3 N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By, MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION % '? ASH, i 7V a Parcel I.D. 015-271-59 1 Property owner(s) Timothy and Barbara Weiss Day phone Mailing address 11000 Navrot Circle Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Navrot, Lot 2 Legal description (Township, Range & Section) Lot Size 53,278 Sq. Ft. Number of Bedrooms Three APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ElUpgrade ❑X Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ r - ' (SF and/or D) Private Well ❑ t RUSH! %nR�� '�i ®�� `„� Water Storage ❑ e THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: JUL 2 8 2014 L Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. �% 4 C..� (i(;c d, (Signature of property owner or authorized agent) CWA; Permit/Rush Fees: pit% Waiver Fees: _ Date of Payment: 3174111 Date of Payment Receipt Number: OL (.A Receipt Number: Permit No. otX 1, { 11;1-11 Waiver No. PemtApp_ -_ ANDERSON ENGINEERING `P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) July 28, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 2, Navrot Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The absorption system on the subject lot has failed and must be replaced prior to the issuance of a COSA. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing septic tank will be uncovered, inspected and verified suitable for continued use. The existing absorption trench will be left intact and tied to the new system with a flow diverter valve. Also identified on the plans are the locations of the existing well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot when the initial system was constructed indicated Silty Gravelly Sand (SP/SM) in the absorption zone of the trench. The percolation rate was determined to be less than 1 minute per inch. We have designed the new trench with an application rate of 1.0 gallons per date per square foot. We are proposing to place a 45' long trench by 5' wide with a 4' effective depth. The total depth of the system will be 9' with the distribution line at 5' below the existing surface. A flow diverter valve will be placed and the existing absorption trench will be tied in for future use. The ground surface on the lot slopes to the southwest in the area of the absorption trench. The trench will be placed parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the proposed well and from any Lot 2, Navrot July 28, 2014 Page Two surface water in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, jv�(:�- a4'�' Michael E. Anderson, P.E. Attachments NAVROT SUBDIVISION LOT 2 53,278 S.F. 10' Utility Easement i________________e_______ I � 1 i Existing ®ng i 150_ Radius— ll IExisting ___ ------ Class C Well LOT 2 ®well HOMAN ACRtS I LOT 3, NAVROT `C I — — 45' Long x 5' Wide I ------ — MT x 4' Effective Depth CO I Absorption Trench TH 10 I 1,000 Gallon FD Septic Tan C0; LEGEND SV ��� Three Bedroom Home TH50 Existingg 38' Lon MT — Monitor Tube MH — Mon Hole FCO Clean AN;?ion TrencF Out Try E OF WORK j �� i _Test Hole Co — Clean Out Integrity of Existing / �N FSV — Flow Splitter Valve 2CO — Double Clean Out Gallon Septic Tank for ued Use. Place Flow �� 1 r Valve and Constructng x 5' Wide x 4've *LOT Depth Absorption. Connect Existing j Existing for F u e Use.®Well 'l �q' , •LOT 1, DAS ACRES ' 1 � ExistingODWell 1\ ' ` Not .1••C�+OF + 5' G Easemas ent ................ p� Z i0 If 49tSE} �....... .... ....... .....:....� o NOTE: /.......................................... � MICHAEL E. AN➢ERSON j j: LAN I � A r No Areas of Excessive Slope or Surface Water are Within 1. of Any Part of the C i Fr1 N New Septic System. No Wells or Wastewater I♦rf i, NO. CE -4381 •' �� �j: Systems on Adjacent Lots Conflict with the Proposed Septic System. •p L&;+ .PAF iAV SCALE V = 50' ���1h'OFESSI��O LOT 2, NAVROT SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS Three Bedroom Home 5' Wide Trench System Perc. Rate: <1 Min./Inch Verify Existing 1,000 Gallon Septic Tank Application Rate: 1.0 GPD/SF 4' Drainfield Rock 3 Bedrooms * 150 GPD/Bedroom = 450 SF Absorption Area 450 SF/1.0 GPD/SF/5 SF (Width) *.5 (Red. Factor= 45 LF Trench Length THEREFORE: Construct a 45' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trenches to be 5' Below Original Ground Surface. Total Depth to be 9' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. Place Flow Diverter Valve and Connect Existing Trench for Future Use. 5' i TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) i� NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. �.....: Minimum 4' Separation From Groundwater. 7V Minimum 100' Separation From Private Wells in the Area. Minimum 100' Separation From Surface Water or Streams: *k, 49th MICHAEL E. ANDERSON 11 No. CE433i ra FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 2, Navrot S/D DATE PERFORMED: August 3, 1994 PERFORMED FOR: Jerry Nancnn COMMENTS: Pt SM Reddish sandy Ioam GM Sandy silty gravel Many boulders lenses of SP SP/SM Silty gravelly sand Silt content variable Becomes sillier below I D.H. Depth to Groundwater Date o roue water onitor tube dr 8116/94 U) O J Vl �`� .��Tl�(� '•AAS"'� THEODORE P. 3AUORC �• •,, CE - 3589 Y • �p ` Aquo' SITE PLAN 25% ck e T.H. Percometer Reading Net Drap {Inches) 8 4 1 reso o #1 2 PROP. 300 j05 kNaime T.H. 4 BDRM 25% #5 OUSE / 2 3 8 #1 A water 23 3 8 Add water #3 10:55:25 10:56:00 1U: 1! 1 215/8 g 2158 /4 134 Add water I 10:57:45 233/8 #4 15%O 0161 3 4 .o of Ui Gi W. NAVROT Date Reading ck e (minutes) Percometer Reading Net Drap {Inches) 8 4 1 reso o 2 300 j05 kNaime 23 3 8 4 Add water 15 273/8 Start 2 3 8 #1 A water 23 3 8 Add water #3 10:55:25 10:56:00 1U: 1! 1 215/8 g 2158 /4 134 Add water I 10:57:45 233/8 #4 0161 3 4 PERCOLATION RATE <1 (minutesAnch) PERC HOLE DIAMETER g TEST RUN BETWEEN 7.5 FT AND 8.0 FT PERFORMED BY FLATTOP TECHNICAL SERVICES. I `��j'L,,.,,,,_ CERTIFYTHATTHISTESTWASPERFORMEDIN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECTON THIS DATE. DATE: /fiery "J" 26 /9,9y TEST HOLE # $ LEGAL DESCRIPTION: Lot: DATE PERFORMED: Aul PERFORMED FOR: ]err DEPTH (feet) Pt P. FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Hanson SM Reddish Sandy Loam SP/SM Silty gravelly sand Similar to T.H. #1 Lenses of clean sand below 9' I1 SLOPE Depth to Groundwater I Date Lu a O W f .. a.a 1....fa...•.. c3a f THEODORI 1'..'OORE "•a CE -3589 �L 4nfsf ��a.yi,.•,f� GQ• SITE PLAN 25% Clock Time T.H. Percometer Reading `— #1 PROP. T.H. BDRM 25% t!5 OUSE / 15% ;its.;.:... NAVROT Date Reading Clock Time Not Timo (minutes) Percometer Reading Net Drop (inches) L-1 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN_ FTAND FT COMMENTS: Recommend that soil absorption system be constructed in area characterized by test holes 01 and 415. PERFORMED BY FLATTOP TECHNICAL SERVICES. I 1•-�"� ln'o ,L. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECTON THIS DATE. DATE: 2CS /99 /146-- A Municipality of Anchorage Page I of 3 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 94 03 42 PID Number: OI 5 2`7 15 9 Name: DoN ALD FINCH Wastewater System: 5rNew []Upgrade Address: Il000 NAVRoT CIR ANCI'I 99Sf� ABSORPTION FIELD Phone: 35"y-� IS'3 No. of Bedrooms: 3 peep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: I' 2 Total Depth from original grade: ID r GPD/Sq. Fl. Lot: Block: Subdivision: 2 Depth to pipe bottom from original grade: Gravel depth beneath pipe N VRo-r 5 FL S Ft. Township: Range: Section: Fill added above original grade: Gravel length: O Ft. 39 Ft. WELL: New ❑Upgrade Gravel width: 2-5- Number of lines: I Distance between lines: Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. 390 SQ. FI. L'I peg F F -8!O Driller: - ALPINE DRILLING Date Drilled: Static Water Level: Installer: 4Cj)CSon Enhir Date in ailed: l0 1 94 Ft. riles Yield: I Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Xseptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines n tACNotz GAE -TANI< )000 W811 125 I 12 $ f .,- I r 3O Material: STEE L Number of Compartments: 2 SurfacWaters >lOg1 7!001 — 7/001 LIFT STATION LotC. I J 351 -... / O I Size in gallons: Manufacturer: Line a Foundation I o f 23, .— _ "Pump on" level at: 'Pump off' level at: High water alarm at: CurtainPump Make & Model Electrical Inspections performed by: Drain _ - — — Remarks: S� darn /nrlall « BENCH MARK ' voV�toC_ Grepq _ Location and Description: I TOP of FouNDAT+Ot.t NORTH EAST CORNER Assumed Elevation: 100,0 ENGINEER'S SEAL , rU"''V Fe.ATroP 0131 y1 • '�^.i1 .ry • r Inspections performed by: TEcN . SVCS. Dates; 1st_�y :/,..........'.....:r'%,, v.�,- 2nd )0) 0>�41:�°.........I......�. Department of He lith, a d Hu an-Se"rvices approval . T1-Ic0DOi E F. ,MORE CE - 3589 .; is Reviewed and approved '� ��— Date: _ �` �R �'r�`•°••.. ��'�a9 Permit No, SV q�ID 3 42 Page _ 2- of 3 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 2 NAVRoT PID No.: 01527 159 WELL A /FouNrMTia 3 -DORM SEPTIC 'Tf1Nk C.O. I 3-1 i 10.5 TRE NCH )=ND C.O. Sa 55 72013 A (1/03) - ..S1rPT1C..,.-7AIAk................... E I6....r4o. I. - G M ENGINEER'S SEAL NAVR�T I �r Gr t A,f p rw y�rerian Rp s'd�. C IRC.LGc .ey"�kb1'ri fr •w,n �y +ini �� °i�. 't�TMri Yrr rrii00ni 4v1°fr >t,";.� :A1 90�r.i..J ebJ I V. 77A F. !AO08(: �• fel. Permit No. 5w 3403Li2 Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 o Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 2 NAVRo-F PID No.: 015-2-7159 From : ALPINE DRILL 907 3450202 LOCATION OF WELL 80i10UGH I SuilDrVIe1ON LOT I BLOCK TOWNS"IPRANOE LOCATIONISKETCH: - Conk. - I ���' Apr.03.1995 08:07 Ph1 P01 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF WATER WATER WELL RECORD =110% WAS SECTION TOWNS"IPRANOE MERIDIAN CIN CIE ®s C7w WELL. OWNER: rj DEPTHS MEASURED FROMUcasing top Oground surface WEL' DEPTH: DATE OF COMPLETION Depth of hole: It BOREHOLE DATA: Depth Depth of casing. Material Type and Color From To DEPTH TO STATIC WATER LEVEL: :Z (f____jt below )a top of casing ground surlece METHOD OF DRILLINO: ^alr rotary ❑ cable tool 0 other ^ USE OF WELL:*<domestle O Irrigation 0 monitor _ C] public supply 0 other _ ,,,.._ CASING STICK. P: ft. Diem: In. ts61ft /W.7 Casing type: ti in, tot-26/jt WELL INTAKE OPENINQ TYPE; Aopen end 0 screened C] perforated C] open holo r Depths of openings: --to ft P 1 SCREEN TYPE: --In. Slot/Mash Size: Length:pth: ft ~�� ® GRAVEL PACK TYPE - �} � (/ Volume used: Depth to top: GROUT TYPE: Volume: ]C Depth: from It to It R L. C E I V D DEVELOPMENT METHOD:� —-- Duration• APR 1 3 19 J PU�jPLtC LEVEL AND YJ LD: Evi ToW ft after hrs pumping k Qpm Municipality of An hi:PUMP INTAKE DEPTH: _ It Horsepower: _ Dept. Health & Hum Servic S WELL DISINFECTED UPON COMPLETION? 0 YES 0 NO CONTRACTOR INFORMATION: REMARKS: A eg stere uskness amu PLEASE MAIL WHITE COPY OF LO® TO: ONRIDIVISION OF WATER lgnatur o Authorized RespiesentativIiate PO BOX 772116 Off' -111 r y EAGLE RIVER AK 99577.2116 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:SW940342 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:FINCH DONALD L & BETSEY A OWNER ADDRESS:11000 NAVROT IR ANCHORAGE, ALASKA 99516 PARCEL ID:01527159 LEGAL DESCRIPTION: NAVROT LT 2 LOT SIZE: 53278 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 9/12/94 EXPIRATION DATE: 9/12/95 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) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: DATE: ISSUED BY: ��C�,,,. t/%� z/ ��re DATE : _!?_-_-/2 " l µ CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: August 26, 1994 14530 ECHO ST, ANCHORAGE, ALASKA 99516 The purpose of this letter is to provide the required design narrative in support of our application for a permit to construct water supply and wastewater disposal facilities on Lot 2, Navrot S/D, located at 11,000 Navrot Circle. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed wastewater disposal system will be constructed between test holes #1 and #5. As can be seen from the soil log for test hole #1, the native material between 5' and 17' below ground surface is a variable silty gravelly sand with a measured perc rate of slightly less than 1 minute per inch. Because the receiving soil is classified as sand and no shallow water table was encountered, there should be no need to install a sand filter, and thus a trench type soil absorption system can be used. Using the soil application rate of 1.2 gpd/sq. ft. specified in the wastewater ordinance for soils with measured percolation rates of less than 5 minutes per inch, this 3 bedroom residence requires a total absorption area of (3 x 150)/1.2 375 square feet. The proposed 38 foot long trench design with 5 feet of sewer gravel beneath the horizontal distribution pipe has a total absorption area of 380 square feet. A suitable site for an equivalently sized replacement trench is designated on the site plan. The topography of the lot includes a knoll composed of silty gravelly sand located near the southwest portion of the lot. This is the area where the house and on-site soil absorption system are proposed to be constructed. The northern portion of the lot is low lying terrain characterized by poorly drained slow perc'ing soils. The proposed project will have no impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space/surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, J.—c.�.�%'1•o-mac_ Ted Moore, P.E. BLM LOT 11 LOT 1, BLOCK 2 c90Li LOT 2 FIRE WEED HILL A---------- LOT 2 HOMAN ACRES I I 1 1 ' 1 K 1p0, \ L LOT 2 \ NAVROT S/D \ — -----1400" I �I PROPOSED I WELL T.H. I #4 11 T.H. / ' #2 L i i i i T.H. �#3 #1 REPL I AGEMENT_ LOT 3 I LOT 4 / 1' ------------------------ / / i i TRENCH SITE INSTALL 38' LONG 3 BDRM HOUSE INSTALL _ 1000 GAL SEPTIC TANK LOT 1 DAS ACRES HOUSE / / *gJ•L Tbt�r` d SOIL ABS. TRENCH W. 5' SEWER GVL. ••• -- - - - - - SEPTIC SYSTEM THIS AREA • •• e•.•.•• THEODORE F, MOORS' ,� •r CE - 3589 �` s LOT 3 NAVROT S/D SEPTIC SYSTEM THIS AREA WELL / NAVROT CIRCLE X( LOT 2, NAVROT S/D WELL AND SEPTIC SYSTEM SITE PLAN FLATTOP 1 INCH = 50 FEET ANCHORAGE, ALASKA 99516CES I DRAWN AUGUST, 994 14530 ECHO STREETA I NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. MONITOR-\ ® 38 "A" TUBE °a=::—=___________===_=o 38' LONG SOIL ABS. TRENCH WITH 5' GRAVEL BENEATH PIPE „A„ CLEANOUT GALLON SED�SEDPTIC TANK -' u DOUBLE PLAN VIEW SCALE: 1 of = 10'-0" MONITOR TUBE 3 SECTION "A - All SCALE: 1 " = 5'-0" '• .'0... ... 1 ....... Y} THEODORE K. AAOORt rt° '•�4 CE - 3589 4v ark•*4. i..44'•iz, y Ifattop 7echnica(Services 14530 Echo Street, anchorage, AK99516 Phone (907) 345-1355 Lot 2, Navrot S/D 11000 Navrot Circle Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installation of a 1000 gallon septic tank followed by a 38 foot long soil absorption trench containing a total of 5.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The new 1000 gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 38 foot long trench in the approximate location shown on the site plan. The total depth of the trench shall be 10 feet, with the longitudinal axis of the trench being parallel to the natural contour of the original ground. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to, allow proper infiltration, 3.3 A total of 5.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 5.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minirnum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 2, Navrot S/D DATE PERFORMED: August 3, 1994 PERFORMED FOR: Jerry Hanson nro7u COMMENTS: Pt SM Reddish swidy loam GM Sandy silty gravel Many boulders lenses of SP SP/SM Silty gravelly sand Silt content variable Becomes sillier below 12' SLOPE ................. 20%: 0 .. / 15%.... Depth to Groundwater Date No groundwater 8/3/94 Monitor tube dr 8/16/94 W CL O AV "•+i � '. TMEODORE i. �OORE ; ,. . 1.z r 0: SITE PLAN 25% Clock Time T.H. Percometer Reading Net Dro (inches 8/3/9412" Presoak 10:49:00 #1 27 3/8 f PROP. 10:50:30 10:51:15 1:30 T.H. 4 #1 BDRM 25% #5 Add water OUSE / l� 10:55:25 10:5600 10: 7:00 10:57:45 1 1 21518 23 3/8 215/8 233/8 1 3/4 13/4 #4 10:58:45 1 215/8 13/4 .s r s?,� 15% NAVROT LE Date Reading Clock Time Net Time (minutes) Percometer Reading Net Dro (inches 8/3/9412" Presoak 10:49:00 27 3/8 Add water Start1-0,31-45--23 10:50:30 10:51:15 1:30 23 3 8 273/8 3/8 4 #1 3 Add water 233/8 #2 Add water #3 Add water 10:55:25 10:5600 10: 7:00 10:57:45 1 1 21518 23 3/8 215/8 233/8 1 3/4 13/4 #4 10:58:45 1 215/8 13/4 PERCOLATION RATE <1 (minutes/inch) PERC HOLE DIAMETER 8 TEST RUN BETWEEN 7.5 FT AND 8.0 FT PERFORMED BY FLATTOP TECHNICAL SERVICES. I T "e CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Acer l' 26 19,9y FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 2 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 2 Navrot S/D DATE PERFORMED: August 3, 1994 PERFORMED FOR: Jerry Hanson DEPTH SLOPE (feet) Pt 1 SM Reddish sandy loam XXI2 3 GP/GM Silty sandy gravel 4—. . 7 8 SM/ML Fine sandy silt Soft, saturated at 8' g Drier below 10' 11 12 13 14 15 16 17 18 19 B.H. Depth to Groundwater Date No groundwater seen 8 3 94 w a O SITE PLAN T.H. #4 16 rn T.H. #2 c Q� A T.H. #3 53.4 T.H. #1 PROP. 3 BDRM HOUSE T.H. #5 .......................... .......................... 10% 0% Date Reading Clock Time Net Time (minutes) Percometer Reading Net Dro (inches JPERCOLATION RATE (minuleslnch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS: No monitor tube set. Soils not desirable for construction of on-site soil absorption sstems. PERFORMED BY FLATTOP TECHNICAL SERVICES. I5j ..� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /7-el9 W l- 2G l99y V FLATTOP TECHNICAL SERVICES 14530 ECHO ST, ANCHORAGE, ALASKA 99516 TEST HOLE # 3 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 2 Navrot S/D DATE PERFORMED: Aueust 3, 1994 PERFORMED FOR: Jerry Hanson DEPTH SLOPE 1 SM Reddish silty sandy loam May be fill material Log found at 5' 4 5 7 SM Silty Sand Pockets of ML 8 10 ML Sandy silt Pockets of SM B.H. 12 13 14 16 17 i Depth to Groundwater Date No roundwater seen 8 3 94 W IL O rn �r :.49TH W, •" •a.a ••••.•• a ••f•••••ei.'v�•� ,�i•THEODORE �. „hOORc ". CE - 3 c 9 a t� ,' • Y f ..... • • uCa Y. SITE PLAN T.H. #4 16 rn T.H. #z 6 F T.H. #3 53.4 T.H. #1 PROP. 3 BDRM HOUSE T.H. #5 Date Reading Clock Net Time Percometer Net Dro Time (minutes) Reading (inches PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FTAND FT . COMMENTS: No monitor tube set. Soils not desirable for construction of on-site soil absorption systems PERFORMED BY FLATTOP TECHNICAL SERVICES. 1_7�r%%tr,.`` CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: -,7 - ZG 799 y FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 4 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 2. Navrot S/D DATE PERFORMED: Aueust3.1994 PERFORMED FOR: Jerry Hanson DEPTH :::::::::::::: SLOPE (feet) 1 SM Brown sandy nd loam ML Gray sandy silt 4 5 .................. 15 16 17 18 19 Depth to Groundwater I Date . aver•. °�.+.. •.�..... y. 31 � °•i Cr- - 3539 ,•` ,f.y �' f4'} '+., n••,. r Vie, SITE PLAN T.H. #4 16 T.H. y moo. #2a, T.H. #3 53.4 7T.H. #1 s) � PROP. 3 BDRM HOUSE T.H. #5 0% ........:.....:. f 10% Date Reading Clock Net Time Percometer Net Dro Time (minutes) Reading (inches L_J PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FTAND FT COMMENTS: No monitor tube set. Soils not desirable for construction of on-site soil absorption systems. PERFORMED BY FLATTOP TECHNICAL SERVICES. I �� %_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: d"5:5'rl- e6- V FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 5 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 2, Navrot S/D DATE PERFORMED: August 3, 1994 PERFORMED FOR: Jerry Hanson DEPTH SLOPE (feet) Pt F. SM Reddish Sandy Loam SP/SM Silty gravelly sand Similar to T.H. #1 Lenses of clean sand below 9' COMMENTS: Recommend that soil Depth to Groundwater Date No groundwater 8/3/94 Monitor tube dr 8/16/94 W o. O fib••... Y..• ri...,/iy,. ar'G. 'a�e'�it. THEODORI F. :',QORE f}t `•� CE -3589 •� ' S��1 �11`tin '•.aa.....•• C'y� SITE PLAN 25% Not Time (minutes) T.H. Net Drop (inches) #1 PROP. T.H. BDRM 25% #5 OUSE / 1 .s � Sew 15% NAVROT �= 10% Date ReadingClock Time Not Time (minutes) Percometer Reading Net Drop (inches) PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FTAND FT stem be constructed in area characterized by test holes #1 and #5. PERFORMED BY FLATTOP TECHNICAL SERVICES. I f�– '/ho, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: A- (r t 26 !9 9K v —_—� Parcel I.D. 015-271-59 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 i Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Navrot, Lot 2 Location (site address) r` 5zr�rx Expiration Date: ' 11000 Navrot Circle Anchorage, AK 99516 Current Property owner(s) Mailing address Real Estate Agent Timothy & Barbara Weiss Day phone 11000 Navrot Circle Anchorage, AK 99516 r -11 Day phone 2. TYPE OF DWELLING: 1 �� x1 Single Family (w/wo ADU) • ' `� d ❑ Duplex f3upmITTA ❑ Multiple Dwellings (Single Family and/or Duplex) qv 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Waiver/Variance request for: JUL 3 1 20K 4 Received by: z r- Date: °g COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ +I (..j.jo = g2A,w Date of Payment g ! 1y c%. Receipt Number 0-Ng0 COSA# ot:UH 131$ Waiver Fee $ Date of Payment Receipt Number Waiver # TYPE OFe1lyASTEVVATER SR SAL: a,,: ❑. x Individual fi] ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: z r- Date: °g COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ +I (..j.jo = g2A,w Date of Payment g ! 1y c%. Receipt Number 0-Ng0 COSA# ot:UH 131$ Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE _Iz� System #1 Approved for. ? bedrooms System #2 Approved for bedrooms Disapproved Phone 522-7773 Date 7/31/14 Conditional approval for bedrooms, with the following &2,' _49TTH _ kU E ANDERSON - W M CE -4381 By: l/� / _ r //(d Original Certificate Date: 9 TheQniciglr, off A ti age Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f - :.i c If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Navrot, Lot 2 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 10/13/94 Sanitaryseal (Y/N) Y Total depth 261 ft. Cased to 261 ft. Date of test Static water level FROM WELL LOG 10/13/94 118 ft. Well production 60 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate •271 mg/L Arsenic ND ug/L Date of sample: 7/25/14 B. SEPTIC/HOLDING TANK DATA Parcel ID: 015-271-59 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 7/25/14 159.3 ft 3.0 g.p.m. Collected by: Anderson Engrg. Tank Type/Material Septic/Steel Date installed 10/13/94 Tank size 1,000 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping 7/29/14 Pumper Around the Clock Pumping C. ABSORPTION FIELD DATA Date installed 7/30114 Soil rating (g.p.d./ff orftz/bdrm) 1 GPD/SF System type 5' Wide Length 46 ft. Width 5 ft. Gravel below pipe 4.0 ft. Total depth 9 ft. Eff, absorption area 460 fe Monitoring tube Y Depression over field N Date of adequacy test New Const. Results (Pass/Fail) For—bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench. Date installed "Pump on" level at Datum in. Size in gallons Manhole/Access (Y/N) "Pump off' level at in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >1 00' Absorption field on lot >100' On adjacent lots >100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer/septic service line >25' Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >51 Property line >51 Water main 0 Water service line 0 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10, Building foundation >10, Water Service line Surface water Curtain drain None Noted Wells on adjacent lots >100' Absorption field >5' Surface water > 100' Water main N/A Driveway, parking/vehicle storage >10, F. COMMENTS Flow Diverter Valve in place. Existing Absorption Trench connected for future use. G. ENGINEER'S CERTIFICATION '%*WLR%% �F, OF fit! I certify that I have determined through field inspections and review of Municipal records that the above systems are in ,.• QS, (t, .�tQ:� •. Vr conformance with MOA COSA guidelines in effect on this date. 69.1E YPE • *' Engineer's Printed Name Michael E. Anderson, P.E. � ...:... T R ../j ..•.....• Date 7/31 /14 �.......... ......u..............��.. • MICdiAR E ANIMSON : ? �I CE �% -4381 A ep COSA brown sheet_10.10-12.doc LOT 11 z I C > LOT 2 Cn N W V z r /j ® / I r 3'x10' I LOT 3 FIREWEED HILL SUBDIVISION I I - I I LOT 1 I LOT 2A I I N 89'59'10'E I 185.01' I 0' UTILITY EASEMENT LOT 2 \ 53,278 s.f. \ HAINLINK F 3'x10' Rfsi eon ( CLEANOUTS` 1Z 12'x5.5' PORCH CK o' 5' GAS EASEMENT JY NAVROT CIRCLE I` PLOT PLAN AS BUILT X SCALE 1° = 50' GRID SW 2634 Project No. 14-138 Lang & As S O C I a tes, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax OF A COp®p ken*langsurvey.com / jonathanOlongsurvey.com ©w`�a,.•••• I hereby cortify that 1 have surveyed the following described property: 4QQ LOT 2, NAVROT SUBDIVISION (PLAT 78-162) Obi H O Anchorage Recording District, Alaska, and that the improvements situated thereon are .. .......... P/1 within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed Q Vii' Q premises and that there are no roadways, transmission lines or other visible ...., .KENNETH.g .... �..; .. easements on said property except as indicated hereon. OO c l 1 (ice Dated this the -2W, Day ofTCa�Zul k , at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plot. oOQO©c';e Location (site address or directions) 11# UrJo lVCtvYo>< Cr'rtlt Property owner M et I at Fn c,; pay phone 3 2 N - l 6%S3 Marling address 11 900 Netvrof Circ /•e. finc6oree of /4k 9931e Lending agency. 'F,rsf AIcrf'1 Oa,,) A- aA fMc_ h qe Day phone 276 -630o Ma'ilingaddress P• ri.'13ox' 100 7217- /Qn[hara4e� AGc 4951E Agent N` A (ClotP au>~ �cnSoLr Ch" n lncrAlre _. pay phone �:: . Unless otherwise requested, HAA. will be held for plckup: .2 NUMBER OF BEDROOMS: - 3 3. TYPE OF WATER SUPPLY: Individual well , ✓_ Community well Public water NOTE !f community well system, provide written confirmation from State ADEC, attest ing to the legality and status of system. - '%W TYPE OF WASTEWATER DISPOSAL: Individual on-site ►% Holding tank Community on-site Public sewer y NOTE: .If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 921 1 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. If urtherverify 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 FIa.Fh�n TecAni cap! Sgrvrcer - Phone 3 ys- t35'S Address IIS30 Echo 2 %1^cha�a�r 2, Abc 99s�� reJ 1J 1995' Engineer's signature ��O`°-``— Date r4r i 6. - DHHS SIGNATURE r ��THEOCE F. AIOORE� � A� � �"„ CE -3589+ � .•.t Approved f_or ` bedrooms _'���° ••••*•+'•• @ 72-025(RV.1/91) Back MOAN21 Municipality of Anchorage AEML Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo f 2,L Ncc vrot S / Parcel I.D. Foundation 10' To property line A. Well Data _Absorption field 5 Water main/service line > 25' Well type Py t If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) _ Y Date completed IU / 13 / 9 y Driller A t.ria { Total depth 26 / Cased to ?K1 ' Casing height ? Sanitary seal (Y/N) _ Y Wires properly protected (Y/N) `r _ FROM WELL LOG AT INSPECTION Date of test 10 /1-3 / 9 1/ oZ Static water level 1t , z D _ Well flow 60 g.p.m. _g.p.m. N c Pump levell z — M c.o rn f C SEPARATION DISTANCES FROM WELL TO: c R Septic/holding tank on lot 12 5' ; On adjacent lots > 100' z — Absorption field on lot ! Z 8 ; On adjacent lots > 100' Public sewer main _ N• A. Public sewer manhole/cleanout N. A. Sewer service line _ 130, Petroleum tank Non •e WATER SAMPLE RESULTS: Coliform O co I / too vn-. Nitrate G O• 1 L)14 Other bacteria None rerbrAeok Date of sample: N/ W / 95 11 H / i / 9S_ Collected by: F/u /ems recti Svc 13. SEPTIC/MOLDING TANK DATA Date installed 10 L33 Tank size I OG 0 Compartments_ 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) N. A. Alarm tested (Y/N) _,N - A. Date of pumping NN A,2 w )2 w) Pumper N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1 25 On adjacent lots�) 0000' Foundation 10' To property line 6s _Absorption field 5 Water main/service line > 25' Surface water/drainage �> 10 0' 72.026(3W)•Front CONTINUED ON BACK PAGE C. LIFT STATION N • %r . Date installed Size in gallons Vent (Y/N) High water alarm level _ "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Date installed ►0 / ►`f /_9� (AL, 4 Soil rating (GPD/Ft) I Length 39' Width 2.5' Gravel thickness Surface water System type Tree ch _Total depth ► Total absorption area 3 90 0' Cleanout present (Y/N) Y Depression over field (Y/N) N Date of adequacy test t4- A. ( N e w ) Results (pass/fail) v for 3 Bedrooms Water level in absorption field before test — After test Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ' On adjacent lots > 100' Property line �S To building foundation 23' To existing or abandoned system on lot N. A On adjacent lots > 30' Cutbank N. A. Water main/service line > 25" Surface water > t 00' Driveway, parking/vehicle storage area Curtain drain Nan e S e e n E. ENGINEER'S CERTIFICATION / certify that / have checked, verified, or conformed to all MOA and HAA guidelines C.., a9 �oLv,n ne ea�ese vpeeeeec:-il ��eev Dara nose vee ve eve ceav�� h, w •c °vee ^e6 J Signature Engineer's Name T eac&ve MGc'`� Date /4 r; 1 f ! 199s- System 99 HAA Fee $ 3 00 0w Waiver Fee $ !0' Date of Payment �% `�� �f Date of Payment Receipt Numbers �D U Receipt Number. 72-026 (3193)' Back