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Municipality of Anchorage 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: ,4V `I 7 o;2, S PID Number: 05—/ F -7- Y
Name: r L
L�;l, � <." � z
Wastewater System: XNew ❑ Upgrade
Address:'7.�32 �•/T7�, �QN� C� yG �.vGr A
ABSORPTION FIELD
Phone:
No. of Bedrooms: -/
(Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating: ra
/
Total Depth fCT, O 5T original grade:
'
O GPD/Sq.Ft.
LbennJeath
Lot: / Block: .9 Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
S
Ft.
a' Ft.
Township:
Range:
-
Section:
Fill added above original grade:
Gravel length: 7 7
Al-
W
. e7 Ft.
Ft.
WELL: 0New ❑ Upgrade
Gravel width:
Number of lines:
1
Distance between lines:
vA
3 Ft
Ft.
Classification (Private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe material:
(/C
7 / v<rTG
V V1.c?i•F[.
2d/. 2 S Ft.
O/ SD. Ft.
Driller:
Date Drilled:
Static Water Level:
'10
Installer: e'/r` S
Date installed:
9- -
Su/l t•H W,0 -<. we-/ys
9-•�-s
/ FL
i Ex— 9% —0 09
Yield:
Pump Set at:
Casing Height Above Ground:
O GPM
UP1/(N Ft.
:2 -TANK Ft.
SEPARATION
DISTANCES
Vseptic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption-11ati
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Tank
Sewer LinesWell
l//
r(%�
/1/fi
}/Ovi
Material: 5�.�t`
Number of Compartments:
Surface
LIFT STATION ///�
I
,vA
Lot
.zZ i
rQ i
3��
Size in gallons:
Ma rer:
Line
Foundation
N�
"Pump on" level a
"Pump off' level at:
gh water alarm at:
Curtain
�/�
Pump Make & Model
Electrical Inspections performed by:
Drain
BENCH MARK
Remarks:
Location and Description:
Assumed Elevation:
FtEN,SSg?l
.
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a
S'o. a06asn Btcs¢gm G•,',. {P
3gj . Ea14
1 1 1F� 6
1st
4i'�y aFyvip6 ataaas,cmarc
Inspections performed by: Dates:
2nd?'97
ri : Louis A. Bviera �c4
—'i'-
g F r +a CE -6736
1F``tie�¢••s>»40
Department of Health and Human Services approval
0' y4a'
Reviewed and approved by: �� y� C '- l ��� Date: 0.10
72-013 (Rev. 9/91) MOA 25
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Permit No. SW970255
Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.D. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description SAMPSON ESTATES BLK 1, LT 6
PID No. 0rlkD- 't
GOB
�2.58a ELL LOC 2
124.3
A N
2 3 N GPRPGE 4
a HD6SE
£ SWING TIES
SEPT1250 GAL �1"
TANKIC� 3j F-NCN A -C = 109.9
B -C = 138. 3
D �TH20 A -D = 122.7
o' 0TH1 B -D = 168.7
SCALE 1"=60'
® — TEST HOLE
•— MONITOR TUBE
o — SEWER CLEANOUT
— WELL
— LEACHFIELD
ELEVATIONS NU LOT CDR REBAR
(NOT TO SCALE) ASSUMED ELEV = 106.84
9/9/97
ORIGINAL ENGINEER'S SEAL
GROUND ooOOOp��
FILLLEVEL AT+ o`er OF q�opQ
99.0 �P�� ........... �S�Q�
.3'
49 T
... ....
TANK O D
97.2 6.9 96.7 96.7:.:..........................0
O '.LOUIS A. B U T E R A ." �O
QO'. CE -6736
90.2
a44��4400��6PQo
ADDRESS + `J } Sol /y 11, [A NrT I- FW'15 L
LEGAL DESCRIPTION S407to S ,&3 CS 7'
• I4 L IC � � �. DT! b
PERMIT NUMBER 4 %OA SSDate of Issue, -
TAX INDENTIFICATION NUMBER
°
- """"` well located at approved permitocation? G(es C] No
r
`Method of Drilling: ir rotary ❑ cable tool
Depth of well:
Casing Type STEEL Wall Thickness So inches
' 3 '
Diameter b inches, depth o?D 1 feet
Liner Type: ri 4.4 E
Casing Stickup Above Ground:. feet
Static Water Level (from ground level): / feet
Pumping level: feet after hrs. pumping gpm
Recover Rate: oZ o d gpm
Method of Testing: )9 1 A.
Well Intake Opening Type:
❑ Screened; Start feet Stopped feet
❑ Perforations Start : x - feet . Stopped Tfeet
Grout Type: &L JTD A) t rZ Volume oR 5
Depth: from 0 feet, to feet
Pump Intake Depth:
Pump Size hp Brand Name
Well Disinfected Upon Completion? ores ❑ No
Method of Disinfection: C/11.aAi.Jh T)Q644971 SnsP�ii'�
Ove oC 9jRD46rJ
ALT 7 AQAjeL
SA -00 6,1A AJr4- d4dr 41)Y
I I -
50004 6,t04.1c'Z
i�L
P 30 1997
Drillers Name
It is the responsibility of the property owner to submit a copy of the well log to the proper authoi
ora' 'Oe: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough:
ner tof Environmental Conservation.
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:SW970255 DATE ISSUED: 8/13/97
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE: 8/13/98
OWNER NAME:LANCE, CRAIG AND LESLIE
OWNER ADDRESS:9732 NILTINA LANE
EAGLE RIVER, ALASKA 99577
PARCEL ID:05182224
LEGAL DESCRIPTION:
SAMPSON ESTATES BLK 1 LT 6
LOT SIZE: 40659 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
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:
PROPOSED RESERVE TRENCH MAY NOT BE LOCATED
LESS THAN 35 FEET FROM A CHANGE IN SLOPE
TO GREATER TH 25%
C
RECEIVED BY:
DATE:
ISSUED BY: �///% !%T'�✓ t�'rr^c f' DATE: �) —13'- �'
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
July 29, 1997
Jim Cross, P.E.
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Sampson Estates Lot 6, Blk 1
Narrative & Permit Application
Dear Mr. Cross:
The proposed septic upgrade will have very limited impact on adjacent properties for the
following reasons:
The surrounding lots are large and all wells are locate to the North, allowing
sufficient room for septic sites.
2. Immediate neighboring septic systems are all +30' distance.
3. Reserve space is adequate for 2 trench systems as shown on the siteplan.
4. Drainage will not be affected and is not a major consideration in our design.
We are requesting a 15' variance to the usual 50' code setback to a change in slope of greater
than 25% for the reserve septic trench. The neighboring well radii are such that we are forced to
place the trenches at this distance from the slope as shown on the site plan. The slope is fully
vegetated and undisturbed and is not excessive. The location of the leachfield at 35' would not in
our opinion compromise the effectiveness of the leachfield or cause effluent surfacing.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\1997\97 -036 -Nair
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
Sampson Estates Lot 6 Block i - 07/29/97
Single Family 4 Bedroom Dwelling
LEACHFIELD SIZING
4 BR = 600 gpd
Soil perc rate = 18.5 minutes/inch
Soil acceptance rate = 0.6 gpd/SF
Required absorption area =I 000 SF
Use a trench with 6.5' of gravel, 77' long, 3' wide trench
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G:\WPDOCS\1997\97-013-CAL 1
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
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Sampson Estates Lot 6, Blk 1
7/29/97
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 and State
Department of Environmental Conservation 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, Department of Environmental Conservation requirements.
6. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
B. SEPTIC TANK
1. The septic tank shall be a minimum capacity of 1250 gallons and be of MOA approved design.
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 9' 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.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH= 9' GRAVEL DEPTH = 6.5' under pipe, 2" over pipe
TRENCH LENGTH= 77' TRENCH WIDTH= 3'
SOIL RATING= 0.6 GPD/ft2 BEDROOM CAPACITY= 4
SEPTIC TANK = 1250
Twenty-four (24) hours notice required for all inspections.
\1997\97-036-spc
NO SURFACE WATER
NO KNOWN CURTAIN DRAINS
WELL/SEPTIC SATE PLAN
LEGAL: Lot 6 BK 1 SAMPSON ESTATES
OWNER: LANCE
CONTRACTOR: N/A SCALE 1" = 60'
JOB 97-036A DATE: 07/31/97
EAGLE RIVER ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 694-3297
®
- TEST HOLE
•
- MONITOR TUBE
0
- SEWER CLEANOUT
- WELL
- EASEMENT
- PROPOSED LEACHFIELD
EXISTING LEACHFIELD
��. OF, q49jo Ag ttt
sem' TH�
�, •� LOUIS A. 6UTERA
�,,�� • CE -6736
0
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 " U' Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
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3 4 6
PERFORMED FOR: DATE PERFORMED:!
LEGAL DESCRIPTION: G.M So 444eS %04 S'Bk:/Township, Range, Section:
SLOPE SITE PLAN
1
2
/Li)
4 I y �ia-i, Stingy/v2nY
1 Gi¢ns2 Haar bo'!-om
5-
6
s
5r-ey
7 r
8
9 �l
H
Tk
j WAS GROUND WATER
10 f+ ENCOUNTERED? �e
S
i II
L
IF
r YES, AT WHAT 0 0 3 io
j DEPTH? P
12 a E
1 Depth to Water After
13Yom• /
Monitoring? Date..
14-
15-
16-
17
4151617 1i
18 U0 -H ale
19
7
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
Preso�
Z
as
1
7-34,--12 I c7:( 6
3 4 6
aZ
I I v
30m:n
V,b
16
3
I v. So
3' 14
ti
i
30,„.
6
,6
s
I I
n
%'X6
.6
20
PERCOLATION RATE I �' (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS floiE / "tisso is,- zr-.w7'
PERFORMED BY: Flt f I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
0
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
or Al
� �y'^.'eeows.oeee�
Lou% A. iSufore
se CE -6736
eo
PERFORMED FOR: G-clNGe DATE PERFORMED: 7—x8-77
LEGAL DESCRIPTION:!0Md'fcnEsia�SLu��1310�� I Township, Range, Section:
TN z
1
2-
3-
4-
5 3a 5 iI
I�
6
1
7
I
I
9-11
4w
10
r
11
d
12 !
;I
13 L
14-
15-
16-
17
a151617
18
19
20
COMMENTS rll�:5r'
orya�;c-Te�Su� �
�&M )
51,14 a I %h
5A d , NO WT-
encouA-�eled. Ver�11yY
dense nQar 6o oM
5 re.Y
f3o+I•oin o-.'
X01 e
SLOPE
WAS GROUND WATER /� O
ENCOUNTERED? �/�
SITE PLAN
r_�
6"
PERCOLATION RATE I (minutes/inch) PERC HOLE DIAMETER
i t
TEST RUN BETWEEN FT AND FT
PERFORMED BY: f2 %� T I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �A
72-008 (Rev. 4/85)
S
IF YES, AT WHAT
N/ADEPTH?
L
D
P
E
gepth to Water After
Monitoring? 9E gate:
SITE PLAN
r_�
6"
PERCOLATION RATE I (minutes/inch) PERC HOLE DIAMETER
i t
TEST RUN BETWEEN FT AND FT
PERFORMED BY: f2 %� T I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �A
72-008 (Rev. 4/85)