HomeMy WebLinkAboutMOUNTAIN MANOR TR DMo ntain
Manor
Tract D
#050-682-02
~ M unicip al ity of An ch orage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: $W030222 PID Number: 050-682-02
Name: Wastewater System: [] New [] Upgrade
Wallace Homes
Address:
18306 Parkvw. Terrace Lo. E.R.. AK 99577 ABSORPTION FIELD
Phone: Number of Bedrooms:
[] DeepTrench [] ShellewTrench [] Bed [] Mound [] Other:
696-8207 4
LEGAL DESCRIPTION so, Rating: GPD/Ft2 Total Depth from original grade:
0.8 8.0 Ft.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
Tract D Mountain Manor 1.95 Ft. 6.05 FL
Township: Range: Section: Fill added above original grade: Gravel Length:
2-5.2 Ft. i 63 Ft.
Gravel width: Number of lines: I Distance between lines:
Well: [] New [] Upgrade 2 Ft. I~1 na Ft.
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: FI= Pipe Material:
Private/Existing Ft. Ft. 756 D3034 & F810
Driller: Date Ddlled: Static Water Level: Installer. Date Installed:
Ft. Cat's Eye Ex. 07/01/03
Yield: GPM IPump Set at: Ft'll Casing Helght Above Ground:Fi. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
Fro'From To Septic Absorption Lift Holding Public/Private Manulacturer; Capacity:
Tank Field Station Tank Sewer Une Anchorage Tank 1.500 GaL
Material: Number of Compartments:
we, 100'+ 100'+ NA NA 25% Steel 2
$u~aceWate~ 100% 100% N^ ~A LIF:T STATION
Size; Manutacturor;
Lot Une 5'+ I 0% NA NA Gal.
5'+ 10'+ NA NA 'Pump on' level at: 'Pump off' level at: I H,gh water alarm at:
Foundation
in. In.~ in.
Curtain Drain NA *50% NA NA Pump Make & Model Electrical Inspections performed by:
Remarks:
*none known BENCH MARK
Location and Description:
Top of sana tube
Assumed Elevation:
1 O0 Ft.
Inspections performed by: KND Engineering, Inc. Dates: 'ist 7/1/~003
DeTl?m s .p I
AS-BUILT SYSTEM DETAILS/SITE PLAN PerMi~ SW030888
MOUNTAIN MANOR SUB]). TRACT ]] PID#O50-682-02
N? /' TRACT D
SCALE' 1' = 50'
A-E=29.1' FINAL GRADE
..- PREPARE~ FOR,
~ALLACE HONES
EAGLE RIVER, AK. 99577
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Jun 25, 2003
Expiration Date: Jun 24, 2004
Permit Number: SW030222
Legal Description: [_M~M~'~.~'~ ~?
Design Engineer: 0070 KND Engineering
Owner Name: Wallace Homes
Owner Address: 18306 N. Parkview Terrace Loop
Eagle River, A 99577-
Parcel ID: 050-682-02
Total Bedrooms: 4
Site Address: 18306 N. Park View Terrace
Lot Size: 118003 SQ. FT.
Permit Bedrooms: 4
This permit is for the construction of:
[~] Disposal Field r~ septic Tank D Holding Tank D 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 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:
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPliCATiON
FOR A SINGLE FAMILY DWELLING
Parcel I.D. (~ ~ O -"
Permit Number SW O ~O ,~. ~
Property owner(s) WALLACE HOMES
Day phone 696-8207
Mailing address (1) 18306 PARK VIEW TERRACE LOOP; E.R.; AK 99577
Mailing address (2).
Zip Code
Legal description (Lot,.BIock & Sub'd.) MOUNTAIN MANOR TRACT.
Legal description (Section, Township & Range)
Lot Size ] / ~ ! ~:)O ~ Acres/Sq. Ft.
Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewe~J.r~Qra_de
THIS PROFI~;FE-;"R~[NTAINS:
Hot.Tj~).... ....
??i:..'
Well Only
Water Storage
[]
[]
[]
Jacuzzi
Water Softening Unit
I certif~/.'t ;~.'.o~e information is correct. I further certify that this application is being made for a
Single Famil g and is in accordance with applicable Municipal Codes.
(Signat~=~"property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev, 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
20441 PTARLgGAN BLVD.
EAGLE RIVER, AK 995YY-8Y$6
(907)696-6111/FAX (907)696-8111
June 24, 2003
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: New sewer/~dl"permit - Mountain Manor Tract D
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit on the subject
lot. On April 4, 2003 two testholes were performed for the proposed system. The
results of these tests are attached. The general slope of .this lot is from east to west at a
grade of approximately 15-20%.
We have designed our system utilizing the existing testholes that were excavated for
the proposed 4-bedroom house. The lot will be served by an existing individual well,
located on the northwestern portion of the lot. We propose to install one 2' wide deep
trench. Water was not encountered during the excavation or during monitoring.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100' of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
]l(I~I]]) Engineering, Inc.
Attachments:
On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
Owner/Contractor Specs
~/ELL &
K D
~/ASTE~/ATER DISPBSAL SYSTEM
MOUNTAIN MANOR SUBD, TRACT D
\ \
TRACT D
DETAILS/SITE PLAN
3
NO PUBLIC VELL~ VITHIN 200' ~
PROPBSED SYSTEH.
M] PRIVATE VEILS VITHIN 800' ~'
PROPOSED SYSTEN EXCEPT AS NOTED,
~ ~PTIC SYST~S VITHIN ~' OF
~OSED V~ EXiT AS NOTED.
DESIGN DETAILS
4 BDRM X 150 GPO = 600 GPO
600 GPO/0.8 GPO PER SQ. FT. (6.41 MIN/IN.)= 750 SQ. FT
750/(8'(W) X 6'(D)) (6.0' GRAVEL) = 68.5 FT. TRENCH
USE 1 TRENCH - 63 (L) X
Total depth oF system Is 8.0' From original grade.
Total depth oF gravel below distribution pipe Is 6.0' .
NOTES:
USE 1850 GALLON SEPTIC TANK, INSULATE IF <4' OF COVER.
8. . INSULATE TRENCHES WITH 2' HD BURIAL FOAM.
3. CONTRACTOR WILL ENSURE MINIMUM 87. SLOPE INTn SEPTIC TANK.
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
5. CONTRACTOR WILL ENSURE .ALL SEPARATIONS TO ADJACENT
~ J% *. ......... *~
WELLS, SEPTICS, LOT LINES, FOUNDATIONS AND ALL OTHER SETBACKS.
PREPARED FOR:
WALLACE HOMES
18306 PARKVW. TERRACE LOOP
EAGLE RIVER, AK. 99577
(907) 696-8807
FIELD BOOKS c~Pul~:
BOUNDARY;. GASTALDI BRA~: V~G
ST~NG:. NA c~cx~: KMD
A~U~LT: NA ~: 6,/'24/05
~. n~= ~ NW255
xc~ ~= 03018.DWG ~,o.= 03018
Scale: 1'= 100'
PAGE 1 DF 8
~~) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-81 ! 1
D
WASTEWATER DISPOSAL SYSTEM DETAILS
MOUNTAIN MANOR SUBD, TRACT D
;-2
PROPOSED 1250
IGAL TANK
LU
12'
CO
MT
PROPOSED 4
BDRM HOUSE
MT
TH03-1
59' 56'
/
.~~ ...... .~..~+~ ~
9'm
..........
PREPARED FOR,
WALLACE HAMES
1.8306 PARKVW, TERRACE LnaP
EAGLE RIVER, AK, 99577
(907) 696-8207
FIELD BOOKS co~Pu'~D:
eouNo~Y:. QASTALDI o.^~: ~O
STAmNO: NA m~: KMD
A~aLT: NA
DWC. ~
AC~3 ri_z: O,3018.DWG
,/'24/'0,3
NW255
0'3018
ScaLe, 1'=
PAGE 8 DF 8
~~ ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-611 !/FIX (907)696-8!
~D ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
SOILS PERCOLATION TEST
Performed for:
Wallace Homes
Date Performed:
4/4/O3
Project:
Mountain Manor, Tract D
TEST HOLE # 03-1
11-
16-
17-
18-
Depth
(Feet)
ORG/OL -black/red overburden
SP/sm -med dense, with silt,
moist
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? DRY Date? 4/14/03
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 4/4/03 1:00 - 6,, _
2 1:10 10 min 11/16" 5 5/16"
3 * 1:11 6" .
4 1:21 10 min 14/16" 5 2/16"
5 * 1:22 6" .
6 1:32 10 rain 15/16" 5 1/16"
7 * 1:33 6" .
8 1:43 10 min 1' 5"
9 * 1:44 6" .
10 1:54 10 min 15/16" 5 1/16"
11 * 1:55 - 6"
12 2:05 10 min 1' 5"
· Water Added
19-
20-
HOLE PRESOAKED
PRIOR TO TEST
Percolation Rate 2 (min/in) Perc Hole Diameter
Test Run Between 5 feet and 6 feet
6#,
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
Performed for:
Project:
I[
SOILS PERCOLATION TEST
Wallace Homes
-. OF 4
,..,
:
Date Performed:~~
Mountain Manor, Tract D
TEST HOLE # 03-1
11-
15-
16-
17-
18-
Depth
(Feet)
ORG/OL -black/red overburden
SP/SM - med dense, with silt,
moist
B.O.H.
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? DRY Date? 4/14/03
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 4/4/03 1:00 - 6- _
2 1:10 10 min 4 3/16" 1 13/16"
3 * 1:11 - 6,, .
4 1:21 10 min 4 6/16" 1 10/16"
5 * 1:22 6" _
6 1:32 10 min 4 7/16" 1 9/16"
7 * 1:33 6" .
8 1:43 10 min 4 6/16" 1 10/16"
9 * 1:44 6" _
10 1:54 10 min 4 7/16" 1 9/16"
11 * 1:55 - 6"
12 2:05 10 min 4 7/16" 1 9/16"
· Water Added
19-
20-
HOLE PRESOAKED
PRIOR TO TEST
Percolation Rate 6.41
Test Run Between
(min/in) Perc Hole Diameter 6"
6 feet and 7 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
ENGINEEI G, I C.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907) 696-6111/FAX (907) 696-8111
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES AND MATERIAL SPECIFICATIONS
LEGAL DESCRIPTION: Mountain Manor Tract D
GENERAL:
1. The scope of this project includes the installation of a septic tank and/or drainfield to serve a
single-family residence on the referenced property as delineated on the attached Municipality of
Anchorage (MOA) permit and site plan.
2. Construction shall be in accordance with the approved site plan and design drawings; MOA
permit with any special provisions or conditions, and all applicable State and Municipal
Wastewater Disposal Regulations.
3. KND Engineering, Inc (KND) assumes no responsibility of the accuracy of the as-built survey
. provided by the.owner or owner's representative
4. The owner or contractor is responsible to notify the'eng'~r'0f an~ discrepancies noted on the
design plans or drawings prior to commencing work. These discrepancies could be, but not
limited to, possible encroachments, surface water, varying soils, unplatted easements, types or
use of dwellings on or adjacent to property, nearby public wells, etc.
5. The contractor shall be responsible for locating any necessary underground utilities, easements,
property lines and surface water. The owner and/or contractor shall ensure, if deemed
appropriate, that a registered land surveyor prior to construction flags all setbacks.
6. The contractor shall be responsible for verifying all pertinent separation distances and
component layout.
7. Unless specifically agreed otherwise, the property owner shall be responsible for final grading
areas subsequently depressed from soil settling. On all leachfield mound systems, the property
owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded
area.
8. The MOA Development Services Department On-Site Water & Wastewater Program must
certify contractors installing wastewater disposal systems. Owners installing their own systems
must also receive prior approval from said MOA Department.
SEPTIC TANK / HOLDING TANK / LIFT STATION INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall
include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded with proper material and compacting to prevent
damaging, settling or shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches above the final grade.
4. Septic tanks installed with less than 4 foot of cover shall be insulated. The contractor will
ensure that the fill over the tank does not exceed the burial depth rating.
5. A foundation cleanout shall be installed one to four feet from the building foundation. In the
line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent
pumping system exists within the septic tank). These cleanouts shall be located on undisturbed
soil not more than 10 feet from the tank. The second cleanout, in line, shall be to clean toward
the septic tank.
6. Final grading over the septic tank shall be such that a positive slope exists away from the septic
tank.
Page 1 of 3
Reference: Mountain Manor Tr D
Date: 06/24/03
Page: 2 of 3
7. All H.D.P.E. tanks shall have a vertical length of 4-inch perforated drainpipe besides the tank
extending to the bottom of the tank to above grade to monitor ground water.
8. All tanks shall be anchored when there is not enough adequate soil cover to resist buoyancy
forces in high-groundwater areas.
9. All holding tanks and lift stations shall have an audible and visual alarm inside the residence.
10. All lift stations shall be wired in compliance with the Uniform Electrical Code and all MOA
guidelines.
11. The contractor shall remove the old tank, or abandon it in compliance with the Uniform
Plumbing Code. The contractor is solely responsible for the abandonment procedure.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavaction become smeared,
they must be raked or scratched (roughed-up) before gravel (sewer rock) placement.
2. Once the sewer rock is installed, the distribution pipe is installed level with the perforations
facing downward. Gravel is then to be placed over the distribution pipe to provide a minimum
of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure
the silt barrier covers the entire gravel surface before placing backfill.
4. Monitoring tubes shall be four- (4) inch diameter, installed approximately in the locatio _ns
........ Sl~(~;n'~n-the- de~ign,'~nd extend a 'mi6imur~-~f i2-i~che's-ab0~;e f~l'g-r~de-~ ~'h~- po~tio-n6f -tl~e
monitoring tube extending through the gravel shall be perforated from the bottom of the trench
to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as
noted on the design.
5. Backfill over the final gravel layer must not be less than twenty-four inches. Insulation must be
installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the
trench must be mounded to prevent the formation of a depression after settling.
6. All advanced technology waste water disposal systems (Advantex, Biocycle, Intermittent
Dosing Sand Filter, etc...) shall be constructed, installed, maintained and monitored per
manufacturer's specifications and MOA requirements.
MINIMUM MATERIAL SPECIFICATIONS:
1. A MOA approved septic tank manufacturer must construct any septic tank proposed for
installation.
2. The following pipe materials are MOA approved for use in septic system installations:
Type of Pipe Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company
Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or
equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between
the final leachfield gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing
the ~200 sieve. If deemed necessary, a sieve analysis should be performed.
7. When sand is being used as a filter material, its gradation specification must conform to current
MOA or DEC requirements.
Reference: Mountain Manor Tr D
Date: 06/24/03
Page: 3 of 3
INSPECTIONS:
Typically there will be three (3) inspections required during the installation of the wastewater
disposal system. These inspections will occur as follows: ~
1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds
and before the installation of any gravel. A septic tank may be set in place, but may not be
backfilled before this inspection.
2. The second inspection must be conducted after the placement of the sewer rock, distribution
lines, standpipes, and cleanoUts, but before the placement of the silt barrier, insulation, or any
other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required, especially with the installation of multiple
trenches, sand filters, pressurized distribution systems, etc. The inspecting engineer is to be contacted
at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take
place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's
activities.
The owner shall contract with the contractor to perform the work outlined in these specifications and
attached plans and in accordance with the attached MOA permit. All materials, components, and
construction practices shall comply with the MOA's and the State of Alaska's latest ordinances,
~'~la'tlo~s~'6r-~li~i~ 'r~rdiftg ~ells and ~ept~ ~y~ter~s~'--The fail~"bf tfi~ inSp'e~tin'g eng~eer' ~0' ....
notice a material or construction non-compliance does not relieve the contractor of his/her
responsibility to correct such deficiency. There will be no contractual arrangement existing between
the contractor and KND Engineering, Inc. KND shah be the owner's representative and will inspect the
work as stated above to document the contractor's activities. Final acceptance of the contractor's work
rests with the owner and the MOA.
KND shall have no liability to the owner or to others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the contractor to carry out the work in
accordance with these construction documents. KND's inspecting engineer will not be responsible for
the construction means, methods, and techniques, sequence, procedures or the safety precautions
incident to this project.
BY PROCEEDING FORWARD WITH THE INSTALLATION OF THE WATER AND/OR
WASTEWATER SYSTEM (S), THE PROPERTY OWNER, CONTRACTOR, AND WELL DRILLER
ACKNOWLEDGES HAVING READ AND ACCEPTED THESE SPECIFICATIONS.
Owner: Contractor:
NOTE: PRIOR TO CONSTRUCTION -- THE CONTRACTOR SHALL HAVE THE
EXISTING 100-FOOT WELL RADIUS FLAGGED.
'86/25/2883 16:38 987696811!
KND INVESTMENTS
P~GE 83
86/25/2883 1G:38 9876968111 KND INVESTMENTS
S0'/-688-~54~
Rpr' O'~ n3 O4:43p 3iw Sullivan
P~GE
p.l
PoB1
(g~:rtifiei~ Brillfng ~ng
SULLI¥~iI WATER.WELLS
DR, xW DOHN FT ....
~ OF ~OR.tiATION:
--ltv. I,, .... ltl.-' ....
. ,If|.
gL. tO g'f.
..Fr. ;o.__.... Irt. _
Municipality of Anchorage
Development Services 'Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)= 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE.FAMILY DWELLING
Parcel I.D. 050-682-02
GENERAL INFORMATION
Complete legal description
LocatiOn (site address or directions)
Expiration Date:
Mountain Manor: Tract D
19152 Jamie Dr.;. Eagle River; Al( 99577
Current Property owner(s) Wallace Homes Day phone 696-8207'
Mailing address ~. c'~'~O~ ~ ~'~"b~~ ~~' (~ ~
· 'Lending ag'ency ,~.~, ~. qc~ ~'-~'-'~ 'Day phone
Mailing address
Real Estate Agent
Dayphone
2. NUMBER OF BEDROOMS:
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
4
3. TYPE OF WATER SUPPLY:
Individual Well. []
individual water sto~ge []
.. Community Class Well []
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual On-site [~
Individual Holding tank ~
Community On-site ~
Public Sewer . . ~
.I I
The Municipalit~;'of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional
civil 'engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the
transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal
and/or water supply, system. DSD also issues HAAs upon request to homeowners. Certificates of Health
Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C Well
and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one
year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or
a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Municipality of Anchorage
Development Services DePartment
Building Safety .Division
~' On-Site Water & Wastewater Program ': .~
· 4700 South Bragaw St. . ~
P.O. Box 196650. Anchorage, AK 99519-6650
wWW~ci anchorage ak us
(907) 343-7904 ~i
HEALTH AUTHORITY APPROVAL CHECK :isT
Legal Desdr )tion: MOUNTAIN MANOR, TRACT D
A. 'WELL DATA . ' ' ' ,
Well ,type_p_d_v_.a.~ If A, B, or C provide PwslD #
Date licompleted 5/1 986 Sanitary :seal (Y/N) ¥:
TotalidePth ~._~J~_0__ft. ". '. Cased t6
. i';' !:'i i::' '.. 'FROM WELL LoG~'.'
,~ !~ [i : , ;' . : , , ' " '
Date ". {e~'t ~ 5 / 1 9 8 6
"Stat{C~te'r'leVei .~ ~ 182 '
Wel' ,at~tion .' Z ,5
; '.~ ,
parcel ID: iO50-682-02
" -Weii k~3g (Y/N) Y
Wires proper!~? protected (Y/N) Y
Casing height!(above ground)
AT INSPECTION
' ' 4/7/20Oi~';!':
ft."
g.p.m.
colonies/lO0 mi.
24.
.TRENCH
WATERiSAMPLE REsuLTs: ,:,:: ~ ' ~' ·
'Colif(~'r ~ . colonies/100 mI.Nitrate ~1;41 .mg./I.Other bacteria: 0'
~ "' Collected b'y:'. ~KND Enoineerino
r i 'I~ A mg.ll. Date ofs~:mple: _ _
,;,, I i ', ;, ' ' .... i~ ,~ ,, : r ''
B.SEPTIC/,H,O, LDINGTANK DATA" i' :::::: r ' ; ' r : ;' i ~ [ ' : '
Tanl~l~6/Material 'sEPTIC/STEEl. Date~installed '7/1/03 Ta'nk size 1,500 gal.
Number 9f;Compartments Z ' Cleanouts (Y/N) Y , . ,
Four{~ ~3r{'iCleanout (Y/N) Y Depression'°ver tank (Y/N) N High water alarm (Y/N) N
Dateiof ,pu~,mp~ng. NA -.'new tank.' pumpe'r ....... .~ ~,~..
C. ABSORPTION FIELD DATA" ; ! : :? ;:" ~ [:i;
Date"lin§tailed 7/'1/03 Soil rating:i..ig4~.d./ft~ orft~/bdrm) 0.8 : .'SyStem !';~ type DEEP
·d; ' ,~ · '' ' : , ' ! , t '.
Length i63 -. ·., ff.':Width-..2 . ' ~:,..;; ~' . .... ft. Gravel b$1o~v~ pipe .6
Total: (~l~t~ 8__ ff. Eft.. absm'ption area :7{J~.ft,~. Monitoringtube: Y : Depress,on" ,. i f'.over field" N
': '"' ........... ' ' (Pass/Fail) 'pASsii~!:': 'For 4 bedrooms
Date,ofiadequacy test NA - new System :. Results
'(:J~j3 ~ i'i . New depth'
,Fluic~ t in absorption field before~.te~t .!'.' in.' water added ' "g'~l
Elal~s~ !i;Time: ' .min. Final fluid"~lep'th -' . in. : Absorption irate '>=
lu,venation treatment (past .12 m°.)'!(WN & type) !;' ~lf yes, give date
, ' · ~ ' '"! ' J',l'
ii :i ,. '.:.'! '.'1,
'in.
g.p.d.
1-27-04; 5:5BPM; ;907 561~301 # 2/ 3
SGS Ref.#
Client Name
Project Name/#
Client Sample ID
Matrix
1040430001
KND Engineering
Mountain Manor, Tract D
Mountain Manor, Tract D
Drinking Water
Samplc Remarks:
All Dates/Times are Alaska Standard Time
Printed Date/Time 01/27/2004 15:53
Collected Date/Time 01/22/2004 13:50
Received Date/Time 01/22/2004. 15:57
TechnlcaIRelease~~7/Director tephe Ede
Allowable Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date Init
Waters Department
N[trate-N
1.41 0.100 mg/L EPA 300.0 B (<=10) 01/23/04 JIB
Microbiology Laboratory
Total Coliform
0 col/100mL SMI89222B A (<=1) 01/22/04 DKC
66/25/2003 ~6:38
9076968111
Samplc l~cmarks:
p~atet Rc~'ults PQL Uait~ Me~ho~ 1.h~its Date Date Ini~
Aucni¢ : 0.00200 U 0.00200 mg,'L E~A 200.9 (~-~0.05~ 04/07,~ 04/o1~d03
i.26 0.200 m~/L F. PA 300.0 (<~10) 04/07103
Total Coliform
2:3 OB, No ~oli
coPlOOmL $M15 9_'29_7R (~=I'}
04/07/O3
JAM'IE DRIVE