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Municipality of Anchorage Page / of �-
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater System and/or Well Inspection Report
/Disposal
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Sw 96 q Number: G/ -22 ' 3
Permit Number: F `a PID
Name: n mar,
Wastewater System: 0 New Upgrade
Ad sass:
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ABSORPTION FIELD
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Phone:
No. of Bedr oms:
*' Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Z
Total Depth from orpigmalg�de:
�
/V GPD/Sq. Ft.
+S /'
Lot:�� Block: Subdivision;
Q 11
Depth to pipe bottom from original rade:
S - 5' L: Ft.
Gravel depth beneath pipe
.3' 7 5- Ft.
Township:
Range:
Section:
Fill added above o 'incl grade:
Gravel length:
•--'
Ft.
Yo Ft.
WELL: 0 Newevom ❑ Upgrade
•
Gravel width:
Ft.
Number of lines:
Distance between lines:
FtFt .
Classification (Private, A,B,C):
T al Depth, ased To:
Total absorption area:
Pipe material:
ST -�3G 3 /10
Ft. Ft.
sD. Ft.
Driller:Date
Drilled: Static Water Level:
Installer:
Oii1 S ✓
Date installed: q
to — (v Z 3
Ft.
__
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
$septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
HoldingPublic/Private
Mar ctures
Capacity in gallons:
00
From
Tank
Field
Station
Tank
Sewer Lines
jQ
/0
Well
9160-1-
f
o200�-
Material:
Number of Compartments:
urface
Water
_
LIFT STATION
Lot
/
Sze in gallons: Manufacturer.
Line
%Q
jo 4 -
"Pump on" level at: "P High water alarm at:
Foundation
54-
`O 4-
_
Curtain
Pump Make S el
Electrical Inspections performed by:
Drain
BENCH MARK
Remarks:
Location annd� Description:
5 16zh
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Assumed Elevation: /
Ft
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A VW(f Jae. Dates: 1s (0117Z9 9
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Inspections performed by.
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Department of Health and Human Services approval
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Reviewed and approved by: Date:el
72-0t3 (Rev. 9/91) MOA 25
PERMIT NUMBER: AS -BUILT DRAWING PARCEL 1221 —3B1R:
SW99O129
A B y — _
ST1 31.5 29.1 �o' 4T— --�z
ST2 34.0 31.2 BL2 (
Flow DrvERTER(FD)
DBL1 34.9 32.5 Cd —�' s B L
�,,,. '` I CO/A(T-EXISTING CRIB
DBL2 35.5 33.2 2 , EMA NINA R PLACE FOR
J USE AS A RESERVE SITE
FD 36.5 34.2 GENERAL. LOCAT10
OF KEY BOX
C01 21.7 51.1
MT1 32.2 52.8 3 BEDROOM f
L OUSE 8
CO2 57.5 57.4 f
MT2 56.8 55.2 f f
t f f
f f
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Flwt aur -100.10+
sn 5Vray orrPrx �( rcv or 01KAf U tf - 9N\ ' ^ / A ONU.Ef 96.10
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ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 28. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 336-3246
LEGAL DESCRIPTION:
SEACLIFF SUBDIVISION, LOT 5A, BLOCK 2
TYPE OF WORK:
AS—BUILT OF SEPTIC SYSTEM UPGRADE
PREPARED FOR: PHONE NUMBER:
DYNAMIC PROPERTIES 345-2059
DATE: DRAWN BY: SCALE: PAGE:
6/28/99 A.C.G. 1 = 4D' 2 OF 2
o OF 4p
0
J f A. ISS.: P
OP � —7953 �p�
Prof e s sioli�a�
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
cl' 7'rti
Upgrade
Permit Number: SW990129
Legal Description: SEACLIFF BLK 2 LT 5A
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: John Marquess
Owner Address: 9341 SHORECREST DRIVE
ANCHORAGE , AK 99515-1037
Date Issued: Jun 09, 1999
Expiration Date: Jun 08, 2000
Parcel ID: 011-221-31
Site Address: 009341 SHORECREST DR
Lot Size: 15719 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
✓❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: [-0J51/
Date: 6 — / — F?
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 211. Anchorage, AK. 99504
Phone (907) 337-6179 — Fax (907) 338-3246
May 26, 1999
Municipality of Anchorage
Department of Health & Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref. Septic System Upgrade for Seacliff Subdivision, Lot 5A, Block 2
To whom it may concern:
1. GENERAL: The existing 3 bedroom home is served by a private septic system and a
community water system. The septic system was found to be in a state of failure and in need of
replacement. One test hole was dug on 5/19/99. The soils are summarized as follows.
2. SOIL CONDITIONS: Test hole #1 was excavated to a depth of 15 feet. There was
approximately 2 feet of organics at the top of the test hole. The material beneath the organics to
the bottom of the test hole was a GW/SW material. One pert test was performed in test hole #1
at a depth of 7 feet. The pert cavity absorbed water as fast as it was added (<1 min/inch). It is
our opinion that the insitu soils will act as a sand filter.
3. DRAINFIELD: We are proposing to install one trench that is 38 feet long by 5 feet wide. It
will be 9 feet deep with an effective depth of 4 feet. This corresponds to an absorption area of
380 ft2, or an application rate of 1.2 gpd/ft2 (assuming 450 gpd total flow).
4. SURFACE WATER: There are no surface waters within 100 feet of the proposed upgrade.
5. TOPOGRAPHY: The ground where the proposed trench is to go is virtually flat. In short,
there are no concerns regarding the slope of the terrain.
6. CLOSING: If ypu have any questions, please call me a 337-6179 or 244-9612.
M.S.
LOT 6A, BLOCK 2 LOT 3A, BLOCK 2
SEACLIFF S/D ! SEACLIFF S/D
I
PROPOSED DRAINFIELD UPGRADE. EXCAVATE 9'
DEEP (MAX.) BY 38' LONG BY 5' WIDE. ADD 4'
OF CLEAN, WASHED SEWER DRAINROCK. 1
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SEMENT �,... _ — —o
0 _
� o
INSTALL DBL CO O
TH#1+ INSTALL FLOW DIVERTER \
FCO� CO/MT
�`�.
�.%EXISTING CRIB TO BE USED
GENERAL LOCATION / AS A RESERVE SITE
OF KEY BOX
o l'a
EXISTING SEPTIC TANK TO BE
EXISTING ABANDONED COMPLETELY AND f
3 BEDROOM REPLACED WITH A NEW 1000
HOUSE GALLON SEPTIC TANK j
j
j ,✓
LOT 4A, BLOCK 2
SEACLIFF S/D
j ,10 /
j
j NOTES:
j ALL PROPERTIES WITHIN 200' OF PROPOSED SEPTIC
j ARE SERVED BY A COMMUNITY WATER SYSTEM AND
PRIVATE SEPTIC SYSTEM.
THE CONTRACTOR SHALL HAVE THE NORTH AND
EAST UTILITY EASEMENTS FLAGGED BY A REGISTi
LAND SURVEYOR PRIOR TO CONSTRUCTION.
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
SEACLIFF SUBDIVISION, LOT 5A, BLOCK 2
DESIGN FOR SEPTIC UPGRADE
PREPARED FOR: PHONE NUMBER:
DYNAMIC PROPERTIES 345-2059
DATE: DRAWN BY: SCALE: PAGE:
5/21 /99 A.C.G. 1 = 30' 1 OF 1
OF A �Q
ffir f /��
�eff y A.ss
E-7953
lw�l'r0fessi0�o
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
7320 E. CHESTER HTS. CIRCLE ' ANCHORAGE, AK. 99504
PHONE (907) 337-6179 • FAX (907) 338-3246
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: SEACLIFF SUBDIVISION; LOT 5A, BLOCK 2,
PERFORMED FOR: JOHN MARQUES
DATE PERFORMED: 5/19/99
AWWC, Inc., May 1999
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 213 — Anchorage — Alaska 99504
Phone (907) 337-6179 — Fax (907) 338-3246
Onsite Wastewater Disposal System Standard Construction Specifications
I. REFERENCE PROPERTY: Seacliff Subdivision, Lot 5A, Block 2
Il. DEFINITIONS:
1. Property owner: The legal property owner or his/her representative.
2. Engineer: Alaska Water & Wastewater Consultants, Inc. or AWWC, Inc.
3. Contractor: The company hired by the property owner to install the septic system.
4. DHHS: Municipality of Anchorage, Department of Health & Human Services
5. M.O.A.: Municipality of Anchorage, Department of Health & Human Services
III. RESPONSIBILITIES:
• Property Owner Responsibilities:
1. The property, owner shall contract with the contractor to perform the work outlined in these
specifications and plans, in accordance with the attached DHHS permit. There is no contractual
relationship between the contractor and the engineer. The engineer shall inspect the work as, required by
DHHS to document the installation. Final acceptance of the contractor's work rests with the owner and
the DHHS.
2. This well and/or septic system design is for a single family residence only. The homeowner is
responsible for notifying the engineer if the residence is used as a duplex, business, or multi -family
dwelling. In such cases, the installation permit must be obtained from the State of Alaska, Department of
Environmental Conservation.
3. The validity of the design site plan is limited by the accuracy of the as -built survey provided to the
engineer by the property owner or his/her representative. The property owner shall notify the engineer
regarding any known inaccuracies associated with the as -built survey. The engineer assumes no
responsibility for the accuracy of the survey.
4. The property owner is responsible for notifying the engineer of any unplatted easements, not shown on
the as -built survey, which the new well or septic system may encroach into.
5. The property owner shall notify the engineer of any seasonal groundwater or surface water runoff
conditions, known to him/her, which could potentially effect the operation of the septic system. The
proposed septic system must be at least 100 feet from any streams, ponds, creeks, swamps, bogs, or any
other surface water as defined by the DHHS.
6. The property owner is responsible for notifying the engineer if, to his/her knowledge, any of the
adjacent properties are used as a duplex, business, or multifamily dwelling. The new septic tank and
leachfield must be at least 100 feet from any private well, 150 feet from any class "C" well, and 200 feet
from any community well, unless appropriate waivers are obtained.
1 of4
AWWC, Inc., May 1999
7. The property owner and/or his contractor shall report to the engineer any observed condition which
would put the septic system in violation of State or Municipal regulations.
8. Unless specifically agreed upon otherwise, the property owner is responsible for final grading of the
areas which settle after construction. Prior to awarding the contract, the homeowner should communicate
to the contractor any expectations regarding, but not limited to, post construction site clean-up,
re -landscaping, and restoration of any asphalt, fences, trees, decks, ect. that are effected by the
construction. If the property is being sold, the property owner shall ensure that the aforementioned items
are addressed with the buyer, and, if the work is to be completed after the sale of the property, that
necessary funds are escrowed to fund the completion of the work.
9. If the property owner intends to install the septic system he/she must first have obtained approval from
the Municipality of Anchorage, DHHS (343-4744). Homeowner installations typically require more time
for engineer inspections. The homeowner should discuss the additional costs, associated with such
inspections, with the engineer, prior to starting the project.
10. The property owner is responsible for payment of all the engineer inspection charges. The number of
inspections will vary depending on the actual field conditions encountered and the construction methods
used.
• Contractor Responsibilities:
1. The contractor is responsible for locating all buried utilities, easements, property lines, and surface
waters; and shall ensure that all setbacks are flagged by a registered land surveyor prior to construction.
2. Construction shall be in accordance with the approved site plan and design drawings, and any special
provisions noted on the municipal sewer permit. The contractor is responsible for notifying the engineer
of any discrepancies noted on the design plans or drawings, prior to starting work. The installation,
materials, and workmanship shall comply with all applicable State & Municipal regulations.
3. The contractor is responsible for field verifying the separation distances to all adjacent wells and septic
systems, shown on the design drawings, prior to starting construction. Any encroachments that would
effect the installation, for which waivers do not exist, should immediately be brought to the attention of
the engineer.
4. Ensure that all materials being used are in compliance with the most current guidelines established by
the Municipality of Anchorage. This includes, but is not limited to, the following:
a. Drainrock
b. Sand filter material for conventional beds, trenches, or mound systems.
c. Sand filter material and pea gravel for Intermittent Sand Filters (ISF).
d. Anchorage Sand and Gravel (AS&G) "block pea" material for Upflow Filters.
It is recommended that the contractor provide the engineer with current sieve analysis' from the
sand/gravel supplier to document the suitability of the material. The engineer assumes no responsibility
for ensuring that the materials delivered meet the MOA requirements.
5. The contractor shall ensure that the septic tank, lift station, or holding tank purchased has a burial
depth rating suitable for the actual installation.
6. Notify the engineer at least 24 hours prior to starting construction. If deemed necessary, a
preconstruction site visit shall take place. The contractor shall coordinate with the engineer any
inspections which will be required during weekends, holidays, or before/after normal working hours (8:00
2 of 4
AWWC, Inc., May 1999
am to 5:00 PM). The property owner may incur additional charges for inspections which do not occur
during normal business hours. It is the contractor's responsibility to notify the engineer a least 2 hours
prior to any inspection.
7. The contractor shall report to the engineer any observed condition which would put the septic system
in violation of State or Municipal regulations.
8. Any remaining test hole excavations shall be filled and mounded. Unless instructed otherwise by the
engineer, the old test hole groundwater monitoring pipes shall be removed.
9. The contractor is responsible for final grading so as to ensure that surface runoff does not adversely
effect the septic system constructed, adjacent septic systems, or adjacent structures.
10. The contractor is responsible for obtaining approval from the property owner for any additional
construction costs associated with design modifications or changing field conditions, prior to doing the
work.
• Engineer Responsibilities:
1. The engineer is responsible for inspecting the installation of the septic system and preparing as -built
documentation, to the satisfaction of the M.O.A.. Inspections are performed as necessary to document the
construction of the system to the satisfaction of the M.O.A. In all cases, the following inspections shall be
performed:
* The bottom of all trench/bed excavation
* Top of sand on all sand filters
* Top of drainpipe
* Septic tank, or lift station, or holding tank prior to backfill
* Placement of filter fabric and insulation
* After final grading is completed
Additional inspections may be required depending on the construction methods used by the contractor and
the type of system being installed.
2. The inspecting engineer has no direct authority over the contractors activities or construction practices.
Should the engineer identify conditions which dictate a design change, he or she may recommend that
work be stopped,. and/or the design be modified. If design modifications are necessary, the engineer shall
notify the property owner or his/her representative.
3. The engineer shall inspect the condition of the existing septic tank and determining its suitability for
re -use. If the engineer determines the septic tank to be structurally unsound, it must be replaced.
W. CONSTRUCTION GUIDELINES:
• General
Construction shall be in accordance with the approved site plan and design drawings, and any special
provisions noted on the municipal well and/or sewer permit. All materials, components, and construction
practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic
systems, as well as DHHS policies. The failure of the inspecting engineer to notice a material or
construction non-compliance does not relieve the contractor of his/her responsibility to correct such a
deficiency.
3 of 4
AWWC, Inc., May 1999
• Septic Tank, Holding Tank, or Lift Station Installation:
1. The burial rating of the tank shall be adequate for the actual burial depth encountered.
2. The tank shall be level and sufficiently bedded to prevent settling or shifting of the tank.
3. All standpipes on the tank shall extend a minimum of 12 inches above final grade.
4. Tanks installed with less than 4 feet of cover shall be insulated.
5. The sewer service line from the house to the tank shall be sloped a minimum of 1/4"
per foot, unless prior approval is obtained from the engineer.
6. The inlet and outlet lines from the tank shall be bedded in drainrock or the soil shall be adequately
compacted to prevent future settlement of the soil.
7. A foundation clean-out will be installed, 1-4 feet from the house, if one does not currently exist.
8. Post tank clean -outs shall be installed per MOA requirements. Does not apply to holding tanks or lift
stations with pressurized lines.
9. All tanks shall be anchored to resist buoyancy forces in high groundwater areas. This applies when
there is not adequate soil cover to resist buoyancy forces. Engineer shall make this determination.
10. The final soil cover shall be graded so that there is positive drainage away from tank.
11. All holding tanks and lift stations shall have an audible and visible alarm inside the residence.
12. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical
Code.
13. The contractor shall remove the old tank, or abandon it in compliance with the Uniform Plumbing
Code (UPC). The contractor is solely responsible for the abandonment procedure.
• Installation of Conventional Absorption Bed & Trenches:
1. Excavate the proposed bed/trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level (2 inch maximum variation between high and low spots). If
the sidewalls or bottom of the excavation become smeared, they must be raked or scarified before
placement of the filter sand or drainrock.
2. The trench or bed should be at least 5 feet from the test hole excavation.
3. All soil tests and excavation depths are advisory to the design and are to be verified in the field by the
engineer. If design changes are necessary, and the changes effect the contractor charges to the property
owner, the contractor shall obtain approval from the property owner prior to proceeding with the work.
4. Once the drainrock is installed, the distribution pipe is to be placed level (0.02 feet difference between
high and low shots) with the perforations faced downward. Drainrock is then to be placed over the
distribution pipe, to provide a minimum of 2 inches of cover over the pipe. The drainrock shall not be
pyramided over the drainpipe but shall be the same elevation over the entire trenchlbed width.
5. A silt barrier must be installed between the final drainrock layer and the native soil backfill. The silt
barrier shall cover the entire drainrock surface.
6. Monitor tubes shall be installed at the locations shown on the design drawings, and extend a minimum
of 12 inches above final grade. The portion of the monitoring tube extending through the drainrock shall
be perforated from the bottom of the trench/bed to the invert of the distribution pipe.
7. Backfill over the final drainrock layer must not be less than 2 feet. Insulation must be installed when
the backfill depth is less than 3 feet. The insulation shall cover the entire width of the trench/bed. the
contractor shall "shoot' the final grades to ensure cover depth is adequate, prior to notifying the engineer
that the work is complete. The final cover over the drainfield must graded so that there is no potential for
water to pond over the trench/drainfreld.
4 of 4
�-. GRF l'cR ANCHORAGE AREA B0, AUH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME MAILING ADDRESS �6(- SLg-eAXvt v4�. PHONE3;(y--oA
LOCATION LEGAL DESCRIPTION UAVI-1-
SEPTIC TANK:
DISTANCE 4J.00 NUMBER OF
FROM WELL MANUFACTURER MATERIAL COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 66(5 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH—,LENGTH—,DEPTH
S' A 4
j �a
LINING MATERIAL CRIB SIZE: DIAMETER—DEPTH—DISTANCE
FROM: WELLO'1'—
TOTAL EFFECTIVE
3
BUILDING FOUNDATION_, NEAREST LOT LINE
ABSORPTION AREA (WALL AREA) SQ. FT.
ADDITIONAL ABSORPTION
WELL:
]�//)
TYPE CONSTRUCTION "�M DEPTH DISTANCE FROM:
BUILDING NEAREST N A EST
FOUNDATION—,LOT LINE SEWER LINE
SEPTIC SEEPAGE
TANK', SYSTEM
CESSPOOL OTHER SOURCES
c�
APPROVED DISAPPROVED REMARKS
DISTANCES:y `�
INSTALLED BY:
PIPEMATERIAL: (IXy
LOT SLOPE: '
REMARKS:
v
Form No. EQ -031
DIAGRAM OF SYSTEM
U./A.A.C. -
GREATER ANCHORAGE AREA BOROUGH
,K�A�Of
PERMIT NO.
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
b++llq F TELEPHONE 274-4561 A1111 C' ,>IS'T
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
C._Ci (/nn"•- Qj 93.0o2C-t' PHONE
NAME OF APPLICANT S W��"' � � MAILING ADDRESS
INSTALLATION LOCATION Sq -a2 -e C412,0r7_
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK ✓ SEEPAGE PIT , DRAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED �0
I \1
FINANCED THROUGH
TO BE INSTALLED BY
SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED "
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE �L V TYPE �r STzZI SEEPAGE AREA SIZE
C
�s /��
MINIMUM DISTANCES, REQUIREMENTS &UMM• akz-L-
5
FOUNDATION TO SEPTIC TANK
�r
FOUNDATION TO SEEPAGE PIT
Zv 1
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK 6-1, SEEPAGE PIT
TO NEAREST LOT LINE.
DRAIN FIELD /0 /
2 / DRAIN FIELD /o/
i
WELL TO SEPTIC TANK ZOO , SEEPAGE PIT
zoa
DRAIN FIEL , ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
SEEPAGE PIT
DRAIN FIELD / 11
%
SEPTIC TANK, ��}�) . SEEPAGE PIT DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
GATE
�-- APPLICANT'S SIGNATURE~
FORM NO. EQ -016
TYPE
DIAGRAM OF SYSTEM
BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
a 4 1
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK d :70
TYPE AND SIZE OF FACILITY TO BE SERVED
MAILING
/ '!
SEEPAGE PIT
PERMIT NO.
RESS 1 3 d ( "` 1 41L"��1.F� ^' I PHONE � '� J'Z 7
DRAIN FIELD OTHER
FINANCED THROUGH TO BE INSTALLED BY
SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT BOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE o d0 TYPE
CZYI.l,. 1
MINIMUM DISTA ES, REQUIREMENTS
I
FOUNDATION TO SEPTIC TANK +
FOUNDATION TO SEEPAGE PIT /S 1
DRAIN FIELD
SEEPAGE AREA SIZE ---/` ( )-KG TYPE
SEPTIC TANK TO SEEPAGE PIT WALL -J
1
s
1
FIELD
SEPTIC TANK , SEEPAGE PIT
DRAIN
TO NEAREST LOT LINE.
/
WELL TO SEPTIC TANK
f
SEEPAGE PITy —.
DRAIN FIELD
ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
SEPTIC TANK, SEEPAGE PIT , DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS, REGARDIN INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE �� APPLICANT'S SIGNATURE c '"�
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section cam
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # 011 -221-31 HAA # bA QL93 L
1. GENERAL INFORMATION
Complete legal description Lot 5A• Block 2; Seacliff Subdivision
Location (site address or directions) 9341 Shorecrest Drive
Anchorage AK
Property owner John Marau ss Day phone
Mailing address C/0 Dynamic Properties 3111 "C" St. Anchorage, AK
Lending agency
Day phone
Mailing address
Agent Bob Brock/ Dynamic Properties Day phone 261-7603
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water xx
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 xx
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 #21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verifythat 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
Address
Engineer's signature
ALASKA WATER &
Alaska Water &
W"tewater Consultants, its.
Shaft be PAID $ m76 �
CW prior to, closing for the
Engineering ,Services Provided,
6. DHHS SIGNATURE
By:
V_� Approved for T HRS 8- bedrooms.
Disapproved.
Conditional approval for
Additional Comments
2B
Phone � ' 7—L�7(i
Date L- /,)-
s
E.996I ��01
bedrooms, with the following stipulations:
Date (0- 30-1-2
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025(P .1/91) Back MOA B21
Municipality of Anchorage �� ���� ��pp���� 2 9 1999 l
DEPARTMENT OF HEALTH & HUMAN SERVIL"ES
Environmental Services DivisionMUNaPAury OF ANCHORAGE �c
825 L Street, Room 502 • Anchorage, Alaska 995ffle jT'0 Y474*vl1lO V
;W Health Authority Approval Checklist
Legal Description: ` 20("j1• � 1-U4 5% 6k,2- Parcel I.D.:
A. WELL DATA
Well type
Log present(Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well production
WATER SAMPLE
Coliform
sample:
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to
FROM WELL LOG
g.p.m.
Nitrate
B. SEPTIC/HOLDING TANK DATA
Casing height (above ground)
Wires prgpTrly protected (Y/N)
AT INSPECTION
Collected by:
Other bacteria
Date installedf Tank size 1066 Number of Compartments Cleanouts�N)tS
Foundation cleanouON) Ye 7 Depression (Y�� High water alarm (YO-) i% a JJ
Date of Pumping 4 ! Pumper
C. ABSORPTION FIELD DATA
Date installed 22 Soilratin (g.p.d./ft2 rft2/bdrm) System type 5 (Vlje�41-eiIC%
Length l Width Gravel thickness below pipe -3,95 Total depth X,Sf
y
Effective absorption area J�c� % Monitoring Tube presentl&N)-)L— Depression over field (Y6 /Vo
Date of adequacy test /)(), 4 . ) Results (Pass/Fail)
Fluid depth in absc
Fluid depth
Peroxide treatment
72-026 /96)'
(ins) Minutes
(Y/N)
Im
For
gal. water added (in.):
Absorption rate = _
If yes, give date
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles
E. SEPARATION DISTANCES
Size
level at*
*Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
:��Sewer / service line
"Pump off" level at*
_went lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation Property line f- Absorption field 5
Water main/service line /6 4— Surface water/drainage /GO f _ Wells on adjacent lots 06%
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line !10 Building foundation /D Water main/service line
Surface water /fX5 .-A- Driveway, parking/vehicle storage area -5
Curtain drain /? c3/1 e— K,0 GW ✓1 Wells on adjacent lots
F. ENGINEER'S
l certify that I
in conforman
field inspections and review of Municipal
felines in effect on this date.
Signature /-
Engineer's NameI
Date (o Z `] �
HAA Fee
Date of Payment
b /2 ,� �� 9
Receipt Number d 4 5;yly
72-026 (Rev. 3/96)*
Waiver Fee $ _
Date of Payment
Receipt Number
2
OF A
MUNICIPALITY OF ANCHORAGE
} DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section C4
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # O t t- A ), I- _a I
HAA # ti Y- 'l i, C C_ \'I
1. GENERAL INFORMATION
Complete legal description Lott 5A; B°ock 2; Seac,U46 Subdi.vizs ,on
Location (site address or directions) 9341 Shore.enest D.LiOe
AnchoAaae., AK
Property owner
John
Marques
Day phone 243-5403
Mailing address
9341
Shortea7e.ati V41 ve
Anchorage. AK 99515
Lending agency -Day phone
Mailing address
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
3
XXX
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 XXX
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#21
5.
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 5 ENGINEERING
17034 ragle—Kiver Loop Road NoT204--Phone
Address ;agle diver, Alaska 99577
Engineer's signature " Z / Z_-,1_, --,, —
DHHS
-,1,�----
DHHS SIGNATURE
Approved for — S bedrooms.
Disapproved.
(✓ C Y — ,�— cj -7 CJ --
Date / �c
`'CE. 0 A�C�11ti ' s klI
41
ROBERT C. COWAN ;t A
Ct
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA N21
96-01-15 12:26 RCVD
Municipality of AnchoragaMICInp,t
DEPARTMENT OF HEALTH & HUN€l�li�l 6tQ!! � 5r Hc�n„ k
Environmental Services Division ""2Vi�Esa�yr�lON
825"L" Street, Room 502 Anchorage, Alaska 99501 x:,(0743-4744
e
Cr
Health Authority Approval Checklist EL)
Legal Description:1-o T .S' A g z - x a S f <4 c ci,=,= Parcel I.D.: LO 1/ 3 I
A. WELL DATA
C.)~1- Cr„�YS A
Well type If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well production
WATER SAMPL SULTS:
Date completed
Cased to
FROM WELL
Nitrate
EXe of sample:
B.SEPTICHOLDING TANK DATA
Date installed 7Y Tank size
(above ground)
properly protected (Y/N)
AT INSPECTION
9—
p.m-
Other bacteria
Collected by:
aj)13s-
g.p.m.
Number of Compartments j Cleanouts 61N) y.IEs,
Foundation cleanout &IN) Y -f S Depression (Ye N `'' High water alarm (YA,
Date of Pumping 1"l � �� Pumper H S6AV/ C"i J
C. ABSORPTION FIELD DATA
Date installed �°� y Soil rating (g.p.d./ft'- oftZ/bdrm System type
Length "/ Width F(' A6 Gravel thickness below pipe 6 Total depth
Effective absorption area3 �� Monitoring Tube present&/N) Y f Depression over field (Y'& ^� U
Date of adequacy test //)3/96 Results Pass ail) P4 S 1 For 3 bedrooms
Fluid depth in absorption field before test (in.): 3 Immediately afterS`j �L gal. water added (in.): S' o
Fluid depth 1 dd (ins.) Minutes later: J 3 Absorption rate = y S-0 -Y-- Q.p.d.
Peroxide treatment (past 12 months) (YN /v6,it K�c'v—' If yes, give date
D. LIFT STATION
Date installed Size in gallons 1—
Manhole/Access (YM) "Pump on" at* "Pump off' level at*
High water alarm level at* *Datum
Cycles teste
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO: N C e �l m _ 1,4
" �L
Septic/holding tank on lot ; On adjacent lots
Absorption field oil . On aeent ots _
Public sewer main Public sewer manhole/cleanout _
Sewer /sept ice line Lift station _
SEPARATION DISTANCES FRONK SEPTI HOLDING TANK ON LOT TO:
Building foundation / Property line a O Absorption field
p ) 00 �` Wells on adjacent 01 X70
Water maitr/service line '� � Surface water/drainage j'tcent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation 4- Water main/service line
Surface water /00 f Driveway, parking/vehicle storage area
Curtain drain A'o ` "A' ° `'"/ Wells on adjacent lots a Property line 1 `I
F. ENGINEER'S CERTIFICATION
I certi/ that 1 have determined thru field inspections and review of Municipal records thVstei
in conformance ivith J1 OA H; 1 guid lines in effect on this date. r� y0 A „9
Signature
Engineer's Name
ROBERT C. COWAN
Date r4 4 • .. +
HAA Fee $
Date of Pay.
Receipt Nui
Rev. 8/95 OSS: haa.wk.doc
Waiver Fee $
Date of Payment
Receipt Number
t CE -8801
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