HomeMy WebLinkAboutSECLUDED HILLS BLK 2 LT 2r
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SUBMITTA
AUG 092018
Municipality of Anchorage
Community Development Department Page 1 of 2
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: OSP181194 PID Number: 017-343-10 ❑ New ❑✓ Upgrade
Name: ABSORPTION FIELD
ALAN & PAMELA BAILEY
Address ❑ Deep Trench El Shallow Trench ❑ Bed ❑ Mound
13265 BADGER LANE ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
4 GPD/SF Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot Ft. Ft.
SECLUDED HILLS 2 2 Fill added above original grade Gravel length
Township Range Section Ft. Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES Ft. Ft.
To Septic AbsorptionHolding Sewer Total absorption area Number of trenches Dist.between trenches
From
Tank Field Lift Station Tank Line Ft2 Ft.
Well 106.2 N/A N/A N/A TANK ❑Septic I 1 S.T.E.P. ❑Holding 0 Other
Manufacturer Capacity
Surface Water 100+ N/A N/A N/A ANCHORAGE 15000a1.
Material Number of compartments
Lot Line 53.4 N/A N/A N/A STEEL 2
NA
Foundation 17.8 N/A N/A N/A LIFT STATION
Manufacturer Capacity
Curtain Drain N/A N/A N/A N/A ORENCO 250 Gal.
Pump on level at Pump off level at High water alarm at
Remarks TANK REPLACE ONLY
40 in. 36 in. 45in.
Pump make and model Electrical Inspections performed by
- P2005 MOA BUILDING SAFTEY
PIPE MATERIAL House to tank 3034 Tank to 3034
Installer
drainfield
A+ HOME SERVICE Drainfield CO/MT
Inspector PES BENCH MARK (Assumed elevation) 706.Oft
Inspection t Location and description
1
dates: - 8/3/2018 rt 8/6/2018
3rd - - 4t„ NE BOTTOM TRIM
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
..r OF A�,� \�
Conditional Approval: Date ..g...1 -,,:)....-•O.
.cS',�lcy t
' 1• •never •FY.'ISonnorae'P
C5, 811449
Approve. 1 Date C.-13'JO ��.�•
�- l\\�� �..
Inspection Report__1-1-12.doc
10'x30' Anchor -E_ s.mtC /' _
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T1 4.6 18.7 �/ \ �/ / —.,-/%'+++** ,.__s•. .5
T2 12.0 17.2
LS 12.5 16.8 / EXISTING ABSORPTION BED _'
695 / TRUE N 0- , SCALE : 1'=50'
700 705 710
/ 715
VJ\ ----L, \ / / /- /
1 r\ � l LS ' -1
3 /
1 \ — ' T2 INSTALLED 1500. S.T.E.P. TANK
1 / _ /
4 ^`Alirillillmuft,,..._ ABANDONED EXISTING TANKS 3
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BDR I� /PER MOA CODE
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702.4 / 1500 g S.T.E.P.
PROFILE
— SCALE: NTS
NOTES: PANNONE ENG SVC, LLCDote
, OF" .•
RECORD DRAWING _ P.O. BOX 102954 ANCHORAGE, AK 99510 P8/8/18
PHONE (907) 907
( )272-8218 FAX 272-8211 Scale
ar•iiillo•'•••• P.I.D. NO
— SECLUDED HILLS B2 L2 - = -7-343-10
ALAN Sc PAMELA BAILEY •• }'even A:•-anriaie' pERMIT N0.
DRAWN ACP .^•;• CE 8149 0SP181 194
13265 BADGER LANE
SITE PLAN ANCHORAGE, AK 99516 '-:� Sheet
2 OF 2
rr0 MUNICIPALITY OF ANCHORAGE .Ment S,
f On-Site Water&Wastewater Program 10 P• r
t` PO Box 196650 4700 Elmore Road
i l Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 „ n•
"s http://www.muni.org/onsite +'
1)c I'arttncni
,Nf XONPGt*
On-Site Wastewater Disposal System Permit
Permit Number: OSP181194 Effective Date: 7/18/2018
Work Type: SepticTank Upgrade Expiration Date: 7/18/2019
Tax Code Number: 01734310000
Site Legal Address: SECLUDED HILLS BLK 2 LT 2 G:2937
Site Mailing Address: 13265 BADGER LN, Anchorage
Owner: BAILEY ALAN I & Lot Size in Sq Ft: 51506
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4
This permit is for the construction of:
❑ Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By`\ ,� � '', Date: 6`
7 t8 I�
Issued By: f 4i h'.((L4 CQ' Date:
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
Parcel I.D. 017-343-10
Property owner(s) Alan Bailey & Pamela Rowell Day phone
Mailing address 13265 Badger Lane Anchorage, AK 99516
Site address 13265 Badger Lane
Legal description (Sub'd., Block& Lot) Secluded Hills Block 2 Lot 2
Legal description (Township, Range & Section)
Lot Size 51,506 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑ Initial ❑ Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑X Upgrade Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
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 Mu ••••.I C..- .
tgn to -,o Ipro.- • C;', err or authorized agent
Permit/Rush Fees: 15•D D Waiver Fees:
1 Date of Payment: 13 ,204 Date of Payment:
Receipt Number: 0 ' I C Receipt Number:
Permit No. •S i or
Waiver No.
Permit App_:-:•:_.,c:
Pannone Engineering Services ac
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panengak.com
July 11, 2018
Subject: Secluded Hills S/D Block 2 Lot 2
Tank Replace Permit Request
Design Narrative
This is a design narrative for a permit to install an upgrade 1,500g S.T.E.P. Tank to replace three existing
tanks, which are over 35 years old, to be issued for this property. The three existing tanks will be
decommissioned per code. Currently the lot is developed. The proposed system will utilize a replacement
1,500g S.T.E.P. tank that will be connected to the existing drain field. The existing tank is located
approximately 105' from the well. The proposed tank will be placed outside the existing well radius. All
required separation distances will be met.
1. Upgrade Tank Design.
A foundation clean out installed if needed.
The tank will be located: 5'+ from any property line or drain field
10'+ from any water line or building foundation.
100'+ from any surface water
100'+ from any private wells
200'+ from any public wells
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 907.272.8218.
Sincerely,
Steven R. Pannone, P.E.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
3
ir
a/ N.m ...: ..I
•. SCALE
• •�, 1„
���^: STEVEN R. PANNONE 4, = 5 O
CE-8149 ;4% o 270. 00
w•h ••1 ?../ •�• N69 9'f0 , -,-
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S, TdNdi, 5/, 506 F pal /
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o ! to sii //
„‘I A-BAND0Nt�EQ c_e9
�, a ti. USE ZOIV+r
,� 0)/5c) APPROVED
f ,i/ /
Dy .___. r__-_cidizidx-49:2 ---- .
. If, z1 /
o/ 4, ,0 L:-
Date
{'1°� All work shall be done as shown on this
N �E) plot plan. Approved plans and speetti-
'/�J `�0 ��.25'' `^'6u' cations shalt not be changed, modified
' ified
�'� BAD�E� �' /�5 p / : t, ,-,•,t ,”-I1,,,t+ first obtaining a
�:d7 �13. ,.r .+`t' .\u
L� ?Rs-- 4t OF_A1 t�1
.. Qs1-11
LEGEND 2 *.49TH 9*fie
0 5/8' REBAR SET THIS SURVEY
- = iii. _r
!?. •
el; LESLIE L BRAi7AIN .Z
DRAINAGE ARROW (t:�j' IAC.. y1-F
X SPOT ELEVATION _
illiOft ,\%'>
)P OF FOUNDATION WALT. LEVATION. Portion 0 IT SHALL BE THE RESPONSIBILITY OF THE BUILDER a rte' NO Portion of this
/V6' '7f DATUM OR OWNER TO VERIFY THAT THE BUILDING LOCATION tcture shall encroac,
'c\'AT1GN5 BASED ON SHOWN MEETS ALL SUBDIVISION COVENANTS ANDLOW, Any F4foa
4EPARED FOR, LOCAL ZONING CODES AND ORDINANCES. ALL LOT
Karg, j"on7"nOC/m9 INFORMATION SHOWN IS FROM RECORDED PLAT ONLY.
PLOT PLAN I HYCK LOT 2 , BLOCK 2
LR 1DA4-2°_83 NYMAN SECLUDED HILLS SUB
,K !GRIDz,037 &HAYES
a.
JD 9soe.0 ,.4.M,., ._.,...,.. 1+0..,.0•1 (P dl - I )
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_g2o 107_ - ____ _ PID Number:
Name: ALAN koRPl
Wastewater System: L-1NewIg Upgrade
Address:
132(65 B bGER LANE
ABSORPTION FIELD
Phone:
3145- — (o105
No. of Bedrooms.
LL
I
*�
LI Deep Trench CI Shallow Trench 'N Bed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating
o.a'
Total Depth from original grade
3
GPD/scl. FI.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
2 2 SECLUOEb NILLS
2.5 Ft.
0.5 Ft.
Township:
Township: 771
12 N
Range:
3 w
Section:
27
Fill added above original grade:
0.5
Gravel length:
Ft.
Ft.
WELL: Fx1571,RNew I] Upgrade
Gravel width
21
Number of lines:
4
Distance bSeenlinF'
Ft
Classification (Private, A.B,C):
Total Depth:
Cased To.
Total absorption area:
Pipe material:
FL
Ft.
$(0I SO. Ft.
I IN PVC
Driller:
Date Drilled:
Static Water Level:
Installer:+
A HoME SERVICES
Dale insjailed: I
613-S /92
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
FI-
Ft.
SEPARATION DISTANCES
XSeptic EJ Holding OS.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
ANCHORAGE TAN(C
E>CIST-loo0 NEW •500
Well
1oS ro c.0
/
15S
1
110
_
r
80
Material:
5TEE L
Number of Compartments:
2 I
S�
Water
iloot
i/oo'
7/00'
—
,/oo1
LIFT STATION
Lot
Line
I
45
I
45
,
f5
-
,
tfD
Site in gallons.
580
Manufacturer:
ORENCO ANCM, TAN 1:
Foundation
_
2D/
Ssr
35 /
_
O
"Pump on" level at:
31"
"Pump off' level at:
271j
High water alarm at:
3711
CurtainPump
Drain
-
-"
"-"
-
Make & Model
Y2 KR ORENCO
Electrical Inspections performed by:
Muw OF ANcNQRA6E
Remarks: 5-1,1r the ort In a1 1000 Se /zc /gntz
BENCH MART(
ar S 14 r/ In a&C- Com d. 't wor referInea In
Location and Description:
TOP of DECK Ncx-r -ro 4ouSE f. COMAI0Fl
10
eru;re , A new SAO t/ S fic Int, k woJ 1'nsS ,
I vs Gt n aGl 6 CC/AAI S-00 a 1, tan k w, Orenco. H. S,
_
Assumed Elevation:
/00.0
The SOIL CL6S. ✓Jed 11 S114Akl` �ur9 er 7eietA shown on r,(ert n olcu�(
ENGINEER'S SEAL
www
.mow J1 \�
. OF �j���
',,,...,.,,',T, a
• • �
-� V V
"hp durfbcAhon i Ino, crAot {tole S acre Ls per cz rovecf`aa1 at -ray
t�coF1 and Seea,1 fr Over sgp1-te s ycckM a heinC' dont by 2,w4r.
Inspections performed by: FtA7'ro? TCCH SVCS Dates: 1st 6/3/92
�10 � �a�-
:*C*be 49TH* •op*«
_
2nd _ G �3�9z _
0
Flnaf 61S'(92
Department of Health A pduuuman Services approval
jl �•••••••"'••"•••••�••
•. THLODORC F. MORE ,^
�9 ` ; CE-3589
,-
Reviewed and approved by: _�' �21�-- Date:4,�•�......^����av
P2tt'�s
G-VlU tneV. s/Bl) MUA 25
Permit No. S W `i 2 010'7
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, SLk 2, SECLUDED HILLS PID No.: 01734 310
NORTH WEST
MON1Y"O2 TV3G
MEW
SOIL, AIRS
6E 0
E-_�
M.T.
T.B. M.
DOUBLE
NEW SO0 64L
LIFr STA ,
N6w Soo C,
SEP. TAkk
ALARMNouSE
EXtST,t4G
INSIDE ---
'r) 1000 GAL.
GARACe
5E P. YAt{k
B
HOUSE CoRNERS
B
Soo GAL 1
�.
/0
SJANk C.o. 31.57
0
1-I5T STA. tf6,51 39
MAN HOLE -
WELL t1ORTHIVEST 90' 1D6
M.T. SOIL 6���
A IIS. 8 E D ���(`T��
AGE �4
ENGINEER'S SEAL _
\
SCALE % 1 --50
0 ; ,9TH 0 k �
Flattop Technical Services # : THEODORE K. MOORE ; � �
�� �'• CE 3589
- .� Ar
14530 Echo Street
Anchorage, Alaska 99518 �i`�y•"""••••F•��°•P
PIp12SS`'
k 1b`
72-013 A Me Q1Q11 MnA 9s
.
Permit No. _ S W q 2 010'7
Page 3 of 3
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: LoT 2 SLK 2 , SECLubED HILLS PID No,: 0I f3q 3io _
"TOP of
DECK.; NEXT TO
HoUS�00.0
00- GROUND ELEV.
q7.7 NEAR sfPvc vAN 5
EXIST, NE W
1000 CAL Soo CAL
SeP.TAAk
SEP. TArlk
92.4,-) q2.2'
VERTICAL SCALE
NO tlOPIZO TAL SCALE
72-013 A (2/91) MOA 25
NEw
SOO GAL
LIFT STA. Ftq2.1'
100.0 6ROvr4O ELEV.
OVER BED (BFFOPE-
�TuPsofc. + RESEEDING
q7.6�
INVERT ELEV. ALL
DIST, PIPES W
AasoRBTIONI aED
DRY
-e, ELEV, 87
/4/
Flattop Technical Servi eE
14530 Echo Street
AnchorageAnchorageJ Alaska 99$16
ENGINEER'S SEAL
:THEODORE F. MOORE
•.• CL • 3589 'Slop,�
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 WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920107
DESIGN ENG.INEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:KORPI ALAN A
OWNER ADDRESS:13265 BADGER LN
ANCHORAGE, ALASKA 99516
PARCEL ID:01734310
LEGAL DESCRIPTION: SECLUDED HILLS BLK 2 LT 2
LOT SIZE: 51506 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 5/27/92
EXPIRATION DATE: 5/27/93
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: FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
n
ISSUED BY:
DATE: 5 ✓ 7 19'e
DATE: J 2 7— �'2
CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E.
PH: (907) 345-1355 May 18, 1992
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sus:
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 wastewater disposal facilities on Lot 2, Block 2, Secluded Hills S/D, located at 13265
Badger Lane. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for
your review.
This upgrade is proposed because a recent adequacy test indicated that the present soil absorption
trench was operating in a surcharged condition, and is probably impacted by seasonal high groundwater.
The proposed system will be constructed in the vicinity of test hole #1. As can be seen from the soil
log, the native material between 3.5' and 5.5' is a slightly silty gravelly sand with a measured perc rate of
2 minutes per inch. Using the soil application rate of 0.8 gpd/sq. ft. specified in the wastewater ordinance
for soil absorption beds constructed in material with a perc rate between 1 and 5 minutes per inch, this 4
bedroom residence requires a total absorption area of 750 square feet. The proposed 20' wide x 38' long
design has a total absorption area of 760 square feet.
Since the proposed soil absorption stratum is at a higher elevation than the septic tank, a lift station is
necessary which will enable pressure distribution of the septic tank effluent. The hole size and spacing is
based on a design pump rate of 20 gpm. Each 5/32" hole will pass 0.64 gpm at 5 feet of residual head or
0.5 gpm at 3 feet of residual head. The proposed design provides for a total of 38 holes spaced at 4' on
center, which will accommodate the design flow.
The topography in the area of the proposed construction slopes down towards the west at
approximately 5%. The proposed replacement site is characterized by similar soil conditions and
topography.
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 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,
Ted Moore, P.E.
Lor I
m
Ni
Lor 16
iUSTAMENA TERRACE"
LOT ISA
SEPr(c 0
S YS TEM ._�y
270' Q
lo'UrILITY ESMT.
REPIAcenenlr
v 0 SITE
T.N.#aq k
�a N f5 20' x 3a'
LOT 2 Sora A•os, eEo
SL k- 2 T.FI.I Q
M. T.
O � 7.0
LANF
EXISTING
TRENCR --z'.
To Qp ABAr�DoNfD
� r3oR��r
FIoUSE
LOT 3
EXISTItgr,///
1000 GAL.
Sr pTIc TANk
To 6E REPI.ACC_O HOUSE
w• N�+w r�oo rFA�
57'Ep TARK
cr?4NCo c ipr crN.
W EL L
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
LoT2, SLI<2,
SECLUDED HILLS
SEPTIC
SYSTEM UPGRADE
SITE PLAN
SCALE I`.So1
NOTE'. TRIS Is NOT
DA,rE: s/92
A SURVEYEo PLAT,
DWN BY:
ALL LOCATIONS
ARE APPRox (MATE ,
1'14" SCHED 40
PVC NDN -PERF
A
20`
p _ 1'/µ° SCHED 40
ti PVC Not,( -PERF
NO
PLAN VIEW o 'T°° GAL
° srcp rA Nr,
I"= 10` W. oREnco"
4«r .srAr/ON
SOIL COVER ORIGINAL
3 RouNA
�I �� 2" RIGID WS)LATION x
*4,�SAIND
" FILTER FABRIC f
�Y(,. PVC g ± P'r + sM
9",i SE WE R ' GRAVEL
LEVELING Cou
SA/SM
2°
S E CT I O N A- A Flattop Technical SdMces
I " = 514530 Echo Street
Anchorage, Alaska 99516
,rro ur At _44
:490k,
THEODORE F, MOORE , ' At
� ,�• CE .3589 Ve AV
A.�kthAvev
IOT21, RLK2 . SECLUDED HILLS
SEPTIC SYSTEM UPGRADE
PIAN 4. CRoss - SEC_TIDN
SCALE' AS SOWN
DATE : 5(I�9z 2Ev; &-/22/92
DWN BY' Ti
I'/y I, SCHED 4o PVc LATERALS M,'(;
W S/32" HOLES SPAc¢D 4' O.C. LIP
ORIENT }TOLES DOWN
5 STA66ER Note SPAciNG IN AID 3. PIPCS
i
M.7.
p 5' ALL JoiWT5 To BE GLvED
20`
p _ 1'/µ° SCHED 40
ti PVC Not,( -PERF
NO
PLAN VIEW o 'T°° GAL
° srcp rA Nr,
I"= 10` W. oREnco"
4«r .srAr/ON
SOIL COVER ORIGINAL
3 RouNA
�I �� 2" RIGID WS)LATION x
*4,�SAIND
" FILTER FABRIC f
�Y(,. PVC g ± P'r + sM
9",i SE WE R ' GRAVEL
LEVELING Cou
SA/SM
2°
S E CT I O N A- A Flattop Technical SdMces
I " = 514530 Echo Street
Anchorage, Alaska 99516
,rro ur At _44
:490k,
THEODORE F, MOORE , ' At
� ,�• CE .3589 Ve AV
A.�kthAvev
IOT21, RLK2 . SECLUDED HILLS
SEPTIC SYSTEM UPGRADE
PIAN 4. CRoss - SEC_TIDN
SCALE' AS SOWN
DATE : 5(I�9z 2Ev; &-/22/92
DWN BY' Ti
Flattop Technical Services
14530 Echo Street, Anchorage, AK99516
-'hone (90 7) 345-1355
Lot 2, Block 2, Secluded Hills
13265 Badger Lane
Wastewater disposal system installation
Specifications
Revised 5/22/92
1.0 General:
1.1 The scope of the project consists of replacement of the existing 1250 gallon septic tank with a new
1500 gallon STEP tank with an integral "Orenco" lift station which pressure distributes effluent into a 20'
x 38' soil absorption bed.
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 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 STEP Tank:
2.1 The existing septic tank is to be properly abandoned by pumping, crushing and burying it at a site
designated by the property owner.
2.2 A new 1500 gallon STF,P tank as supplied by Anchorage Tank shall be installed in the
approximate location of the present septic tank no closer than 100 feet from any private well. The tank
shall be buried no deeper than 4' - 6", and the tank shall be equipped with a 5' insulated manhole riser.
The wiring penetration through the manhole riser shall be located above ground level, or the space around
the wires completely sealed with caulk. The lift station pump shall be an "Orenco" package system as
supplied by Anchorage Tank. Special care shall be taken thoroughly compact the material beneath the inlet
and outlet pipes and to protect them against displacement or breaking as the soil settles.
3.2 The contractor shall be responsible to obtain the necessary Municipal electric permit and
inspection, and to provide a copy of the electrical inspector's report to the engineer overseeing the
construction of the wastewater disposal system.
3.3 The on, off, and alarm floats shall be set at the elevations specified by the lift station supplier, and
their proper operations shall be verified by the contractor.
4.0 Soil absorption system:
4.1 The soil absorption system shall be constructed by stripping the overlying peat and sandy loam
strata off the proposed 20' x 38' soil absorption bed area to expose the top of a slightly silty gravelly sand
stratum at a depth of approximately 3' below original ground level.
4.2 Care shall be taken to not overexcavate the site. The bottom of the excavation will not be level.
The bottom of the bed shall be leveled by placement of a leveling course of coarse pit run NFS sand.
4.3 A total of 9" 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 6 inches 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.
4.4 The discharge pipe from the lift station and the distribution pipes within the soil absorption bed
shall all be 1.25" dia Schedule 40 PVC with all joints being glued. The distribution laterals shall have
5/32" holes drilled in the bottom at 4' centers with the hole spacing staggered in alternating rows.
4.4 Monitor tubes 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.
4.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. 2" of burial
type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. A
minimum of 2 feet of soil cover is to be placed over the filter fabric.
4.7 The top surface of the cover material shall be raised a minimum of 6 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.
4.8 All lawn areas disturbed by the construction and/or soil absorption mound top and side slopes
shall be covered with 4 inches of topsoil and seeded with an approved grass seed to promote rapid
revegetation. This work is to be done by the property owner after the backfill has had a chance to
consolidate.
5.0 Inspections:
5.1 A total of 5 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 light elevation, and conforms with the soil test information, (3)
after the sand leveling material has been placed, (4) 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 insulation or filter
fabric, and (5) after final backfill and grading is complete. The lift station requires one inspection after the
tank has been set level and the piping connected, but prior to backfill. This inspection may be incorporated
with any of the above inspections.
5.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
Flattop Teclin4cal Services
14530 Echo Street
Anchorage, Alaska 9951f,
0�t Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
�.�,,•cpy. •�y. •�•••////-iJJ-��•'••. •:obi'
i 00H•Y••••• IB•
THEODORE P. MOORE
'•• CE • 3589 of
.041
r: H • tk l �a�—J
PERFORMED FOR: ALAN KORLDDATEPERF'ORMED- 4f 2.8 — S•wq-z
LEGAL DESCRIPTION: L2, B2. 8ECL UDtD WILL 5 Township, Range Section: SEC 27,, T121`4. R 31,V
DEPTH PT SLOPE �.•_,�R•P.y,�L�pt �_
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
SM REDDISH SANDY LOAM
GP/GM SOMEWHAT 51LTY,
SANDY GRAVEL
SP/SM SLIGHTLY SILTY,
GRAVELLY SAND
SMALL 920 SEEP AT ONE
CORNER of 7 -i= -.sr P rr
ML
5P/SM SLIGSH-wl SILTY,
GRAVELLY SAMb
ML
WAS GROUND WATER
I1`40I5TINCT TRANSITtot4 ENCOUNTERED?
SM SILTY GRAVELLY IF YES, AT WHAT
SAND DEPTH?
B.H.Depth to Water Aller
Monitoring? DRY Dale:
S
L
O
P
E
Reading Date
Gross
Time
_
■_■■■pq
Depth to
Water
Net
Drop
12"PRe oA 5 Q2
12:16•3o
271g
No
4 60
12:20.00
12'. 20: 3o
23 '/
27 3/
START
T
Milo
23 M/g
■Elm
3
3/
s
+ A20
In
MEIN
__21
23 %z
t Hzo
12 31: 00
12'. 31: 30
3
21 7/
23 yZ
1 S
12'• 34: 30
3
21 i/s
s
Reading Date
Gross
Time
_
Net
Time
Depth to
Water
Net
Drop
12"PRe oA 5 Q2
12:16•3o
271g
4 60
12:20.00
12'. 20: 3o
23 '/
27 3/
START
12:7.4:30
23 M/g
12:2'7; 3o
3
3/
s
+ A20
12:28 "00
__21
23 %z
t Hzo
12 31: 00
12'. 31: 30
3
21 7/
23 yZ
1 S
12'• 34: 30
3
21 i/s
s
PERCOLATION RATE�•g_"
(minutes/inch) PER(: HOLE DIAMETER i3
TEST RUN BETWEEN4_FT AND q• 5 FT
/-
See
J cormtr o orf p'r no g!2gfci+� ry crn alums« /Y�i^
PERFORMED BY: _FLATTOP SEC , SVCS, I _wu,,V_
.— CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: A-V 7 6 /9 2
72.008 (Rev. 4185) —
Flattop WbEliical Service
14530 Echo Street
Anchorage, Alaska 9951r,
Munlclpallty of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
T H. #2
PERFORMED FOR: ALAN KORPIDATEPERF'ORI
LEGAL DESCRIPTION: L 2, B2, 6 ECL UDICD R ILL 5 Township, Range, Section; 5EC 27
DEPTH PT
1 SM REbbISH 5ANDY LOAF
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
5tA SILT`( FINE SAND
POCKE1-S OF CLEANER SP
4-- H,.o SEEP
ML GRAVELLY SILT
DRY
CRvMBLI AFTER DuG o
SIDES OF HOLE SME/
SLOPE
rn
SNI SILTYi FINE SAnlb LPRE
WAS GROUND WATER
ENCOUNTERED? Y
S
sP/5M 5L16NTLy SIL7YF YES, AT WHAT L
GRAVELLY SANA DEPTH? Seed. to H I P
E
Deplh to Water Altel
SP CLEAN Monitoring?' 13 B•G.L, Dale: 6/1219Z
GRAVELLY SAPID
B. N
3�www
.0000•
pTHEODORE F. MOORS;
i•• CE • 3589 •`
6
LIN
lid°1
Gross Not
Time Time
.�■__■
■R■■
■1
.o
HIM
MEN
Reading Date
Gross Not
Time Time
Depth to Net
Water Drop
PERCOLATION RATE tminutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
PERFORMED BY: FLATTOP TECf{ SVC C ��� %I —_�-- -- —' — —
CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9 Z
72.005 (Rev, 4/85)
f'Iattop Te6alvcal Services
14530 Echo Street
Anchorage, Alaska 99511;
Municipality of Anchorage
(*4D
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
TN,#3
THEODORE P. MOORE 1
ill":- #* • 3589 6- 41 A
•. .•
PERFORMED FOR: ALAN KOR P I DATE PERFORMED:
LEGAL DESCRIPTION: L2 B?_y SECLUDED HILLS Township, Range, Section: 5EC 27 T12
DEPTH P.I- SLOPE erc oiof �r
1 ISM REDDISH SANDY LOAM
2 SP/SM SLIGHTL`( SILTY
3 GRAVELLY SAND
GP CLEAN SANDY GRAVEL
4 —H2o SEEPS
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20 -
COMMENTS
ML
5P/SM SLIGHTL`( SILTY
I GRAVELLY/ S4Np
WAS GROUND WATER
ENCOUNTERED? `y�S
TRANSITIONS -To S
IF YES, AT WHAT r L
DEPTH? O
P
E
Beplh to Water AII/er w
Monitoring? I I (o 6 G L gale: S62 2
SP CLEAN
GRAVELLY SAND
B.N.
Reading Date,
Gross
Time
Not
Time
Depth to
Water
Net
Drop
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST nUN BETWEEN FT AND ---- FT
PERFORMED BY: FL OP rEC1t, SVCc
CERTIFY THIS
EST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:5
72-008 (Rev, 4/85)
a
Flattop Tecliriical Services
14530 Echo Street
Anchorage, Alaska 9951E
Municipality of Anchorage
\ DEPARTMENT OF HEALTH & HUMAN SERVICES 1
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
T.H.#Lf
PERFORMED FOR: ALAN KoR
LEGAL DESCRIPTION: L2, B2, SECL(/DrD FALL
DEPTH PT
1 SM REDDISH SANb%LO/-IM
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
sf /s P1 SLIGHTL`! SILTY,
GRAVELLY SAND
O�AA���;
. ��;e•....,4 .
WIN AC��
�THICOO
MOORECE - 11589
A�� IIII
•
_ ______ DATE PERFORMED:'
Township, Range, Section: SEC 27� T12i�`{Z
SLOPE CITC PI AAI
SP C LE'ANf GRAI/ELLY SANp
�� SMgI r H%O Sceps
ML GRAVELLY SILT
5P/5M SL)GHTLY SILTY
GRAVELLY SAND
�pp
I I I I I
LENtSES OF SILTIE&S GROUND WAT ER
AND ENCOUNTERED? _
LENSES OF CLEA1K s
IF Y S, AT WHAT L
MATERIAL DEPTH? 5156 0040W O
P
E
0
Depthto Water Aller „
Montt
Moniloring7 10 r6 R.Q.C. pale: 2 2,
Reading
Date Gross
Time
Not
Time
Depth to
Water
Net
Drop
NEE
3 5 9z S:y6:oo
27 a/8
5:4(9:00
23
+H2O
S:49:30
27 3/
Elm
START
5:52:30
23 3/8
+ Nzo
.S: Sq', 3o
5: ss :oo
2
/a
23, s/8
17 8
fi H, o
5: S7:oo
S S7: 30
2
21 3/y
23 y A
_ 5:51: 30
2
21 7/
0011
Reading
Date Gross
Time
Not
Time
Depth to
Water
Net
Drop
Iz" PRESoA
3 5 9z S:y6:oo
27 a/8
5:4(9:00
23
+H2O
S:49:30
27 3/
START
5:52:30
23 3/8
+ Nzo
.S: Sq', 3o
5: ss :oo
2
/a
23, s/8
17 8
fi H, o
5: S7:oo
S S7: 30
2
21 3/y
23 y A
_ 5:51: 30
2
21 7/
PERCOLATION RATE (minules/I rich) PERC HOLE DIAMETER 8 r,
TEST nON BETWEEN JFT AND 3•15 -
_FT
_4(4' VJ
/It {,
PERFORMED BY:L—
F ATTOP THC} CERl1FY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DA1 E. DATE: � —'9/2 z
72.001) (Rev. 4/65)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME/-/�
Kampf (I.V1I Ac if ✓ie
PHONE
rl U
❑UPGRADE
MAILING ADDRESSI6 16,'5 ��Cil"ti��QQ� �Itic��Q. I I�Dr�
LEGAL DESCRIPTION r
L.oi' � (310 •lC .2 _� �; i�S �� _
LOCATION `
NO. OF BEDROOMS
Uy
We
DISTANCE TO: /C 4 I
Absorption area
Dwelling
/k't� U f �Uf
PERMIT NO.
G .3' ,30
t-Z
Manufacturer
Material
No, of compartments
rn
Lic. capacity in gallons
0
IF HOMEMADE:
Inside length
•—
Width
,_
Liquid depth
,
O
JAZz
DISTANCE TO:
Well
Dwelling
PERMIT NO.
Tz .1
Manufacturer
Material
Liquid capacity in gallons
o
w =
DISTANCE TO:
Well n
!' ro
Foundation
w ,'2
Nearest lot line
�•jU�
PERMIT NO.
�' 0 (O
J w Z
F Z w
No. of lines
Length of each line
Total length of lines
Trench width
3C inches
Distance between lines
s
CqN
p
Top of tile to finish grade
Material beneath tile
� inches
Total effective absorption area
Qj
LU
Q
Length
Width
Depth
_6/[c
PERMIT NO.
aF
L
Type of crib
Crib diameter
Crib depth
Total effective absorption area
LU
N
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Jc
Class
Depth
Driller
Distance to lot line
PERMIT NO.
U.1
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
4—
N
v
LEGAL
PIPE MATERIALS
�i4f �l2on7 , (� 303 (4
SOIL TEST RATI G
/ 93 4 (Ad Lt ,(.-1
INSTALLER
cU
REMARKS
r Lva "i -t
�b1 St.UCµl`"f fr{2 Of%
fL{T
aorJ
�—
wi lf2o i �oftaQ E3 k�1I o�£f2.
eA C k A
olnec C
APPR VED DATE
f'—L/
Lot
.2
81oc-K
2
Le<(L
,�d
A
72-013 (Rev. 3/78)
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological 5 Geophysical Surveys
Drilling Permit No. _
LOCATION OF WELL (Please complete either la, He or Ic.) A.D.L. No. _
la. Borough Subdivision Lot Block , Ib. 1/a at rs. Section No. Township N U Range ED Meridian
mofsof^of o __ S❑ W❑
1c. DISTANCE AND D�IREC1110N FROM ROAD INTERSECTIONS 3. OWNER OF WELL:
Address
Street Address and Area of Well Location -
2. WELL LOG
Material Type
Feet Below
Surface
q WF, L.DEPTH;(final)
f1.
----�'-
5. DATE OF COMPLETION
v _
Top Bottom
-
[]Coble tool ,:Q Rotary Driven Dug
0 Auger O Jetted ❑Bored ®Other:
-- - "-'� - -
- - -
7. USEi; [:] Domestic ❑ Public Supply Industry
O Irrigation O Recharge El commerical
[J Test Wall ❑ Other:
-'- ; - -
- -
- _
8. CASING Threaded -,•_E] Welded
diam. in toI ft. Depth Weight Ibs./ft.
diem, in. to ft. Depth Stickup ft.
j�„ v._. _ :-. `'•'. ,. -,
'. �.::�..
9. FINISH OF WELL.:
Type: _. — Dlametor�
Slot/Mesh Slze: Length:_
Set between _ ft. and _ ft.
Backfilling _ Gravel pack .._
10. STATIC WATER LEVEL: ft.
E) Above or Below land surface Date
Equipment used:
I I . PUMPING LEVEL below land surface end YIELD
ft. after hrs, pumping g. p. m.
ft. after hrs. pumping g. p. m.
12.GROUTING Well Grouted: Yes ❑ No
Material Neat Cement Other:
13, PUM P: (if available) HP
Length of Drop Pipe ft. capacity g. P.M.
Subm. ❑ Jet ❑ Centrifical Other
14. REMARKS:
16. WATER WELL CONTRACTORS CERTIFICATION:
This well was drilled under my jurisdiction and this
report is true to the best
1 Contract
15. Water Temperature __.° ❑ F C
of my knowledge and belief;
License Number
Registered Business Nam a
Address:
Signed: f Oats: f
Authorized Representative
Form 02-WWR (11/81) Copy Distribution: WHITE -Stole DGGS, PINK -Driller, CANARY- Customer
MUNICIPALITY OF ANCHORAGE
Department Health and Environmenta' "Irotection
825 Street, Anchorage, AK. .9501 P—L
264-4720
Permit # * * * HANDWRITTEN PERMIT *
WELL ANDVf-ON-SITE SEWER PERMIT
C(�>
Applicant: /Y i ���L{i'uC7r 75 Mailing Address: _52R Eck
Location:
Phone Number: '31/ 5-O 90 D
Legal Description: L i3 6e(2 /u cl cp)1_--_2�" Lot Size: _
Type of Soil Absorption System Is:
Trench: __ Drainfield: s Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br) %d'(?
ff6ic(S7e a -- t �_3
The Required Size of the Soil Absorption System Is:
DEPTH �� LENGTH GRAVEL DEPTH WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE _ /CrO -O GALLONS
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
# TWO(2) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the esidence is remodeled to include more that 3 bedrooms.
Signer: _� Issued by:
p i ant
Date:
SWP/024(1/81)
PERFORMED FOR:
LEGAL DESCRIPTI
1
2
3
-4
5
6
7
8
9
10
—"11
12
13
14
15
16
17
18
19
20
COMMENTS
> SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
82.5 L. Street, Anchorage, Alaska 99501 2.64-4720
SOILS LOG — PERCOLATION TEST
SM
mcyr� c�r�av�,1
�m0(f,
Gm
YYr)I`Cs4-nd\"
(�tv
-Khan
h cob I,CS
PERFORMED BY: %,-►ld
DATE PERFORMED:
------------
J ii 51 o�rl i�lOG�i� Lc�f2
N --- -
WAS GROUND WATER No �L
ENCOUNTERED?
0 �s
P
E
IF YES, AT WHAT
DEPTH? _
0I/-) II "i (1'InCl
Reading
Date
Gross a
Time
Net
Time
Depth to
Water
Net
Drop
d Hz
g1z6A3
9`56- 6_
/0 h1;i).
•y-6>
—i3
./0
z
'25f
y b':3
/0:05
7�_/5
/Lo mly'.
-v
: y () _
, /Q
a+6t0
�I�Z51g3
�0 1
�0yryh�r7.
y0
1 C1
+li U
Z ,5
I -I zsg3
/U: NS
lvmlr7
-
•,v
`lU
PERCOLATION RATE
CERTIFIED B
72-OOS (6/79)
Of
(minutes/inch)
Y— FT
.66789
70
•-111C.— Municipality of Anchorage ,`\:. . i.7".
On-Site Water and Wastewater Program a 41•. `'/Iri.iii°' "
7.
(907) 343-7904 - , r. I>
a f �
Certificate of On-Site Systems Approval `zo �ti
's8L95l
Parcel I.D. 017-343-10 Expiration Date: ) Ff 3 -125'
1. GENERAL INFORMATION
Complete legal description Secluded Hills Block 2 Lot 2
Location (site address) 13265 Badger Lane
Current Property owner(s) Alan Bailey & Pamela Rowell Day phone
Mailing address 13265 Badger Lane Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
O Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual 0
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
n
Z1/4/413__' _
Received b . A i_ I, A:0, _, Date:
COSA to be released to the engineer,unless otherwise requested by the e eer.
COSA Fee $ 5a4 Waiver Fee $
Date of Payment ?PM q1 Date of Payment
Receipt Number 033646 Receipt Number
COSA# O 1 0`/6 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.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R Pannone Date 8/8/2018
F Cil
6. DSD SIGNATURE % \r/
K System#1 Approved for ({ bedrooms •S even R. 'annone:
•. CE-8149 &/
System#2 Approved for bedrooms �� �s •• '�
Disapproved �'k\ ?OFESSIOA 4,-
Conditional approval for bedrooms, with the following stipulations:
vi
1
ON-SITE ,
WATER AND
5 WASTEWATER
. PROGRAM
`C
Original Certificate Date: 13_(38
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheel_r
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Secluded Hills Block 2 Lot 2 Parcel ID:017-343-10
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 5/28/1983 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 168 ft. Cased to 168 ft. Casing height(above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 5/28/1983 6/21/2018
Static water level U N K ft 128.5 ft
Well production 2 g.p.m. 2.1 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate ND mg/L
Arsenic ND ug/L Date of sample: 7/24/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material S.T.E.P./Steel Date installed 8/6/2018
Tank size 1500 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y
Date of pumping NEW Pumper N/A
C. ABSORPTION FIELD DATA
6/3-5/1992 0.8
Date installed Soil rating (g.p.d./ft2 orft2/bdrm) GPD/SF System type BED
Length 41 ft. Width 21 ft. Gravel below pipe 0.5 ft.
Total depth 3 ft. Eff. absorption area 861 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 6/21/2018 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 0 in.
Elapsed Time: 1440 min. Final fluid depth 0 in. Absorption rate >= 600+
g.p.d.
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed 8/6/2018Size in gallons 250 Manhole/Access (Y/N) Y
"Pump on" level at 40 in. "Pump off' level at 36 in. High water alarm level at 45 in.
Datum Cycles tested NEW Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
100+ On ad scent lots 100+
Septic tank/lift station on lot 1
100+ On ad scent lots 100+
Absorption field on lot J
75+ +
Public sewer main Public sewer manhole/cleanout 1
25+ Holdingtank 100+
Sewer/septic service line
50+ 100+
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10+ Property line 10+ Absorption field
100+
Water main 10+ Water service line 10+ Surface water
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
10+
Water Service line 10+ Surface water 100+ Driveway,parking/vehicle storage
Curtain drain 50+ Wells on adjacent lots 10
F. COMMENTS
G. ENGINEER'S CERTIFICATION +1"
I certify that I have determined through field inspections and of 0j.- ,4 .•1' #
review of Municipal records that the above systems are in 0* ,' ;- /= '.�'r!
conformance with MOA COSA guidelines in effect on this date. ''. . /
Engineer's Printed Name Steven Pannone i":Sri 'k '0 a n n o n e.
CE .8149 • j
Date
8/8/2018 1#lgs ., 'Ar
A `tFROFEs9 P
COSA canary sheet_2-6-15.doc
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ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE:
FOLLOWING DESCRIBED PROPERTY: __ �: OF A( a
s��i�'ac ,i-7 .5" .c1 to>z',/.�,�."z • r DATE �e.11fQ" S tf
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS /6/ ' s fr -� .;� '•.4" i ,
INDICATED. IT IS THE RESPONSIBILITY OF THE e t : .H P•k 4. :Y
OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: i •'`' ;gl�
EASEMENTS, COVENANTS, OR RESTRICTIONS z93,7 r „
WHICH DO NOT APPEAR ON THE RECORDED SUBDI- — 0O Duane Mark $c war .. v
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB'/ �2� �°..' 1�s t•3 .. ���' .r
ANY DATA HEREON BE USED FOR CONSTRUCTION �A' ,� ' � ',�'°'
OF FENCE LINES, OR FOR ESTABLISHING BOUND- DAWN, h,� ;+*''
ARY LINES. �/
MUNICIPALITY OF ANCHORAGE
° DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services Ak
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/ 7 — 3 y 3 - 1 C
1. GENERAL INFORMATION
HAA # _ 1�� 11�':I •(-','a, •�
Complete legal description Loi: 2: B.Lock 2; Se.ce.uded Fiat. s
Location (site address or directions) 13255 Badge,
lAncno•Lage.,
Lane.
A,
Property owner JUheph 9 Cnjcti3 Buka4 y
Day phone 345-0316
Mailing address C/O REAL ESTATE SUPPORT SVS.
8200 Fiur?bo?dt Ave.. S. SuU'e 204
M nneapc,L s, MN 5;,431
Lending agency
Day phone
Mailing address
Agent
Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
1AUISICIPAUTY OF ANCHORAGE
DiVIS10N
3. TYPE OF WATER SUPPLY:
S�t�WE�pAt.SERVICES
28 1996
JON
Individual well
Community well
R�C� it `V JD
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
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) From MOA N21
5.
6.
0
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm S & S ENGINEERING
age ner oop oa o. —Phone
Address Eagle River, Alaska 99577
Engineer's signature
DHHS SIGNATURE
KApproved for bedrooms.
Disapproved.
Conditional approval for
Additional Comments
Mir
Date q 6.
���0 F qC�1
.fiH •.a.✓n .4 .' - -' .' 4 y. Vi.. � MSI j{
;o ROURi
C. COWAN f f
+4
�� tel'
•.'�J � ..
• Y y V'i. �Z`�
bedrooms, with the following stipulations:
Date 7Zs
The Municipality of Anchorage Department of Health and Human Services (DFiHS) 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 hornes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Beck MOA X21
Municipality of Anchorage ��'I'Rp ��'°���ry
DEPARTMENT OF HEALTH & HUMAN SERVIGq, SOP
Environmental Services Division ��// r.PV woe
825"L" Street, Room 502 • Anchorage, Alaska 99501 • (9073e1J44
Health Authority Approval Checklist
LOT k,2-ocvc D- S6"v"')/""-P OI7 3H3
Legal Description: _ _ Parcel I.D.:__
A. WELL DATA
Well type
If A, B, or C, attach ADEC letter. ADEC water system number
Log present Q" y f- S Date completed — 3' / '-X V ( S 7
Total depth / G ^ Cased to / 3 Casing height (above ground)
Sanitary seal (b N) y E f _ Wires properly protected O/N) YE S
Date of test
Static water level
Well production
FROM WELL LOG
s-/ 3L 3
(1/4
WATER SAMPLE RESULTS:
Coliform 0
Nitrate
Date of sample: t 7 ` q 6,
g.p.m.
AT INSPECTION
(0 �a-u/ q&
1 )L
/ • S g.p.m.
0 1 / Other bacteria P
Collected by: S & S ENGINEERING
17034 Eagle RI vex Loop Ituad No. 204
ERgte River, Alaska 99577
B. SEPTIC OLDING TANK DATA
Date installed s/ 63 � 6/"ank size 1 u v o s vNumber of Compartments °� Cleanouts 611) y S
Foundation cleanout S Depression (Y6) High water alarm 6/1) 'Y ff -f
Date of Pumping_ a Pumper 4 f 0 e M E S t'ovi c e S
C. ABSORPTION_ FIELD DATA
Date installed 6 /c/ Soil ratingg.p.d./ft2 or ft2/bdrm) 0.9 _ System type 86-0
Length _Width ci- Gravel thickness below pipe Total depth
Effective absorption area Monitoring Tube present$/N) Yk 5 Depression over field (YX@ 0
Date of adequacy test G rI o `� 6 Results (Pass/Fail) P 4 S ! For _ y bedrooms
Fluid depth in absorption field before test (in.); A IL
Fluid depth p ,a Y (ins.) Minutes later: 0
Peroxide treatment (past 12 months) (Y/N) f" ° Fi
Y Immediately after III 7gal. water added (in.): 0/1 Y
Absorption rate o. o g.p.d.
` " ° i� ✓ If yes, give date
D. LIFT STATION
Date installed (o / q Z Size in gallons _
Manhole/Access 0)/N) Y 4Y S "Pump on" level at* "31
High water alarm level at*
Cycles tested 3
E. SEPARATION DISTANCES
37rr
r0(2
"Pump off' level at* a 7
*Datum r 0 N K AV rY-o,7
SEPARATION DISTANCES FROM WELL ON LOT TO:
Le u olding tank on lot /00 r -f ; On adjacent lots
Absorption field on lot J 0 o ��-
Public sewer main ry 1/f
Sewer /septic service line a S �-/-
1 0 0 1 -7f -
On adjacent lots /00 /'`
Public sewer manhole/cleanout N 1,4
Lift station / b o / --/.-
SEPARATION DISTANCES FROM SEPTIC OLDING TANK ON LOT TO:
Building foundation S -/- Property line /49 t Absorption field
Water main/service line :) S * Surface water/drainage /Oo r"/-- Wells on adjacent lots
/O
J 00 1 4 -
SEPARATION
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation ;L '-4 Property Line 0, S Water main/service line
r �d r
Surface water J ° o -4-Driveway, parking/vehicle storage area -l-
Curtain drain /U Or rt aN 0 w ;v Wells on adjacent lots 1 6 e
F. ENGINEER'S CERTIFICATION
1 certify that I have determined thru field inspections and review of Municipal
in conformance with MO^�guideliZ:-.
f ect on this date.
Signature --
Engineer's Name 6V `t r C - Cs rV 14 �✓
Date /� C
HAA Fee $t� Waiver Fee $ _
Date of Payment /4 �/ �O Date of Payment
Receipt Number�Receipt Number
Rev. 8/95 OSS: haa.wk.doc
�dstr�bo� s are
�0 1 ROBERT C. COWAN Jor
CE 8801
7
It
MUNICIPALITY OF ANCHORAGE a}j
• '^ DEPARTMENT OF HEALTH & HUMAN SERVICES M
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.# 01 - IIA -2) - \C
1. GENERAL INFORMATION
Complete legal description Lo f 219 8 to k 2, Sec (cedecC fii is S I D
Location (site address or directions) 1.3,06-S" Sctager Inane
Property owner _A(an � Ma.rtha korni Day phone 3yS-610,T _
Mailing address 1-306.5- 1361 e /.,ane. f4nrJ�orape, �}G� 995
Lending agency Norwe�f Mor><gag2 Day phone 276- H2Sa
Mailing address-24TO_ Denall�;SuJe- IY06, AAcAora5e4 Ak 99S'
\\
Agent Mal) (cvrr i 4#J Real 1=sfufe Day phone 27y " yyyy
Address 836 C- 15-", Ave.,f4nchoc Te Ac 995*i
c�
Unless otherwise requested, HAA will be held for pickup. 1
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
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 V-1
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 U21
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 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 Fkaf Ter -b i,cQ( Secvi «r Phone 3yS-13sS
Address _1 `1530 Echo Amr-honVe Ak 9951
Engineer's signature Date Tunc 9, 199?
6. DHHS SIGNATURE
Approved for r%A=ny?
Disapproved.
Conditional approval for
Additional Comments
v-
THEODORE F. MOORE;
CE - 3589 ,• 1' A7
bedrooms.
bedrooms, with the following stipulations:
Date
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. 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 421
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 2, &0c 1'c 2, Sed"ded *11f Parcel I.D. 611 / 31/x-- /6
A. WELL DATA
Well type Prt'va �� If A, B, or C, attach ADEC letter. ADEC water system number hlr A,
Log present (Y/N) Y Date completed 5/2/63 Driller Ma4nulon DrtNrn�,
Total depth 16 e Cased to I GB Casing height S7 "
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump level
FROM WELL LOG
2
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot los')
Absorption field on lot 155'
Public sewer main A A.
Sewer service line 80'
WATER SAMPLE RESULTS:
Coliform O co/ /(001"17-LNitrate
Date of sample: `// !6 /9 Z
Wires properly protected (Y/N)
Y
11
AT INSPECTION
o z
ty /46-/92
M
a:2
/3/'
m O
9
g.p.m. ! r 3
g.p.m. <
r'ius
T:r
�
l 6B
< w
c�
.; On adjacent lots > too'
On adjacent lots > /0,'
Public sewer manhole/cleanout N' 6.
Petroleum tank Mane observed(
o. lr,q Other bacteria
Collected by: Flaft Tech Svc
B. SEPTIC/MOLDING TANK DATA
6 f N /92 ,5-00 yal I
Date installed 5"1,? 1 /83 Tank sizeIGS a/ Compartments 2
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Foundation cleanout (Y/N) Y Depression (Y/N) N
4114, Alarm tested (Y/N) N. A.
/92
Pumper 19 t --
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot I
0
To property line
Surface water/drainage > l00'
_On adjacent lots } 100' Foundation 20'
bsorption field 35 Water main/service line—6
0
72-026 (Rev. 7191) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed 61Y 19e Manufacturer—renco / Ilnchot iant-
Size in gallons 5'<>U Manhole/Access (Y/N)
Vent (Y/N) 1' r "Pump on" level at
High water alarm level 37.
Meets MOA electrical codes (Y/N) Y
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot f "-�o' On adjacent lots
D. ABSORPTION FIELD DATA
Y
"Pump off" level at 2y1`._
. Cycles tested 1
tero Surface water
Date installed /�� /9 _ Soil rating 0. 89A!( /Ft" System type _ ;3e -o(
Length y/' . Width —2 t J Gravel thickness 0. 76-' _Total depth 31
Total absorption area 85-1 Q Cleanouts present (Y/N) _ 2 Mom for retyv
Depression over field (Y/N) N _ Date of adequacy test N/A Newj
Results(pass/fail) NIA CNfor H bedrooms
Peroxide treatment (past 12 months) (Y/N) N If yes, give date NIA
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot ISS' On adjacent lots > lc'o' Property line__
To building foundation SS' To existing or abandoned system on lot a 30'
On adjacent lots
> 30
Cutbank N-4. Water main/service line
? 5'0'
Surface water
> «>o'
Driveway, parking/vehicle storage area
> too '
Curtain drain None Seen
E. ENGINEER'S CERTIFICATION
1 certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
I�.•
».rs
;Z .p 7 il4
Signature J� n°-®`�e r • a
49T14,;SYS
Engineer's Name --Th eodor-e Moor1' �••••••••�•••••••.,.•��••''••••»..
Date - T1992� ...... .......�1:....rn::
�t n e % �a .%THEODORE F. MOORE : �
CC -3589 •,'
A�
•• .// 40
HAA Fee $ .�_%b
Date of Payment _ _
Receipt Number a
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $ —
Date of Payment
Receipt Number
t1 PA lc 0 l f,
(-).7-
Time
-).
Time
Time
Time
APPLII
Ni PILLS OUT UPPER HA ONLY
Property Owner
;!�(-, .; ';= / �,� �} �`-)r
: <. =:? �.. -..7 =. •., 1 !:_> -
Phone
Mailing Address
',-� ��J;: ��/r. '-
.,j - Zip Code i
Inspector
Buyer
Inspector
Address
Field Notes:
Zip Code
Lending Institution
1l FY l�
Phone
Address_%�/� ,� �; �• `',-)
Zip Code
Realty Co. & Agent
e-.-_> �� /'f; h7; _
;•• �- % (_,-T ,' :�_ i; •J/�). /,+,�-_!-',>/
Phone
Address
RECEIVED
Zip Code
r
Legal Description
APPROVED BEDROOMS
-----
Street Location
Type of
,,Residence
Ingle Family
❑ Multiple Family
No. of Bedrooms
-
11 Other
Date Sewer Installed
Well To Absorption Area �„�,
Well Log Receivedly
S-
I
Water Supply
Well to Tank1 Qom°
Septic Tank Size �`tJ
IlfNndividual
ATTACH WELL. LOG. A well log is required for all wells drilled since June 1975.
1 ❑ Community
For wells drilled prior to that date, give well depth (attach log if available).
❑ Public Utility
_
Sewer Disposal
19-- ndividual
Year Individual Installed:
❑ Public Utility
When Connected to Public Utility: _.--
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
t1 PA lc 0 l f,
(-).7-
Time
-).
Time
Time
Time
Time
Date
Date
Date
Date ( e
Inspector
Inspector
Inspector
Inspector
Field Notes:
MUNICIPALITY OF ANCHORAGE
1l FY l�
DEPT. Or HEALTH 7<
ENVIRONMENTAL
//PROTECTION
6-\i G 16 i9z.
RECEIVED
APPROVED BEDROOMS
'CONDITIONS OF APPROVAL
( ) DISAPPROVED
`
( ) CONDI 10 AL AlP/PR�O�VAL'
DATE
_ G
Soils Rating
Date Sewer Installed
Well To Absorption Area �„�,
Well Log Receivedly
S-
I
Well to Tank1 Qom°
Septic Tank Size �`tJ
72 023 (8182)
ALASKA HUMOf1f MAL COMROL SRUICCS, InC.
Engineering 6 Enuironmenlal Sludies
Supplemental Soils Information.
Subdivision `) C.� 1� C� '► )1 ���J Block LQ� z-
LOT
LOT LOT LOT
T H T H T H T FI �-_--�—, r
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20
1200 Wesl 33rd Auenue. Suite E • Rnkroge,
Rlosko 99503 • 907) 2761361