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#018-271-35
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Municipality of Anchorage Page of q
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: 60 9 so Isl PID Number: C)l — Z-71 - IS
Name:
k"Vy htlo &V441E HAArAot�
Wastewater System: El New 0 Upgrade
Address:
i!5:z,-49 LotAc,.Row DejjE Agc"A, kv.. -1%1�,
ABSORPTION FIELD
Phone:
SLA C - 2o3tA [zq z - W3.4 � ,
No. of Bedrooms:
1 3
ODeepTrench OShallowTrench DBed DMound XOther
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
GPD/Sq. Ft.
Lot: Block: ', Subcli,ision:.,
—I I Z
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
IvAssr-L V
Ft.
Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
Ft.
Ft.
WELL: EY ELNew M Upgr
Gravel width:
Numberoflines: _F
DistanTeTMee n lines:
.,Sm M
Ft.
Ft.
Classification (Private, A,B,C):
��Pth:
Cased To:
Total absorption area:
Pipe material:
Ft.
Ft.
SQ. Ft.
Driller:
Date Drilled:
Static Water Level:
lnstaAllr: +
Date installed:
Ft.
1 4
Pump Set at:
I
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
0 Septic Q�H �Idmg D S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
A&&_1q04A(j:
3(30.0
welF
I
Material:
Number of Compartments:
Surface
Water
LIFT STATION
Lot
14-
)2—
Size in ga Manufacturer:
Line
Foundation
I
+
" Pump on" level at: "Pumaz�at: High water alarm at:
Curtain
Pump m ' —ei
aka4-mi5d
Electrical inspections performed by:
Drain
10
Remarks:
BENCH MARK
Location and Description:
1-9 M — 6o-r-roms o;r I—o L -4g_ i Ali Pao
Assumed Elevation:
ENGINEER'S SEAL
�v
Inspections performed by- Dates:iSt
Alaska Water & Wastew r
7320 East Chester HtS. Circle jib..
A- Germ"
A horacyp Alaska 99,504
nc
Department of He'aiju Ifff'lluman Services approval
J,
Reviewed and approved by- Date:
72-013 (Rev. 9/91) MOA 25
PERMIT NUMBER:
SW980131
PARCEL ID:
AS -BUILT DRAWING 018-271-35
A B
CO 26.0 35.5
AA/ ELL
16- CO 26.7 32.8
29.5 30.0
A
WELL
G)
ococf)
LOT 7, BLK 1,
TIMBERLUX S/D #2
r
TH#2
(APP X LOC.)
+
+ TH#1
TH13 (APPROX LOC.) FCO
(APPR Loc.)
0
4" C
6" CO
ALARM
—APPROXIMATE LOCATION OF CURTAIN DRAIN
NEW %LON
HONIINI�
AS -BUILT ELEVATIONS
TBM = 100.0, BOTTOM OF LOWER WINDOW SILL
C SE TO POINT V (SOUTHEAST SIDE OF HOUSE)
Lo
1. INVERT AT FCO 94.17
2. INVERT AT TANK 92.67
3. FINAL GRADE = 913.0
4. ORIGINAL GRADE 95.5
PREPARED BY:
ALASKA WATER & WASTEWATER
"7 -
.............
LEGAL DESCRIPTION:
TIMBERLUX SUBDIVISION #2, LOT 7, BLOCK 1,
TYPE OF WORK:
AS—BUILT OF HOLDING TANK UPGRADE
e A.
—7953
Garness.:
PREPARED FOR: PHONE NUMBER:
BONNIE HARMON 345-2034/242-4346
_r
110 6,
DATE-
_7
By.
E:
6/11/98
J.L
1 = 40'
2 OF 2
I-fO4 c
6 199 PAGE 1 OF I
OF �,r4CVjOgAGE MUNICIPALITY OF ANCHORAGE L� 2f-) p cyr�
UNIC�PENTAt.SERVACESDIVlSloN
DEPARTMENT OF HEALTH AND HUMAN SERVICES Lz)
P.O. BOX 196650, 825 "Ll' STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW980131 DATE ISSUED: 5/22/98
DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES EXPIRATION DATE: 5/22/99
OWNER NAME:HARMAN RANDY L & BONNIE M
OWNER ADDRESS:15245 LONGBOW DR
ANCHORAGE, ALASKA 99516
PARCEL ID:01827135
LEGAL DESCRIPTION:
TIMBERLUX #2 BLK I LT 7
LOT SIZE: 39883 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
HOLDING TANK 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 BY: DATE
ISSUED BY: DATE
is r
! + 99504
Phone +0 9 90 .,
Consulting,
May 6, 1998
Municipality of Anchorage
Department of Health and Human Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Sewer Upgrade for Lot 7, Bk I, Timberlux S/D #2. HOLDING TANK
To whom it may concern:
The existing 3 bedroom house is served by a private well and a septic system that consist of a
1000 gallon septic tank and a 1250 gallon septic tank which are being used as holding tanks. The
existing tanks are leaking and need to be upgraded prior to obtaining a Health Authority Approval
for the purpose of selling the house. Three test hole were excavated on the property and the soil
conditions were found to be unsuitable for an onsite septic (see attached soil logs). Given the site
restrictions it is my recommendation that your department allow us to install a 3000 gallon
holding tank. The new holding tank will be installed between the southwest house corner and the
curtain drain that runs along the south property line.
Based upon our assessment of the site there does not appear to be suitable soils, and/or adequate
space available, to support a conventional or innovative septic system. An innovative septic
system would be a risky installation at best. In short, it is my recommendation that a holding tank
be installed. If you have any questions, please contact me at 337-6179.
LOT 3, BLK I.
0 AiMBERLUX S/D #2
1
LOT 2, 1 1 LOT 1. 1
TIMBERLUXBLK S/D. #2 TIMBERLUXBLK S/D. #2
LOT 5, BLK 1.
oo TIMBERLUX S/D #2
SERVED BY PRIVATE
LOT 6, BLK I. WATER AND SEWER'
'\ \ 1 PER M.O.A.RECORDS
TIMBERLUX S/D #2
E
WELL I WELL
LOT B. BLK F,
TIMBERLUX S/D #2
0 -
LOT 7. BLK I. G LOT 11A BK I
TIMBERLUX S/D #2- TIMBERLUX P4
EXISTING SEPTIC TANK
--- - ------
NE ------------- PROPOSED 3000 GALLON
HOLDING TAN
LOT 8, BLK I.
TIMBERLUX S/D #2
LOT 10, BLK I.
LLJ
TIMBERLUX S/D #4
>
SERVED BY PRIVATE
WATER AND SEWER
WELL
RECORDS
WELL 100'+ FROM
PROPOSED HOLDING TANK
LOT 5, BLK D, 0
TIMBERLUX S/D #2 mi
zl
LOT 9, BLK 1,
0,
TIMSERLUX S/D #2
I
TIMSERLUX SUBDIVISION #2; LOT 7, BLOCK 1,
TYPE OF WORK:
SITE PLAN
PREPARED FOR: PHONE NUMBER:
BONNIE HARMON 345-2034/242-4346
ELL
WELL
LOT 7, BLK 1,
TIMBERLUX S/D #2
TH#2
+ (APP IT X LOC.)
+ TH#1
TH13 (APPROX LOC.)
(APPRO LOC.)
I&W, WIN
\-APPROXIMATE LOCATION OF CURTAIN DRAIN
DITCHLINE. HAS SURFACE
WATER THROUGHOUT YEAR.
�lffl�
CO 1* 0. CO
CO
UO GALLON
TANK-
9
TANKS
COMPLETELY
a ess:
—7953
rofess'%O�\45
ALASKA WATER & WASTEWATER -
7320 E. CHESTER HTS. CIRCLE * ANCHORAGE, AK. 99504-
PHONE
9504PHONE (907) 337-6179 * FAX (907) 338-3246
FS -01L LOG - PERCOLATION TEST
LEGAL DESCRIPTION: TIMBERLUX SUBDIVISION #2; LOT 7, BLOCK 1,
PERFORMED FOR: BONNIE HARMON
DATE PERFORMED: 5/4/98
DEPTH
TEST HOLE #1
(feet) , 01 FILL
' a
SM/GM
q
SOME ORGANIC
r
ROOTS/STUMPS
"'j SOIL CLASSIFICATIONS
2
ORGANICS GW ORG
FEAT/ROOTS GP ML
1 y GM 1f CIL
GCOL
SW F MH
5— SP 7 77
CH
ll!�ML rr,
SM OH
DENSE/WET
(SATURATED) Sc
7
8
9
10
11
12
13
14
15
16
17
18
SITE PLAN
I"= 100'
DATE I READING I CLOCK I NET TIME I WATER LEVEL I NET DROP
TIME (MINUTES) READING (INCHES)
19 PERCOLATION RATE
20 TEST RUN BETWEEN
COMMENTS: UNSUITABLE FOR ON—SITE WASTEWATER
PERFOMED BY ALASKA WATER & WASTEWATER 1, _y
THIS WAS PERFORM TD/IN ACCORDANCE WITH ALL STATE
DATE. DATE:C;-ht/19
1 19
(MIN./INCH) PERC. HOLE DIA. 6" (INCHES)
FT. AND /I — FT.
(X CERTIFY THAT
UNI bWALIGUIDELINES IN EFFECT ON THIS �
ALASKA WATER & WASTEWATER
7320 E. CHESTER HTS. CIRCLE * ANCHORAGE, AK. 99504
PHONE (907) 337-6179 - FAX (907) 338-3246
[-SOIL LOG - PERCOLATION TEST]
LEGAL DESCRIPTION: TIMBERLUX SUBDIVISION #2; LOT 7. BLOCK 1,
PERFORMED FOR: BONNIE HARMON
DATE PERFORMED:—... 5/4/98
DEP
" " I =#2
I FILL
TEST H�
(feet)TH
Hl,"'l,l SM/GM
ORGANICS
PEAT/ROOTS SOIL CLASSIFICATIONS
2 —
W/ SP POCKETS
Qt1 GW ORG
3 GP ML
GM L
//4"
CL
4— B.O.H. GC OL
SW MH
/X
SP
5 ID I CH
SM OH
p"N
2�44447;4
6 — RIA" SIC
7
8
9
10
11
12
13
14
15
16
17
18
WELL
N
//A
LLCFT
cl I
LUX S f2
LDrArm OF cuffrm D""
DATE READING CLOCK I NET TIME WATER LEVEL NET DROP
I I TIME (MINUTES) I READING (INCHES) I
19 PERCOLATION RATE
20 TEST RUN BETWEEN
COMMENTS: UNSUITABLE FOR ON—SITE WASTEWATER
PERFOMED BY ALASKA WATER & WASTEWATER 1,
THIS WAS PERFORMEf IN ACCORDANCE WITH ALL
t
DATE. DATE: ti le16l
(MIN./INCH)
FT. AND /
FERC. HOLE DIA. 6" (INCHES)
— FT. I
CERTIFY THAT
ICIGUIDELINES IN EFFECT ON THIS �
ALASKA WATER & WASTEWATER -
7320 E. CHESTER HTS. CIRCLE * ANCHORAGE, AK. 99504
PHONE (907) 337-6179 * FAX (907) 338-3246
[-SOIL LOG - PERCOLATION TEST]
LEGAL DESCRIPTION: TIMBERLUX SUBDIVISION #2; LOT 7, BLOCK 1,
PERFORMED FOR: BONNIE HARMON
DATE PERFORMED: 5/4/98
(feet)
EPm—
(feet)TH
TEST HOLE #3
a SM/GM
']FILL
21
6
7
8
9
10
11
12
13
14
15
16
17
18
SOIL CLASSIFICATIONS
DEPTH TO DATE
GROUNDWATER1 1
3- 1 5/4/98 1
I SITE PL I" = 100'
WELL
LOT 7. ERX I.
TFMBMWX S/D f2
%
LOW= OF amxm mm
DATE I READING I CLOCK NET TIME I WATER READING LEVEL I NET DROP
TIME (MINUTES) (INCHES)
19 PERCOLATION RATE (MIN./INCH) PERC. HOLE DIA. 6" (INCHES)
20 TEST RUN BETWEEN FT. AND I FT.
COMMENTS: UNSUITABLE FOR ON—SITE WASTEWATER DISPOSAL WEM,_l/l
PERFOMED BY ALASKA 'WATER & WASTEWATER 1, G CERTIFY THAT
THIS WAS PERFO!ID
/INACCORDANCE WITH ALL STWT1�r6tNICIPAe GUIDELINES IN EFFECT ON THIS
DATE. DATE: ey
GW ORG
I ML
GP i I
GM CL
GC OL
6,
1 W 6J
SW MH
7Z
Sp CH
N1.
t 0
SM OH
SIC
DEPTH TO DATE
GROUNDWATER1 1
3- 1 5/4/98 1
I SITE PL I" = 100'
WELL
LOT 7. ERX I.
TFMBMWX S/D f2
%
LOW= OF amxm mm
DATE I READING I CLOCK NET TIME I WATER READING LEVEL I NET DROP
TIME (MINUTES) (INCHES)
19 PERCOLATION RATE (MIN./INCH) PERC. HOLE DIA. 6" (INCHES)
20 TEST RUN BETWEEN FT. AND I FT.
COMMENTS: UNSUITABLE FOR ON—SITE WASTEWATER DISPOSAL WEM,_l/l
PERFOMED BY ALASKA 'WATER & WASTEWATER 1, G CERTIFY THAT
THIS WAS PERFO!ID
/INACCORDANCE WITH ALL STWT1�r6tNICIPAe GUIDELINES IN EFFECT ON THIS
DATE. DATE: ey
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES `
Environmental Health Division /
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name L(19
iA $//j�
DISTANCES
FROM TO
SEPTIC
TANK
ABSORPTION
FIELD
WELL
Address
A /l0&'7
� y � �
WELL
Phone(s)
lot/
Permit No.
No. of Bedrooms
LOT LINE
F
LEG AL DESCRIPTION
Lot
Block
Subdivision ,.t.
'W
FOUNDATION
I
^�
J�
Township, Range, Sec on
% r�r%
d�•
AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation,
driveway, water bodies, etc.)
TANKS
y�
❑ SEPTIC
HOLDING
Manufacturer
AN
Capacity in gallons
Material
No. of Compartments
TYPE OF SYSTEM
❑ TRENCH ❑ BED
❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from
original grade
FT
Total depth from original grade
FT
Fill added above original grade
FT
Gravel depth beneath
FT
10
i S'
0
Gravel length
Gr dth
FT
Total absorption area
SO FT
Distance between lines
FT
Number of li
Soil rating
SO FT
Pipe material
Installer
k
Date Installed
WELLS
tS iAf
❑ PRIVATE
❑ OTHER (ldentifv)
Classification (A,B,C)
Total Depth
FT
Cased to
FT
Installer
Date Installed:
REMARKS:
18P -r; e t,il"r WA
23474/0 U 14
Scale• JJVENGINEER'S SEAL
�: • j 6 Inspections Performed by
oWa A
Date:
i r
I - ceriif. that this inspection was performed according to all
Municipal and State guidelines in effect on this date: /0 �✓ r
Health Department Approval: &Zr Date:
v f/
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
825 L Street, Anchorage, Alaska 99501 343-
90V olf
ON-SITE HOLDING TANK PERMIT
Permit Number: 880194 Upgrade
Date !ssued: 09/19/88
Owner Name: RANDY L. HARMAN Day Phone:
O�'`cr �ddress: PO BOX 110672 349-6476
ANCHORAGE, AK 99511
Parcel Id: O18-271-35
Lot Legal: Subdivision: TIMBERLUX #1 Lot: 7 Block: I
Section: 34 Township: 12N Range: 3W
Lot Size 0.92A (sq. ft. or acres>
Max Bedrooms: This Permit: 3 Total Capacity: 3
HOLDING TANK: Minimum Tank Size: 2,000 qallons. A high water alarm must be
installed on the tank and connected to the residence" Depth to top of holding
Lank < 4.0 feet requires insulation over tank.
THI8 PERMIT IS 18SUE:0 FOR A SINGLE FAMILY RESIDENCE ONLY AND
EXPIRES 12/31/81. 'now/�����|m��u�����*/�
I CERTIFY THAT: -
1. l am familiar with the requirements for on-site sewers and wells as met
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I mill install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
S. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for a maximum of 3 bedrooms. I
also understand that the capacity of the total system is 3 bedrooms and
any enlargement will require an additional permit.
DATE:
-7----------~-------�J-----`----------- ---------------
(Qwner) R�NDY L. HARMAN ��
]`sued By: DATE:
A
C
S
ALASKA RUIROWnTAL COMOL SRUIRS, InC.
Engineering & Enuironmenial Studies
September 1, 1998
Randy Harman
Harman Excavating, Inc.
P.O. Box 110672
Anchorage, AK. 99511
Re: Lot 7, Block I, Timberlux Subdivision
Dear Mr. Harman
1 -Ing your
I have inspected your lot for an area that would be suitable for upgrading
existing system. I could not determine any area that was presently suitable for
a system. It appears that with some water flow management that you could
possibly make the western yard area acceptable for an on-site system, seve-ral
years in the future. The peat system that we talked about would probably be one
that could be used, if the MOA approves it.
However, presently, the best thing for you to do would be to install a holding
tank. The MOA issues the permit. You will need a visual and audio high level
alarm which gives you 300 gallons of additional storage after the alarm sounds.
The tank size for your 3 bedroom house would be 2,000 gallons.
If you have any questions, please let me know.
cc: Dan Roth, MOA--.,—,-,,)
Sincerely,
r-�fP1E
Leroy , Reid 7r., PhD
President
1200 West 33rd Auenue, Suite B & Anchorage, Alaska 99503 a ( 907) 561-5040
MUNICIPALITY OF ANCHORAGE
D EPAIRTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL. ENGINEERING DIVISION
tr
V4 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
--O
NAME PHONE NEW
_/Oi6d DUPGRADE
MAILING ADDRESS
P. 0. Box 10-515 Anchorar-,,-e, Alaska 99-511
i-EGAL DESCRIPTION
Lc'i f
OCATION
NO. OF BEDROOMS
Well
losorption area=
Dwelling
PERMIT NO
DISTANCE TO:
Z
Manufacturer
Material
No, of compartments
LJ <
~T
-i.
V)
-K capacity in gallon
IF HOMEMADE:
Inside length
Width
Liquid depth
C3 _j z
DISTANCE TO:
Well
Dw0fDwellingPERMIT
NO.
0 <
Manufacturer
Material
Liquid capacity in gallons
LUT
Well
DISTANCE TO:
Foundation,
Nearest lot line
PERMIT NO.
Lu iA zNo,
of lines Length of eachwidth
Total length of lines
Trench wid
Distance between lines
z �5
CC
4=17405
cc
f finish d
Top othe to nsgrade
Material beneath life
effective
Total effect absorption area
_44
-2, inches
Length
Width
Depth
PERMIT NO.
vi
0
I—
Type of crib
Crib diameter
Crib depth
Total effective absorption area
U
Well
Building foundation
Nearest lot line
DISTANCE TO:
Class r
Depth
Driller
Distance to lot line
PERMIT NO,
Building foundation
Sewer line
Septic tank
Absorption area(s)
STANCE TO:
OTHER
T7_
_T1'PE 5a T, -:_RIALS
SOIL TEST RATING
misTALI-1-:171
v.
rr
Fi EINAAR KS
7,47
7n
606 so&
David' , Korman
W'j. I 19&E
UA I L LtUAL
A PPFI 0 V E D
IN
DEPARTMENT Of EAL_TH AND ENVIRONMENTAL F
5 L: STREET, L , AN CH€_€F!!€7E: HES:.. 99501
264-4720
PERMIT NO. ( 790013
iF'F=`L_ :€: €t:ENT E'ANC:=°F' C •fit'E€^t•ty':4.i ..w "E €a€NE .€ it i 1"F CIRCLE :L_.E 100
_E€aAE._. L.7 BLK I T I MBERL!_ X _ /D LOT SIZE ._:'9 .y .w. €. QUARE": FEET
-YPE OF SOIL ABSORBTION SYSTEM IS: DRAINFIELD
1A I Mi, M NUMBER R OF L..EC:,E".gOMS = - SOIL RATING (SO i" T..°- `BR) = 190
HE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
_6. TEE
LENGTH DIMENSION
I °S THE LENGTH H K I N FEET)
OF THE TRENCH OR L:=RA I NE_ I E !__D.
THE
DEPTH OF H TRENCH H
€_€R PIE IS THE DISTANCE
BET E EEEN ° THE SURFACE ACE OF THE:
GROUND AND THE BOTTOM M
€vtF THE EXCAVATION _:. I N'd
FEET),
THE
GE~:H'<<°'EL DEPTH IS THE
MINIMUM DEPTH t:T€E GEr'EiVEmL"
BETWEEN THE Of_!TFAL_.L. PIPE:
AND
THE BOTTOM OF THE
EXCAVATION K E E's FEET).
pp
_ ... CA �: I i ^
'EEr M I T APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING T')."!E:::
N _E;TALE._AT I ON INSPECTIONS €w€F ANY WELLS ADJACENT CE:NT TO THIS PROPERTY AND THE
E!_bMBER OF RESIDENCES THAT THE WELL WILL. SERVE.
:H€._ KF I LL. I N G OF AN'd°T SYSTEM WITHOUT FIN' AL_ INSPECTION AND APPROVAL AL BY THIS
EF'ART MEN•dT WILL BE SUBJECT T€.€ PROSECUTION.
i I N I N°1im M DISTANCE BETWEEN•d A WELL AND ANY ON—SITE SEWAGE DISPOSAL F'OSAL.. SYSTk: M IS
20 FEET FOR A PRIVATE WELL; OR
.00 TO 200 FEET FES'€::€M €=! PUBLIC WELL DEPENDING !_!PON THE. TYPE OF PUBLIC WELL.
!ELL L€4€GS3 ARE:. REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT :NT W_!:THIN 10 D!"!°'r`S
IF THE WELL. COMPLETION.
€THE € ` REQUIREMENTS MA'r APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS AREw.
MAILABLE TO INSURE RE PROPE R INSTALLATION.
CERTIFY THAT
I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET
ORTH BY THE: MUNICIPALITY OF ANCHORAGE.
I WILL INSTALL THE SYSTEM M I N ACCORDANCE CE WITH THE €:.:ODE'
I UNDERSTAND THAT E THE ON—SITE 'SEWER SYSTEM N` AY REQUIRE ENLARGEMENT IF THE
;L_
'ESI DEN• CE IS REMODELED TO INCLUDE CLt_lDE N'1ORE THAN 3 BEC:°R€.€€_€MS
'l
t=lE'° PL I s:::iIN �FtN'di.:°''r' Ht=tRNI€,`tN•,E
SSUED °., s- —V 3. V
` '�
' y_���� �</ .
' 01 k_j -T kw" C�A F07 50 54 C2 VA k 10 F1 C3 E -E
' DEPHRTMEWT OF HEALTH FIND ENVIRONMENTAL PROTECTION 0 C3
825
\2~
825 'L' STREET, ANCHORAGE, HK 99501
/
264-4720
171 hi --- YT, I_T- Ev On Eo L4 E= FQ F" EEE IT: &I I -I-
PERMIT NO. ( 780972 )
IPPLICHNT RANDY HRRMOM 2045 STONEGHTE CIRCLE 349 1016
'OCHTION LONGBOW DRIVE
-EGHL L7 BI TIME9ERLUX 5UBD LOT SIZE ]988] SQUHRE FEET
'YPE OF SOIL ABSORBTION SYSTEM IS: DRH%NFIELD
1RXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 190
'HE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
'
Dw Eo������=
THE LENGTH DIMENSION IS THE LENGTH (IM FEET) OF THE TRENCH OR DRHINFlELD.
THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IW FEET).
-F- ki E=7 7- FT? EP44 (0 t-1 hi I E0 7- 41 1 "S 15' 1702SK21 F=4=0=77F
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
��(of �j I Fy? E=1 K", ����1 1"; �K 14 K !=w I ly! E=i= "I CA CA ED C3 FA L_ L_ CA t4�
'ERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
NSTHLLHTION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
UMBER OF RESIDENCES THAT THE WELL WILL SERVE.
_--- --- 0- txi K3 < Ili I I 00—E7 F=:E-: -I- I Clr4l& FA FR En F 0 E 0�L J 1 1; �; ��
:HCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
1EPHRTMEWT WILL BE SUBJECT TO PROSECUTION.
12NIMUM DI5THNCE BETWEEN Fl WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
.00 FEET FOR A PRIVATE WELLj OR
.50 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL
/THER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
iVAILABLE TO INSURE PROPER INSTALLATION.
�EEE F0 011 -T- E07 lot F01 I F;? E07 "Ey 11, EE C3 E7 P1 E? EE F?? �11-" �low J, *0
CERTIFY THAT
.� I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
'ORTH BY THE MUNICIPALITY OF ANCHORAGE.
I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
I UNDERSTAND THAT THE OW -SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
:ESIDENCE IS REMODELED TO INCLUDE MORE THAN 2 BEDROOMS.
J8NED: _________
T. H. No. 1
9-28-78
Organics w/some Organic
0.0'
b.' Silt, moist, loose,
o brn .
Silt: w/some Gravel &—S a n 'T,
occ Cobble, sl moist,
loose, graybrn.
(ML -GM)
0. .o
5.0'AB 1430hrs 9-30-78
• Q Sand: w/some Silt & Gravel,
sl moist, loose to med dense,
ZD.' - Sd pred fn to med, graybrn.
CO: • o
8.01
8.5 AB 1515hrs 9-28-78
Gravelly Sand: w/some Silt,
occ Cobble, sl moist, dense,
Sd pred fn to med, graybrn.
(GM)
-12.0'
13.0'WD 1500hrs 9-28-78
Sandy Gravel: w/some Silt,
scat Cobbles, occ boulder,
sl moist to wet, dense, Sd
pred fn to crs, graybrn.
(GM)
17.0'TD
Note: Augers pulled at 5.0' and
10.0'. Soil from bottom of hole
retrieved from lowest auger
flight. In both cases soil was
slightly moist and did not give
indication of water table.
Test Hole Boring Logs represent soils
encountered on: Lot 7, Block I,
Addition No. 3, Timberlux Subdivision,
Anchorage, Alaska.
Michael B. Bergmann
Consulting Geologist
Box 191, Star Route A
Anchorage, Alaska 99502
(907)344-9150
T. 11. No. 2
9-28-78
_Organics: w/some Organic
Silt, moist, loose,
brn^ _ _
0.5'-
Silt: w/some Gravel & Sand,
occ Cobble, sl moist, loose,
graybrn.
\ (ML -GM)
2.51
Sand: w/some Gravel & Silt,
occ Cobble, sl moist, med
dense to dense, Sd pred fn
to med, graybrn.
V (SM)
Augers pulled @ 10.0' -
�1 soil on last flight sl moist.
a. 11.0'AB 1745hrs 9-28-78
O. Note: Augers pulled @ 13.0' -
soil on bottom auger
flight was sl moist.
13.0'TD
Note: Water table is present at
greater depth than 13.0' as
soil at that depth gave no
indication of water table, since
it was only sl moist.
After completing test hole to
13.0' total depth, driller only
cleaned hole to 11.0' depth.
On observing bottom of hole after
pulling augers depth was 11.0'
and water was seen to be rising
thru the unremoved soil in bottom
of hole. Water level appeared to
stabilize at 11.01.
Note: In both test holes the water table
appears to have some artesian
pressure so that when the con-
fining overburden is removed the
water will enter the test hole
from approximately the 13 foot
level.
�
SOILS LOG
~
MUNICIPALITY OF ANCHORAGE
O PERCOLATION
- Tesr
Pouch 6-650, Anchorage, Almslkae95o 276-2221
SO!LSLOG-PERCOLAT|ONTEST
PERFORMED FOR:
Date
Gross
Time
DATE PERFORMED:
Depth to
Water
Net
Drop
LEGAL
DESCRIPTION
ax—
suzps
SITE PLAN
T--T-
l
�--�-�'�+--'�--�-�----�-���---
3
4
`
5
G
[
7
8
|
|
|
-
-
9-
10
lO
ii
WAS GROUND WATER
S
Eu/
l-�_�
�---
/
_
12
^P---- ---- -
e |
IF YES,ar n�r
w
��
DEPTH?
13
| '
14-
15
4 15
�
16� |
. /
17
coMmsmrc
,V
PERFORM soBY: I_,_,- I
11~"~ '-I'll
Reading
Date
Gross
Time
Not
Time
Depth to
Water
Net
Drop
PERCOLATION RATE_
rE§TRUN BETWEEN
CERTIFIED BY:
__(m/n"tes/imm)
FT AND _____~Fr
T
NlUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch &650, Anchcraga, A!.-ska 99502 276-2221
SOILS LOG - PERCOLATION TEST
VSOILS LOG
PERCOLATION
TEST
PERFORMED FOR: DATE PERFORMED i 17 CJ
10
12
13
14 -
15
17
18
19
20
zx WAS GROUNDWATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
'2
0,11 r- [4 0, L E
L 'D zj- I-,
ReadingDate
Gross
Time
rN, 0 t
Time
Depth to
ter
Net
Drop
TEST RUN BET4NEEN
FT AND FT
'C'MMEN1 S
PE13FOHN-IED BY:
PERCOLATION RATE
(minutes/inch)
TEST RUN BET4NEEN
FT AND FT
'C'MMEN1 S
PE13FOHN-IED BY:
CERTIFIED BY:
DATE:
October 11, 1978
Lot 7, Block I, Addition No. 3,
Timberlux Subdivision,
Anchorage, Alaska
Percolation test performed September 28, 1978, on Test Hole No. 2, by filling the
6 inch diameter, 13.0 feet deep test hole (Test was performed on interval 0.5 feet
to 11.0 feet as 2 feet of drill cuttings remained in hole) with water, and measuring
the water level drop periodically for one hour.
TABULATION OF PERCOLATION TEST RESULTS
TIME
LEVEL(inches)
DROP(inches)
ET(min)
RATE(min per inch)
1810
6.5"
start
start
start
1820
10.25"
3.75"
10
2.6
1830
12.0"
1.75"
10
5.7
1840
13.0"
1.0"
10
10.0
1850
13.5"
0.5"
10
20.0
1900
14.5"
1.0"
10
1.0.0
1910
15.0"
0.5"
10
20.0
Average percolation rate for entire hour = 7.1 minutes per inch
Average percolation rate for last one half hour = 15.0 minutes per inch
Michael B. Bergmann
Consulting Geolgist
Box 191, Star Route A
Anchorage, Alaska 99502
(907)344-9150
N00006'03"la 197.79'
Utility Easement '
0
r - -
�r Ln
TH#1
TH#2
42' 86'
M
� O
N
O
N O
r -i
N
Lot 7, Block I, Addition No. 3,
Timberlux Subdivision,
Anchorage, Alaska w
Ln Ln
Ln ri
rn U)
Lr)0
0
N 0000 z
171.45'
0
Longbow Drive
M
_ R=800.00'
NOT TO SCALE
Distances are approximate and have
not been measured by surveying
methods as to locations of test
holes.
Michael B. Bergmann
Consulting Geologist
Box 191, Star Route A
Anchorage, Alaska 99502
(907)344-9150
W I DRILLING., INC.
A"'M\X1!PAL1Ty C'F Ar!i- ' �'OUGE
DEPT
DRILLING LOG
cell 0wner_____Randv HarmonL
Use &f W611' D'Mi�
Location (address of: Township, Range, Section, if known; or distance main road-__'_
Lot 7 Block 1 Timberlux #2 Subdivision, Anchorage
ze of casing-_ 6" Depth of Hole___L4.0____feet Cased to-_10-0-8—feet
vatic water level _ft. (aNXX4 (below) land surface. Finish of well (check one) open end
Screen ( Perforated ( XX ).
Describe screen or perforation N= 60 np-rfc),rnt-ions from .71 -68 ft-_
'ell pumping test at 3—gallons per (hMR� (minute) for-_-1——hours with -100% —Y-9.
of drawdown from static level.
ate of completion — 3/17/79
epth in feet from
,ound surface
Give details of formations penetrated, size of material, color and hardness
0
TO
2
Casing stickup
2
.---
TO—
3
Organics
3
18
Silty gravel
18 ____
TO
23
Damp gravel
23
TO
41
Hard pan till
- 41
—TO
67
Silty hard pan
67
TO
69—
Silty water gravel
69 __-TO
93
Cobbles
93
TO_
140
Bedrock: water seeps in sporadic fractures throughout
-TO
-TO
-TO
Municipality of Anchorage
Development Services Department
Building Safety Division M^ x
On -Site Water and Wastewater Program =S A' E T Y
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018-271-35 HAA # 0 3 O Cv 14
Expiration Date: - 9 - 0 '7L
1. GENERAL INFORMATION
Complete legal description Lot 7 Block I Timberlux Subdivision No 2
Location (site address or directions) 15245 Longbow Drive
Current Property owner(s) Nancy Reeder Day phone 345.8355
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
15245 Longbow Drive Anchorage, AK 99516
Day phone
Jody Moses Day phone 562-6464
Prudential Vista Real Estate
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
Three 3
TYPE OF WASTEWATER DISPOSAL:
®
Individual On-site
❑
❑
Individual Holding tank
❑
Community On-site
❑
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Anderson Engineerinq Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson P.E. Date 121312003
sAr
F fir'. 49th
'♦ �k'; MICHAEL E. ANDERSON
5. DSD SIGNATURE �i� s NO. CE -4381
LL/Approved for 3 bedrooms. 4
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
<<tcrrcrrrrrr�
Additional Comments ON SITE
WATER ANDm
�^:�iaTE1A1AT�'
PROGRAM
J
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By:Original Certificate Date:
(Rev. 12/00)
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"29� --
Ss9° 53'
57'W
Holdim
Venj
I HERE®Y CERTifY TMAT AN ACCURATE 5VRVEY OF UE —.:
.4
nF
POLLC�+IHG Ot9��iE^�O PRODER7Y -� .•�.�,��.e����
LOT 7, BLOCK 11�•''�`�?,'':''�, �,� $
771MOERLUX SUED. ADD• 2 p t�' �' •,�' 0
WAS MADE on March 24 19WAxD THAT THE IV
t+RE ED FOR:
JO $.b .ayaaa.pfaOaLgf` "
pQQVEIdt;NTS SITUATED t?(EREON ARE vlTxifi TXE i�cP- ��s..�• �
ERTY LITIEs, AN0 Do 1OT WERLAP OR EYCROACH 0i� THE Frte G.
~
RCvERTY LYI>u6 ADJACENT TtLRETR,TNA7 310 IN
S .WK G.
p ; cad
BUILT
'. IS A7M a
AS BUIL` CH pjZ0pCMTy LYING ADJACENT TIAEKET9 ENCROACA ON T� � d� •� �� J��
OAM, L r1 VILE N0. IN DUESTIGI A710 TIL'E T TNERE J�AO RCt&OX►TS, �a.�'9�Da"a'°��.►►+°''•
TICAxSuuSkOK LINES Gsa OTHER V"U'LL EAStA MYS bu �a��'OfFSStCNAL�'A.y,'�'
$A IO aft�ERTY EkCt➢T 13 __��S//KO�N. �,/ I n�
� „n' w,r,..,,,,,,�y.�,�r..ro.a AKCKORAGE, AIOSKA�TKlSZ4T/7 OAY CF /r/4!'Gfl� 3L7
ax,
t
I HERE®Y CERTifY TMAT AN ACCURATE 5VRVEY OF UE —.:
.4
nF
POLLC�+IHG Ot9��iE^�O PRODER7Y -� .•�.�,��.e����
LOT 7, BLOCK 11�•''�`�?,'':''�, �,� $
771MOERLUX SUED. ADD• 2 p t�' �' •,�' 0
WAS MADE on March 24 19WAxD THAT THE IV
t+RE ED FOR:
JO $.b .ayaaa.pfaOaLgf` "
pQQVEIdt;NTS SITUATED t?(EREON ARE vlTxifi TXE i�cP- ��s..�• �
ERTY LITIEs, AN0 Do 1OT WERLAP OR EYCROACH 0i� THE Frte G.
~
RCvERTY LYI>u6 ADJACENT TtLRETR,TNA7 310 IN
S .WK G.
p ; cad
BUILT
'. IS A7M a
AS BUIL` CH pjZ0pCMTy LYING ADJACENT TIAEKET9 ENCROACA ON T� � d� •� �� J��
OAM, L r1 VILE N0. IN DUESTIGI A710 TIL'E T TNERE J�AO RCt&OX►TS, �a.�'9�Da"a'°��.►►+°''•
TICAxSuuSkOK LINES Gsa OTHER V"U'LL EAStA MYS bu �a��'OfFSStCNAL�'A.y,'�'
$A IO aft�ERTY EkCt➢T 13 __��S//KO�N. �,/ I n�
� „n' w,r,..,,,,,,�y.�,�r..ro.a AKCKORAGE, AIOSKA�TKlSZ4T/7 OAY CF /r/4!'Gfl� 3L7
Municipality of Anchorage
Development Se^ces Department
Building Division �^ ^
1 5 *AE T Y
On -Site Water & Wastewater Program` `
—_ Qouth __~_ SL
PI.BoxQ0�1�[�2�Q/`.�` , '
';-----'------°-''-
` 343'7BD4
/QO7\`www
, .
[~�AT|F|��T� O� HEALTH AUTHORITY _APPROVAL,. -- ' - — �
�� /\ �� �� DWELLING
' / (][� �^ ~��[�(��� FAMILY `-
Parcel I.D. 018-271-35
1. GENERAL INFORMATION Expiration Date: '
Complete legal description TIMBERLUX SUBDIVISION #2; LOT 7, BLOCK I
Location (site address n[directions) '
Current Property owner(s)
NANCY REEDER Day phone 345-8355'
15245 LONGBOW DRIVE
'
`
Dayphone
`
JEFF STANFORD Day phone
`'^ `
RESIDENTIAL MORTGAGE
Unless otherwise requested, HAA will baheld bvDSD for pickup.
2. -NUMBER OF BEDROOMS: 3—
Individual Well
Individual On-site
n
Individual Water Storage
�
Individual Holding tank
Im
Community C|oss___VeU
[�
Community On-site
[�
Public Water System
Public Sewer
The Municipality of Anchorage DevelopmentServices Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request tohomeowners. CertifioateaofHealth Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
bureissued with new water sample results less than 3Odays old. (Certificates may bereissued for operiod of
up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B
wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineers work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $800.00 at, or prior
to closing for the engineering services provided
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Health AuthorityApproval 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 andlor 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179
Address 6901 DEBARR ROAD, SUITE 213 * ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A. GARNESS, P.E.Date ( 2 D/
Engineers Comments:
In conducting this evaluation, AWWC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA o�
DSD Guidelines & Regulations. The reported results described the performance of the op -4=7 • ' ..• 44
system under the conditions encountered at the time of the test, and separation p
distances measured to readily identifiable features. The operational life of all wells and 0 * H •. •., y*
septic systems depend on the
soils condition,
r levels that may
These conditions are outside the coo ntrol of the evaluator o thea tem. Satisfactory test • . ...: • ..... • • .`
fluctuate during the year, and the water usage of the farm beingserved b the system. 0
ys ry '
results do not guarantee future performance of the system, nor do they guarantee thatf re Gar s
there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide �Q m • C 7953 •' o Q
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any @P�d P, o f e s si°1DO
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
k'" Approved for _ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
Supplemental Engineer's Reort
Other
It{{{(t!llttrr/rr��� J • ON-SITE ;
WATER AND : M
WASTEWATER
PROGRAM R
�JO • � 0�,�,1
TS�, )11�
By: Original Certificate Date:
(Rev. 12100)
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at in. "Pump Off" i.OJ_
ater alarm level at in.
MUNICIPALITY OF ANCHORAGE
• '� DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # 018-271-35 HAA # fl�vp-� r)lr__�
1. GENERAL INFORMATION
Complete legal description Lot 7_; Block I; Timberlux Subdivision #2
Location (site address or directions) 15245 LongbowDrive
A�nc forage , Au
Property owner Bonnie Harman Day phone 562-3050
Mailing address P.O. Box 110515 Anchorage, AK 99511
Lending agency
Day phone
Mailing address
Agent
Janice Mitchell/Prudential Vista Day phone 562-6464
Address _
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
XX
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank XX
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA k21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal syAp&A%i%WWjance with all Municipal and State codes,
ordinances, and regulations iWIf on,the date o>,tHi I infection.
Name of Firm
Address
Engineer's signature
6. DHHS SIGNATURE
_JZ_ Approved for
Disapproved.
THI_ bedrooms.
Conditional approval for
Additional Comments
M
Phone ��
Date
+las r
OF A f
bedrooms, with the following stipulations:
Date G -S_-6;q
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA 021
U. SAr"1-7."~°=^IM �
'
Date installed
Public sewer main �?-- v Public sewer manhole/cleanout A) 11A
Sewer /septic service line a-5 4- Lift station 6z—
line 4- Absorption field
Foundation (9v c' Property
10
ib M
Property line ' Building foundation VVaternlan/aervicm line
Surface water Driveway, parking/vehicle storage area
Curtain dr Wols on adjacent lots
F. ENGINEER'SCERTIFICATIM4///
5. LEGAL DESCRIPTION
l
ti
DATE RECEIVED
v4 _
INSPECTION APPOINTMENTS
.;
TIME
TIME
TIMIE
SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
DATE
Three ❑ Six
DATE
DATE
INDIVIDUAL*
* ATTACH WELL LOG. A well, log is required for all wells drilled
❑ COMMUNITY
_
INSPECTOR_
depth (attach log if available.)
INSPEC17L
INSPECTOR k
1A INDIVIDUAL/ON-SITE**
/97 YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
i
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOWEPT Gk I G:
825 L Street - Anchorage, Alaska 99501 ENVIRONNILi 4 L; ;`.CTION
ENVIRONMENTAL SANITATION DIVISION tAAR I 1 1980
€
Telephone 264-4720
REQUEST
FOR APPROVAL OF INDIVIDUAL WATER AND SE-"- _�Wlvjlo
_
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1..�ROPERTY OWNER
,
PHONE
MAILING ADDRE
2. Q) . \
t),
PROPERTY RESIDENT (If different from above)
PHONE
2. AUYER01
PHONE
MA�ING ADDRESS
_
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
�°•ti, Y y
�
4. REALTOR/AGENT
;.
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
l
ti
v4 _
ST�MET LOCATION
6. TYPE OFR DENCE
NUMBER OF,BEDROOMS
SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER §UPPLY
INDIVIDUAL*
* ATTACH WELL LOG. A well, log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
1A INDIVIDUAL/ON-SITE**
/97 YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-0117 (Rev. 6/79) „� J
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
El SINGLE FAMILY
0 MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ED THREE ED FIVE El OTHER
E:1 TWO 0 FOUR El six
2. WATER SUPPLY
0 INDIVIDUAL
El COMMUNITY
0 PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
ED INDIVI DUAL/ON -SITE
E-71PUBLIC UTILITY
Connection Verified —
PERMIT NUMBER
DATE INSTALLED
INSTALLER
E:]Septic Tank or El Holding Tank
Size: 1000 If Tank is homemade
give dimensions:
SOILS RATING
10(
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
A -a
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
6�APPROVED FOR BEDROOMS
0 CONDITIONAL APPROVAL (letter must accompany certificate)
El DISAPPROVED
DATE
BY
72-010 (Rev. 6/79)
0 Municipality of Anchorage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
May 8, 1990
Mr. Carey S. Meyer, P.E.
Tryck Nyman & Hayes
911 West Eighth Ave.
Anchorage, AK. 99501
Dear Mr. Meyer:
Following a site visit and careful review of the proposed
curtain drain installation for Mr. Harman's lot, I find that my
original concerns remain. These are: separation from the septic
system to the point of discharge, if the road ditch is now or
will become a stream, and the impact the proposed drain will
have on development of neighboring lots.
Currently there is a small stream issuing from Lot 8 to the road
ditch. This stream appears to be more than seasonal runoff and,
if so, would preclude the installation of an absorption field on
the front half of Lot 7. The exception here would appear to be
the small segment occupied by the driveway near Mr. Harman's
house.
I would suggest that a monitoring tube be installed prior to the
curtain drain being constructed. This would allow you to obtain
qualitative data concerning the impact the drain has on the lot.
Curtain drains are effective in lowering perched water tables in
many areas of the hillside. The use of such a drain should
effectively lower the perched water affecting the septic
absorption area. However, if you create a persistent discharge
of water you will need to maintain the 100' separation required
by state and municipal codes.
Please let me know if there is anything you need clarification
on.
Sincerely,
Daniel N. Bolles
On-site Services
117/db
ENGINEERS/SURVEYORS/LANDSCAPE ARCHITECTS
TRANSPORATION and COMMUNITY PLANNING
May 2, 1990
Mr. Dan Bowles
Municipality of Anchorage
Health and Human Services
825 L. St.
Anchorage, Alaska 99501
Dear Mr. Bowles:
Re: Lot 7, Block I
Timberlux Subd., Add #2
Conceptual Plan Submittal
New Septic System
PARTNERS
FRANK E. NYMAN
JOHN F. CHAPMAN
WILLIAM M. SMITH
Attached is a conceptual plan reflecting the existing conditions and new Septic
system improvements proposed to be installed on the above referenced lot.
The existing absorption field has been abandoned and two septic tanks located
on the lot serve as a holding tank. A high groundwater table has adversely
impacted the ability of the absorption field to operate in a satisfactory manner.
We propose to install a curtain drain along the south edge of Lot 7. This
improvement is expected to lower, if not eliminate, the perched groundwater now
affecting the lot. The homeowner is acquiring a permit from Public Works for
the curtain drain outfall into the ditch. Initial conversations with Public
Works has indicated a permit can be acquired for this lot.
Once the curtain drain is in place, we will complete a test hole and a
percolation test to define groundwater conditions and specific absorption field
requirements. The curtain drain is expected to allow for a deep trench type
system once the perched water table has been cut-off up hill.
Please review the attached plan and comment on our proposed solution to the
septic system problems on this lot.
Yours very truly,
TRYCK, NYMAN & HAYES
Carey . MeytP.E.
cc: Randy Harmon
MUNICIPALITY OF ANCHOPAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
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SRB 196X, EAGLE RIVER, ALASKA 99577
Subject:
FOLD
MESSAGE
ROBERT A. SHAFER, P.E.
694.2979
HEALTH AUTHORITY APPROVALS
EXCAVATING I CIVIL ENGINEERING _..
WORK ARRANGED i ADEQUACY TESTS I SOIL TESTS
WATER & SEWER LINES & MAIN EXT.
ON SITE INSPECTIONS
DATE OF MESSAGE ROUTING SYMBOL
SIG OF ORIGINATOR
TITLE OF��TOR
----�71
�!
REPLY
D T Jt.✓j° G�rl�y ! '�%l( Y�.r �: G:�t ° .' ! /r? '�/i� a2F;r%/GAJ �`l�G/Gi
Rr(EIVED
�JUL 21992
4 D y/
rets �
From:
RETAINED BY ADDRESSEE
FOLD
Municipality Of Anchorage
Dept. Health & Human Services
DATE OF REPLY ' ROUTING SYMBOL
RE OF PxIER
J /
TITLE OF REPLIER
��, /� = -��
GARY PLAYER VENTURES
CONSULTING GEOLOGIST
BOX 476-M, STAR ROUTE A • ANCHORAGE, ALASKA 99507 • PHONE 344-7071
August .23, 1976
SOILS TEST
Alan Larson
Lot 6, Block I
Timberlux Subdivision
Depth Soil
0-17 feet
Gravel, dense, silty, sandy,
grey -brown (GM).
Puddles of water were standing at the surface from recent
torrential rains (date of inspection 8/17/76). No subsurface
water was encountered in the backhoe -excavated test pit.
Rock is greater than 20 feet below ground level in this area.
Sincerely,,
Gary F. Player
Consulting Geologist
