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Home My WebLink AboutSEA TURN BLK 1 LT 5Sea Turn Block 1 Lot 5 #017-121-50 Inspection Report_1-1-12.doc 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: OSP141332 PID Number: 017-121-50 ❑ New ❑✓ Upgrade Name: Kent Huey & Mary Living ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑✓ Mound Address 6001 Azalea Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 12 GPDISF 4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1 Ft. Gravel depth beneath pipe 3Ft. Subdivision Block Lot SEA TURN 1 5 Fill added above original grade 1.5 Ft. Gravel length 60 Ft. Township Range Section Gravel width 5Ft. Beds: Number of Lines 1 Distance between lines NA Ft. SEPARATION DISTANCES To Septic Absorption Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Tank Line 517 Ft' 1 NA Ft. Well 100+ 100+ N/A N/A NIA TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 125OGal. Surface Water 100+ 100+ NA N/A Material Steel Number of compartments 2 Lot Line 27.6 13.5 NA N/A NA Foundation 17.5 55.6 NA N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain 50+ 50+ NA N/A Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 drainfiield Installer A Plus Home Services Dralnfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCHMARK (Assumed elevation) 1001 Inspection 1sr 09/12/ dates: ie 4 2" a 09/15/lelY p Location and description - p&h Northernmost deck footing 3'" 0 COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF At Conditional Approval: Date • - • . • • tQ�p ti' q StevenC h.` �anr orae 814 W Approved W Date y /7 /✓� �1 hAgpFE55�pE'4s++ Inspection Report_1-1-12.doc A A 1 A 6LL (E) SEPTIC AREA (E) Fc \ Q 1 � 1 _ J l I � 1� r UPGRADED DRAIN FIELD I Ny-GOLF x 5'W x 3.0'ED x 4.0'TD r S1\ 1y. 73 !v\ �TH_2 `SEPTIC AREA (E)' \I \� TH-1 i' ss - I-... sS \ s5 DC t�^��• \ D OV rn 'Z INSTALLED 12508 SEPTIC TANK w A Q . OF -G'1 A SFr DRAIN FIELD /\ I IN FAILURE. REUSE AS RESERVE O 0 S z NOTES: RECORD DRAWING PLAN � \T )i WELL PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SEA TURN, BLOCK 1, LOT 5 KENT & MARY HUEY 6001 AZALEA DRIVE ANCHORAGE, AK 99516 WITH DCO AND OV ABANDONED 1250q '� --SEPTIC TANK (E) PER CODE LOT 5 w 1 / 777 �v c? \\� Date Of AL,4 �l�� 03/31/15 ,-:'49TH 1„_50' P.I.D NO -Z. )(2 � 017-121-50 814,_ , j IOSP141332 2 OF A B FC 18.9 30.3 T1 23.4 25.3 T2 24.5 21.9 DCO 25.7 21.7 DV 27.9 20.6 FC1 65.5 57.2 M1 66.9 58.9 M2 109.4 96.7 FC2 1 111.3 98.6 NOTES: RECORD DRAWING PLAN � \T )i WELL PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SEA TURN, BLOCK 1, LOT 5 KENT & MARY HUEY 6001 AZALEA DRIVE ANCHORAGE, AK 99516 WITH DCO AND OV ABANDONED 1250q '� --SEPTIC TANK (E) PER CODE LOT 5 w 1 / 777 �v c? \\� Date Of AL,4 �l�� 03/31/15 ,-:'49TH 1„_50' P.I.D NO -Z. )(2 � 017-121-50 814,_ , j IOSP141332 2 OF SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS. 2. SCOPE OF WORK: INSTALLED NEW 12509 SEPTIC TANK WITH DCO, DV, AND SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 10 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. NO APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10 FEET BELOW EXISTING GRADE. TH-1 -1.0 w,• GM/ SM -5.0 GW -7.0 SW _9.o GM/ SM -11.0 1250g SEPTIC TANK DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4(600 gpd) TANK SIZE: 1250g PERC RATE: 2.4 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: WIDE TRENCH 3.0'ED MIN LENGTH: 58 LF USED: 60 LFx5.0'Wx3.0' E.D., 4.0' TD TOTAL AREA: 517 SF RIGID INSULATION FILTER FABRIC SEE DESIGN PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS CU 4" 0 PERF PIPE DIP DUCTILE IRON PIPE DRAIN ROCK 6" ABOVE PIPE INV EL95.3 3 FOUNDATION CLEAN OUT T# 11 MAX C# —2.5 EL.93.8 MONITOR TUBE NO. ELsae RIGID INSULATION DCO -Ti I: ... J DV 3.0 FS FLOW SPLITTER }- BELOW FINISH GRADE EL89.8 ORIGINAL GRADE FG 5.0 DRAIN ROCK TOPSOIL AND VEGETATE 84.8 (9/11/14) SECTION w 0w- o� > U �o U Un DnUnOn Z z j Z O Z W O ITYHHA SEE DESIGN PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE - FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NOTES:- PA `Il`IOl`E ENG SVC, LLC ��QF A/- kl03/31/15/ RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 1` Scale PHONE (907) 272-8218 FAX (907) 272-8211 1w y �' NTS #: . ••••• P.I.D. NO SEA TURN, BLOCK 1, LOT 5 ...� 017-121-50 Steven •f2�•P annoNe PERMIT NO. KENT & MARY HUEY CE_ _81�49, 6001 AZALEA DRIVE �+j T1s I -t Sc'uv OSRi a1332 DESIGN DETAILS ANCHORAGE, AK 99516 ��1�9FD'' " \, Sheet `\�\�ES500 3 OF 4 1 2 3 4 5 6 7 8 9 ,D 11 12 13 14 15 16 17 18 19 TEST HOLE 2 OR ORGANICS GM1 SLIGHTLY SILTY SM - SANDAND. GRAVEL BOH WELL GRADED SAND ANO GRAVEL DATE PERFORMED: 9/12/14 SOILS LOG - PERCOLATION TEST SLOPE i FC TH z TH-1 v Fa M1 SLOPE SIKNLAN DvD`°�\ T2 3 \Ti \ WAS GROUND WATER ENCOUNTERED? n IF YES, AT WHAT DEPTH? -dry' DEPTH TO WATER AFTER MONITORING' - DATE: -/-/-- TH X READING DATE CLOCK TIME NETTIME WATER LEVEL READING NETDROP 1 9/12/14 9:00 --- 3.24 --- 2 9:10 10 MIN 9.24 4.80 3 9:10 --- 3.24 --- 4 9:20 10 MIN 9.20 4.28 5 9:20 --- 3.24 --- 6 9:30 10 MIN 9.21 4.25 PEROLAT10N RATE 1.7 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 5 FT AND 6 FT COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked. Test run for at least one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. - NOTES: PANNONE ENG SVC, LLC -� OF A��\l Date /15 RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK 99510 r '�� • • " • qS l� PHONE (907) 272-8218 FAX (907) 272-8211 ig�P �y+` Scale SEA TURN, BLOCK 1, LOT 5 KENT & MARY HUEY 6001 AZALEA DRIVE SOILS LOG ANCHORAGE, AK 99516 *: ..*. �V P.LD.TNO ....... % 017-121-50 Steven R. Pann e j PERMIT NO. CE 8149 .•tri 4 O 4 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: OSP141332 Tax Code Number: 01712150000 Work Type: Septic Upgrade Permit Effective Dates: September 03, 2014 to September 03, 2015 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: SEA TURN Site Legal Address: SEA TURN BILK 1 LT 5 G:3138 Owner/Address: HUEY KENT D & MARY A LIVING TRUST 6001 AZALEA DR ANCHORAGE AK 995164330 Site Mailing Address: 6001 AZALEA DR, Anchorage This permit is for the construction of: Lot Size in Sq Ft: 43540 Total Bedrooms: 4 Y Disposal Field Y Septic Tank N Holding Tank N Privy 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 freezipn - Special Provisions: The Engineer needs to do a percolation test in the GW/SW layer prior to the construction of the septic field. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. AMC 15.65.060.B.3 Received Issued By: W, Date: ! Y 2 o i � Date: / MUNICIPALITY OF ANCHORAGE Iii w Community Development Department PAL 90xtj 4q9J7 4 Development Services Division6 Fax: 907-343-7 On -Site Water & Wastewater Program t1retchert Stuller ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-121-50 Property owner(s) Kent & Mary Huey Day phone Mailing address 6001 Azalea Dirve, Anchorage, AK 99516 Site address 6001 Azalea Drive Legal description (Sub'd., Block & Lot) Sea Turn, Block 1, Lot 5 Legal description (Township, Range & Section) Lot Size 43,540 Sq. Ft. APPLICATION IS FOR: (M all that apply) Absorption Field ❑X Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 4 APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) ❑X (w/wo ADU) Upgrade ❑X Duplex (D) ❑ Renewal F-1 Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 5109 Date of Payment: $/m/ L- ReceiptNumber: 02ri3S6 Permit No. 65PAJ 13 31) 1 Permit App_-.:- : - ; Ls: Waiver Fees: Date of Payment: Receipt Number: Waiver No. Pannone Engineering Services tic Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@L)anen¢ak.com August 11, 2014 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. 0. Box 196650 Anchorage, Alaska 99519 Subject: Sea Turn, Block 1, Lot 5 Septic System Upgrade Permit Request Ladies and Gentlemen: I am writing to request a permit to install an upgrade septic system be issued for this property. The proposed systems will serve a existing four (4) bedroom house. Currently the existing field is in failure . The existing 12508 septic tank will be abandoned per code and a new 12508 septic tank will be installed. An upgrade wide trench type drain field will be installed and the existing failed field will be re -used as a reserve. This lot is served by a private well. The surrounding lots are also served by private wells. There are no wells within 100' of this system. Soils. Pannone Engineering performed one test hole on this lot in July of 2014, and groundwater was monitored for seven days. Ground water was not observed to a depth of 9.0 feet below the ground elevation in the test hole monitor tube. It is my opinion, based on the results of the soils tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used for a conventional wastewater system. 1. Soil Absorption System Design. a. See Sheet 2 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank-and—drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The proposed drain field is located on the northwestern portion of the lot. The surrounding topography generally slopes from northeast to southwest at approximately 20%-25%. There are no steep slopes within 50 feet of the proposed drain field. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 4. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 41 W ELL (E) S PTIC AREA (E) 44 �N 0 SEPTIC AREA (E) F TH-1 xy INST ALL 1250g SEPT IC TANK (P) WITH DCO AND DV ABANDON 1250g SEPTIC TANK (E) �1 PE R CODE UPGRADE DRAIN FIELD (P) 60LF x 5'W x 3.0'ED x 4,0'TD DRAIN FIEL D (E) IN FAILURE. REUSE AS RESERVE LOT 5 ZF -n WELL NOTES: PAMONE ENG SVC, LLC Date FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ...... 8/29/14 PHONE (907) 272-8218 FAX (907) 272-8211 Ir Scale .... .... ......... P�LD. NO SEA TURN, BLOCK 1, LOT 5 ..... .. . .. . ........ 017-121-50 KENT & MARY HUEY Steven . Ponnope �ERMIT NO CE 8149 6001 AZALEA DRIVE OSP1 41332 PLAN ANCHORAGE, AN 99516 Sheet I OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS. 2. SCOPE OF WORK: INSTALL NEW 1250g SEPTIC TANK WITH DCO, DV, AND SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 10 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. -RIGID INSULATION - FILTER FABRIC 4" 0 PERF PIPE (-DRAIN ROCK 6" ABOVE PIPE INV - 1 BAX ROCK DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4(600gpd) TANK SIZE: 1250g PERC RATE: 2.4 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: WIDE TRENCH 3.0'ED MIN LENGTH: 58 LF USE: 60 LFx5.0'Wx3.0' E.D., 4.0' TD TOTAL AREA: 517 OF TRENCH SEE DESIGN PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS CU COPPER SECTION DUCTILE IRON PIPE TH TEST HOLE FC w T# TANK CLEAN OUT N0, Z CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. o <o sso 0 o Jo w w m w a oz FLOW SPLITTER zm=l� BELOW FINISH GRADE OG �w FG wow= a� 50 40U U UOUO Z Z Q O O � 12509 SEPTIC TANK (P) DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4(600gpd) TANK SIZE: 1250g PERC RATE: 2.4 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: WIDE TRENCH 3.0'ED MIN LENGTH: 58 LF USE: 60 LFx5.0'Wx3.0' E.D., 4.0' TD TOTAL AREA: 517 OF TRENCH SEE DESIGN PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT N0, C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION -. DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NOTES: wt��\\ Date PANNONE ENG SVC, LLC -- �� FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 111 8/29/14 8/29/14 PHONE (907) 272-8218 FAX (907) 272-8211 %gip �y#+ Scale SEA TURN, BLOCK 1, LOT 5 KENT & MARY HUEY 6001 AZALEA DRIVE DESIGN DETAILS ANCHORAGE, AK 99516 * *�/ NTS .. P.I.D. NO 17-121-50 Steven CE 49 49 R8181orie / PERMIT NO .'F�j OSP141332 Ili cs' l`liF�OFESSIONP�' Sheet \\\�SSMW 2 OF 3 TEST HOLE 1 SOILS LOG - PERCOLATION TEST SLOPE OR ORGANICS ` 1 \ �J h ?7 J 2 IH_1 GM/ SLIGHTLY SILTY 3 SM SAND AND GRAVEL 4 /( J � WELL GRADED 6 GW/ SAND AND X SW GRAVEL I TH 7 114U\1 8 9 GM/ SILTY SAND AND SM GRAVEL I \ Cr 10 y_ BOH 12 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? Y 15 IF YES, AT WHAT TH 16 DEPTH? -11.0' X 17 DEPTH TO WATER AFTER MONITORING? -9.0- 18 DATE: 8/6/14 19 DATE PERFORMED: 7/31/14 qjI2�' PEROLATION RATE 2.4 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 3 FT AND 4 FT COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked. Test run for at least one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE ENG SVC, LLC of A �j Date FOR CONSTRUCTION P.O. 80X 102954 ANCHORAGE, AK 99510 c� . . �gsll� 8/29714 PHONE (907) 272-8218 FAX (907) 272-8211 %g�P �y+) Scale 4 ,t l) NTS ...... . ... ... P.LD. NO SEA TURN, BLOCK 1, LOT S ....... ou-121-50 KENT & MARY HUEY Steven annolee / PERMIT No. 6001 AZALEA DRIVE ��+Pt, I CE 8149 , ��/ OSP141332 SOILS LOG ANCHORAGE, AK 99516 `il\�PROFESSOR- Sheet eOF 3 READING DATE CLOCK TIME NET TIME WATER LEVEL READING NET DROP 1 7/31/14 1:20 --- 4.00 --- z 1:30 10 MIN 8.80 4.80 a 1:30 --- 4.00 --- 4 1:40 10 MIN 8.28 4.28 5 1:4D ___ 4.00 "-- s 1:50 10 MIN 8.25 4.25 MUNICIPALITY OF ANCHORAGE �j DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION (` ENVIRONMENTAL ENGINEERING DIVISION 825 L. Street - Anchorage, Alaska 99501 Telephone 264.477.0 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ��y NAME PHONE `i— W �c - �a '�O E0.17M� .^ Iw/// a�l%C ii, .f � ❑ UPGRADE - -- _ MAILING ADDRESS PA L - LEGAL DESCRIPTION �[ �/ cl/ �_ ' I pie 2�1�1 i� Ll lj x) LOCATION r A NO. OF BEDROOMS aC,/Iii l' DISTANCE TO: Well Absorption area / Dwelling , PERMJT NO. �-' 1— Q Manufacturer Material No. of compartments ®I Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth z DISTANCE TO: Well Dwelling —� PERMIT NO. r2'�%Z7LrITA7 V, - O Z Q Manufacturer Material Liquid capacity in gallons w z DISTANCE TO: Well �� % Foundation / _ Nearest lot line / 3 _ PERMIT NO. - <' zca.ae>`S— _j a z Zug No. of lines / Length of each line Total length of lines Trench width Distance between lines .^-- y !�i j C _inches aI- Top of tile to finish grade ed _�._. Material beneath tile J !r _ - a -1/7 ' inches Total effective absorption area uw Length Width Depth PERMIT NO. 0— 4 k- uj Type of crib Crib diameter Crib depth Total effective absorption area w DISTANCE TO: Well Building foundation _ __ _ Nearest lot line J Class DISTANCE TO: Depth Building foundation Driller Sewer line Distance to lot line PERMIT N0. Septic tank —� Absorption area(s) OTHER - PIPE MATERIALS SOI L TEST RATI NG INSTALLER REMARKS We ./ A/01 owed .) — — q•® _— 9. ••ee•eeo>e� e° ®•e HM H W4••. gee aN — - - - GW% O. Talbot •Ajv ®e Ini%_ No. Sl. a -0 �00 40 , %00•aee•••e 1y ®%;2oFs�o,�9W APPROVED DATE LEGAL .® g /Gf4/yg 72-013 (Rev. 3178) Ir" q 9, & PA 1 C- 'Ir. F=" F-10 .r:."r o -e A_A F= r -i r-,4 c.: vi #.,-:i `' s=1 P:3 F___ DEPAF:TME1,4T -'" E•IEALTH ANSI.:' ENVIRONMENTAL rl-,OTECTIONd 825 'i.. STREET: ANCHORAGE, AK. :-r. J. 11-^ 4 72 p.-. F.: L.Y. t_ F) PA IC:., CA E'-4 -."EF F 1 --t... r'. - :. �" E-:1- 1 F - Fs F--" V—". F;_" 11 1 —F F'EE:N1I "r NO. r: 8F 05t*_ 5 :? APPL I CANT SIJNd CO TF'I„n:; CTI ON SRA BM,,' 4 ME ::4 51--:1_F E.,9 I_OCAT1ON•d 4—Zq (Pty. 4-. Z(rcor) LEGAL L5 B1 SEATURN?l WT SIZE: ..1.EWi00f...9 S,Qn_AF.,:Ew (-'FEET TYPE OF SOIL. ABSORPTION SYSTEM IS: TRENCH 1',l I.MI_It9 NUMBER OF BEDROOMS e 4 SOIL RATIN r.: -;i_I F'T/E)F':?-- 85 'THE REQUIRED SIZE OF THE SCS I L_ ABSORPTION SY—STEM I S. : THE LENGTH DIMEtISIONd IS THE: LENGTH (INd FEET) OF 'THE" 'FRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT I'= THE DISTANCE BETWE.ENd THE:: SURFACE OF THE GROUND AND THE BOTTOM OF THE E <,CAVATIONd r: Itd FEET). THERE IS NO SET t'•IIDTH FOR TRENCHES. THE GRAVEL. DEPTH IS THE MU-11MUM DEPTH OFF GRAVEL. BETWEEhl THE OUTFALL FIFE AND 'THE BOTTOM OF THE EXCAVATION INd FEET:?. PERMIT APPLICANT HAS, 'THE PESPON S I B I I_ I TY To INFORM THIS DEPARTMENT DURING 'THE: IN`_:TALL_ATTf)N INSPECTIONS OF' ANY H[?:IfiCENT TO THIS F'F;OPERTN' AND 'THF' NUMBER OF RESIDENCES THAT THE WELL, L'IIL.L SERVE. ...._. _._... ,_... _T_ W 0 °-. =2 1 1F-" F= --'f -_71- 1 CA F-1 F, �' F"_ F-- CA A_..A :T r- L^-.- E. .,._.._............ BAC:E' F'IL_I._IN G OF ANY :=Y'STEM WITHOUT FINAE_ INSPECTION AND AF'F'RW)AL. BY THIS DEPARTMENT I.'•IIL.L BE SUBJECT TO PROSECUTION. M I N•d I MUl''1 DISTANCE BE TWEENd A I.'.IEL.L AND ANY OW -SITE SEWA13E DISPOSAL. SYSTEM I'S, ::I..00 FEET" FOR A PRIVATE WELL. OR J.50 TO 200 FEET FROM H PE.IBUC 14EL-L DEPENDING UPON THE TYPE OF PUBLIC E'•IEL.L. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER UNE I.E. • 5 FEET AND TO A COMMUNITY :,EWER LINE I'.; —79 FEET. klEl._L L -001S ARE. REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 71:0 DAY!. OF THE WELL i^ OMPLET I ON. OTHER iT:i i:?I_I I REMENdTS MAY APPL.Y. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAII-ABI..EF TO INSURE PROPER IN—STAE_LATION. F'-'' EE F" 0--1 1 _f- FE. --e F'"'" I F.: -m L_ : ED, F 0 FE. r"1 r= -.n E. ice•.:. »'= :�.... _" _:)L. 0-;E4 6= o rZA I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE SEWERS FIND 41EL_LS AS SET FORTH H BY THE 11LINd I C I PAL I TY OF ANCHORAGE. I W I I..L I NSTFIL_L 'THE SYSTEM IN ACCORDANCE WITH "THE CODES. . : I. I_INDEF,'E;TF R-,lD THAT THE ON --,.:'.,'ITE : SEWER{ Y S TEMMAY REQIJ I F E ENLARGEMENT IF THE RESIDENCE I,$, REMODEE..ED 'TCS INdC:L.UDE MORE THANE.EDROOMI..... SIGNED: _ �w _?%�` rV4.. C:7 1 S,;LIEF? F-w'r' ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR: C `��1� 'oo' DATE PERFORMED: LEGAL DESCRIPTION: DEPTH (FEET) 1 2 3 4 5 6 7 12 13 14 SLOPE —_ _ t r WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT UUU DEPTH? OF A A 16- to 6 o 17 NX 0. ref 19 Too� AA -1 SITE PLAN I I 20®�@�QP�ES� kai��op�,�uti�s� PERCOLATION RATE_ 22— (minutes/inch) TEST RUN BETWEEN - 2- FT AND FT COMMENTS PERFORMED BY( 72-008 (7/76) CERTIFIED BY: DATE:�Q Date Gross Time Net Time Depth to Water Net Drop " L2� rr � it 20®�@�QP�ES� kai��op�,�uti�s� PERCOLATION RATE_ 22— (minutes/inch) TEST RUN BETWEEN - 2- FT AND FT COMMENTS PERFORMED BY( 72-008 (7/76) CERTIFIED BY: DATE:�Q To C;a_r"t.h Talbot S;.:ar Route ADox 9143 Anchorage, Alaska-, 99507 r L;nrir;nvlic,�tai l'rulr_:clior, 0 ilnronc�lt:Ei ';;Itt�tation 1>ivisiUal M f0Uh17-1 FLJ(>?, 'Vy 5 lti,�dC„i{OPJ.rt, AUoKA 9��Si31 SUBJECI Pc rudt. #800565 DA.rE 10-21--80 Enclosed we are returning the as -built:; for the above permit. The legal description sloes not match with the permit. This is unacceptable until the legal description is corrected and returned to this office. Please note the different: :Legal descriptions(lot) on the copy of the permit and the as-builts. Any questions, please call. this dlepartment at 269-4720. SIGNED hes N. Buchholz, R. ,' -;'.e Senior. I:11virom:nental specialist cc: Jcunes Bumgardne:r Star Route A Box 41741,. Anchorage, Alaska 99507 (iodi4frm 4S _-171 Thomas C./Anita Lipps ATC L]1,\f`1'1RPRT SES Star Route A Box 4084 99502 SIGNED SEND PARTS 1 ANII 3 wim C:AimoN mrACT - PAU'r 3 SVlll. Gr. RETUpP41, VM14 PULY. I'll Yu : 5111:5, y.1, C4 C) C4 cc es— LLJ C4 4 ;I A a p C ri 0 0 0 0 0 0 0 0 :4 1 IM, Ni c,i OE H. F F- . H F- wW. wwU. LLb w N O 0 0 0 0 0 0 0 000000000 o 0: 4 O 0 C') 0 0 C) 0 C 0 A a p C ri 0 0 0 0 0 0 0 0 Ni c,i OE H. F F- . H F- N O 0 0 0 0 0 0 0 o 0: 4 O Z A a p 0 0 0 0 0 0 0 0 H. F F- . H F- N O 0 0 0 0 0 0 0 A a 0 0 0 0 0 0 0 0 A a MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services it 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. # C)C) - 1,'A\ - LfS f) 1. GENERAL INFORMATION 2. 3. 4. HAA # �A & �� Q �'I S Complete legal description LOT 5 64k 1 I 56A TURN Location (site address or directions) 6o0 I A 2 AL EA DR ANcq. AK gRs16 Property owner KENT AvEy Day phone Mailing address Lending agency FIRST NAT 104/16 HANK of ANCN, Day phone 276-6300 Mailing address_ (o46 W65T 4TH A✓E I AKCN . Ak q9 So I Agent NONE Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site ✓ — Holding tank —— Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 421 F1 6. 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 furtherverify 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 F14TTOP TECH SERVICES Phone 3YS- 1356 Address IgS30 FC140 57. ,Q464. AK 995/6 Engineer's signature fid-<� c- Date 9 / ►S 19 Z DHHS SIGNATURE jitx� OF A( '14 0.,,,.....•, •. THEODORE P. MOORE R gip,•.• CE - 3539 !'- cKO= Ar X Approved for 4L bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments ff Lz, ItysF�� jay ��G(c�r By. JOy+i,( 51 t (T7 f Date 9 qZ 111TIr 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 order to satisfy certain federal and state requirements. Employeesof 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 u21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLis-RE& ED Legal Description: 40T 5y &K 1, SEA ivRN _ Parcel I.D. SIP 17 1992 A. WELL DATA Municipality of Anchorag() !Dept. Health & Human Sot vices Well type PRWA1"a: If A, B, or C, attach ADEC letter. A//DEC water system number _ Log present (Y/N) Y Datecompleted 10/1'7/80 _ DrillerSYRCN BROS , Total depth 174 Cased to 1'114 r Casing height 29 Sanitary seal (Y/N) _ 1 V Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM DWELL LOG 10/17(80 X10 g.p.m SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 105' T,) C.O. AT INSPECTION rn O I (7)o n >6.s g•P•r n �1 m O <G r� ti _ 0 On adjacent lots 7 /00 o' rn Absorption field on lot 10(o TO C.0• _ ; On adjacent logs > too r Public sewer main > /O0 r Public sewer manhole/cleanout Sewer service line > $0 r Petroleum tank NOME 0113.5E pVEL> WATER SAMPLE RESULTS: Coliform d co(hoOM4 Nitrate o•/U/ Other bacteria OCC9//ICV0m Date of sample: 9Itfs/9a Collected by: FL.Am)P TECH SVCS R. SEPTIC/HOLDING TANK DATA Date installed 10/111( 80 -Tank size 12SO Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) 2 Depression (Y/N) S High water alarm (Y/N) NA Alarm tested (Y/N) — NA, Date of pumping . (01 .9(9( Pumper I4/ - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot J Q 5 ( bn adjacent lots /00 Foundation I2 / EPON C.0 , To property line 7 /0 Absorption field S / Water main/service line Surface water/drainage >/00 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water _ Date installed /0/1q 80 Soil rating 85 �`r$p�M System type TRENCM Length 55 Width 30" Gravel thickness S4 Total depth 8 7 Total absorption area 415 1:7 Cleanouts present (Y/N) Depression over field (Y/N) N Date of adequacy test `? �8 & z Results (pass/fail) PA SS for 4 bedrooms Peroxide treatment (past 12 months) (Y/N) N o 9C KNo w&l If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 106 On adjacent lots } /oo Property line >/0 To building foundation (9 To existing or abandoned system on lot NA, On adjacent lots ? 30' Cutbank N • A Water main/service line >30 Surface water > I00 Driveway, parking/vehicle storage area � 50 ` Curtain drain NONE 08S6RVC i:� E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelinesineetlaUn�tthe date of this inspection. '01 0 A[ o Signature AV V) .' YH �n •.feef.s.•.f••f.... a ....� Engineer's Name _ T0�i'�/ p�/�[ c^ •.....•-•�. `I • i•-•...�f.. Date 9 / C3'/9 z •. THEODORE r. ,tooRE e % CE- 3539 ,•y+� 6 Ar HAA Fee $ / Zo • 0) Date of Payment 2'—/ 7— ReceiptNumber 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 563313 STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS RESULTS for INVOICE # 58063 Chemlab Ref.# 92.4793 Sample # 1 Matrix: WATER Client Sample ID 5/1 SEA TURN NORTH HOSE BIB PWSID UA Collected SEP 8 92 @ 10:40 hrs. Received SEP 8 92 @ 16:00 hrs. Preserved with AS REQUIRED Analysis Completed SEP 9 92 Laboratory Super SsP(/- J'tlA C. EDE Released By `' ��`-� Client Name :FLATTOP TECHNICAL SRV Client Acct :FLATTOT BPO# POI :NONE RECEIVED Req# Ordered By Send Reports to: 1)FLATTOP TECHNICAL SRV 2) .............................,,..........,........_........................................,............................._......... Paxametex Results Units Method Allowable Limits --------------------------------------------------------------------------------------------------------------------------------- NITRATE-N ND(0.10) mg/l EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: CHRIS. Remarks: .................................................................................................................................. I Tests Performed See Special Instructions Above UA -Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than 1*1ONSGS Member of the SGS Group (Societe G4n6rale de Surveillance) 1I JO, I MUNICIPALITY TY OF ANCH GE MUNICIPALITY OF ANCHORAGE nnFF DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE,CVI hPT. OF HEALTH & 8'25 L Street • Anchorage, Alaska 99501 ��1IVV KKKKKKVVNMENTAL PPOTECTION ENVIRONMENTAL ENGINEERING DIVISION MAR 1 9 1981 Telephone 264-4720 RR ((�� 11'' REQUEST FOR ,i:PROVAL OF INDIVIDUAL WATER AND � sig��mms DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER MAILING ADDRESS- _ i -Y-LENDING INSTITUTION PHONE .��.�.._. MAILING ADDRESS 4, REALTOR/AGENT7�—D— � ,(J �PFIO/NE_ -- MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION n L— 7 � �T 4 AT Z/� C,� G. TYPE OF RESIDENCE - NUMBER OF BEDROOMS lJ--- SINGLE FAMILY ❑ One 0 Four ❑ Other_ ❑ Two C� Five MULTIPLE FAMILY VJiThree ❑ Six 77 WATER SUPPLY 1471 ---INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled 0 COMMUNITY since June 1975. For wells drilled prior to that (late, give well EJ PUBLIC UTIL.I'I-Y depth (attach log if available.) 13. SEWAGE DISPOSAL SYSTEM **If individual/on-site, installation date_l�� d_ 0--[NDIVIDUAL/Oh!-SITE** give If system is over two (2) years old an adequacy test is required 0 PUBLIC UTILITY by this Department. NOTE: THE INSPECTION Fl-.'[.- MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 11-u1 u131 R51 THIS SIDE FOR OFFICIAL USE ONL' r DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE __._ DATE DATE INSPECTOR v� INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMITNUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE DATEINSTALLED ❑PUBLIC UTILITY (� Connection Verified INSTALLER ED Septic Tank or ❑ Holding Tank Size: i -L'D If Tank is homemade SOILS RATING give dimensions: ti TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line WELLTO: Absorption Area to nearest Lot Line e 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (Title) r r LEGAL DESCRIPTION 72.010 0toy, 31%113)