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Home My WebLink AboutGLENN VIEW ESTATES NORTH BLK 1 LT 5Estates North • #051-821-18 Municipality of Anchorage Development Services Department Pegs of 3 On.SRe Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 995196651) www.d.anchorage.ak.us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO40066 Nrna: PID Number. 051.821-18 S inell Homes Wastewater System: New Addl.u: 1900 W. Northern LI hts Ste. 200 Anch. AK 99517 ABSORPTION FIELD 78 wrlb.r"esaaame; Four 4 5' Wide Trench LEGAL DESCRIPTION a°" PAng 45 WD/FP TON r om ananN we* taatic La: acwuia,,: 5.5 pips: Ft. 1 5 U b pps aoln bmn arp"w Pett: Ornbl dh b epaneelh Glennview Estates North 1.5 Tawulyp: Section: IN aww Nwve OWW Peds: Ft. Ft 1.3 cr"vN t..r,ah. 4 Well; R• 136 Ft. AWWUWater3ystem �"°""'"°"` of UM: e1e 5 b avaen WWI. cw.a� bn 1, A e. cr. 10 Ft. TON OaPRr Ceeed b: dal lraa. FL 2 > Dnllar: "• FE 1,360 Rte ASTM 8034 PVC oN. Dri"ed: staft weber l ; r,.b,ny Ft Palsano's Dirtworks 5/20.21/2004 PusN It: C=wQ Nwva OrouN: wM p' ct. TANK SEPARATION DISTANCES ® septic ❑ Holds ng To Soptic Absorption Lin Holding dklPmate ❑ S.T.E.P. ❑Other. From Tank FkH Station Tank sewer Line Anchorage Tank V%" >200' >200, WA NIA >25" 1,250 Steel TWO (2) La Uw >55` web. >100, >100' WA NIA LIFT STATION - NONE ON LOT LNL » >10, WA NIA nN. Fauxle, n >T >10, WA WA ""pan uap in. can«, D,*n None Noted Pwo . b. r . _ . " In. BENCH MARK Floor. Inspections performed by: . Kimbrou h Dates: 1"_ 5/20/04 Department of Health and Human Services approvai5i21/04 Reviewed and approved by: pkw IQ") Date:.l k-, /D- c� � 100.0 Ft Engineer's stamp �£ 4$th MICHAEL E. ANDERSON NO. CE -4381 j Municipality of Anchorage - 4700 South Bragaw Street Anchorage, AKP99519-66 5 - 343-7904 On -Site Wastewater Disposal System or Well inspection Report Permit Number. SWO40066 NORTHWOODS CIRCLE 0 M 15' T. # E. 0 49th !V MICHAEL E. ANDERSON No. CE -4381 I�LAN AS -BUILT SCALE 1" = 50' Page 2 of 3 PID No. 051-821-18 J ESTATES NORTH i, BLOCK 1 45,684 S.F. Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT Page 3 of 3 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SWO40066 PID No. 051-821-18 n . /—'96.53 95.90 / F U Geotextile Fabric Dralnfleld Rock 2.70 80.1 PROFILE AS -BUILT Scale: 1' = 20' E� I- 2 3 4 5 6 7 8 9 10 11 12 14 15 16- 17- 18- 19- MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES, DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION• L 5 B i GLENN VIEW ESTATES NORTH S/D w G PERFORMED FOR:_�PINEI I HOM C In1r DATE: 5/20/2004 PROJECT No - PARCEL IDS TECHNICIAN: T.L. KIMBROUGH p 7—� TEST HOLE # 2 Type of Test: ® Percolation l/ / /l OG/PT 2% SILT WITH GRAVEL ML DENSE DRY m WAS GROUND WATER ENCOUNTERED NO k YES ® WHAT DEFTH DEPTH OF WATER AFTER MONITORING ONE 2% DATE OF MOWTORtNG -5/30/04 F ------ MEL E M10ERSM NO. CE -4381 J PERCOLATION RATE; 48 NIN4INCIO FERC. HOLE DIA• 6 rIlJCHES) TEST RUN BETWEEN• 4 5 FT. and_5,tFT• COMMENTS: NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 10/21/04 Permit Number: SWO40066 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragew Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Legal Description: VfW_&jU="-j Orth BlockltL;k§, Design Engineer: 0014 Anderson Engineering Owner Name: Spinell Homes, Inc Owner Address: 1900 W. Northern Lights Blvd., Ste 200 Anchorage , A 99517 - C -z 0-0[(- s /ZI J oc,— l 0-0_� /6:0,0 Date Issued: Apr 20, 2004 Expiration Date: Apr 20, 2005 Parcel ID: 051-821-18 Site Address: 23500 Northwoods Circle Lot Size: 45684 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑✓ 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 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. 5. The following special provisions. S�S�oy- DtsryN chwn.SE i S." sake "9'V/4'tr'u Mt010 '*Vo New sine G/A4/ DATCP / VVI VY. Received By: Date: 4-ZV - 0 Issued By: r1'I ►" Date: 10 0 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/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 6!43 051 -82 -1 -IS Permit Number SW Property owner(s) Soinell Homes, Inc. Day phone 344.5678 Mailing address (1)1900 W. Northern Lights Blvd., Suite 200 Anchorage AK 99517 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 5. Block 1. Glennview Estates North Subdivision Legal description (Section, Township & Range) Lot Size 45.684 SF Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Three (3) Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Waiver Fees: Date of Payment: Receipt Number.(tLOReceipt Number. (Rev. 12!00) ANDERSON ENGINEERING, P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX MEMO DATE: 5/4/2004 TO: Joe Goodall WITH: MoA/On-Site Water and Wastewater FROM: Mike Anderson SUBJECT: Lot 5, Block 1, Glennview Estates North Subdivision Septic System Permit Number SW040066 The homeowner has upgraded the house proposed for this lot to 4 bedrooms. We have revised the site plan and design for the septic system accordingly. Additional test holes will be placed prior to construction to verify the subsurface soil conditions on the lot. Please modify the permit to allow for a 4 bedroom septic system on this lot. Please let me know if you have additional questions 100' N 15' T. k E. ESMT-- 9th �................... REL E. RMDERSi No. EE -4381 NORTHWOODS CIRCLE 0 M 99.58.04-E R, 27.04' Lai.2 J8 . ____�` �4•�52' 99' F- + 5/8' REBAR (TYP PER PLAT) r I WAGE 96. Throe Bedroom Home xT 0a % ad To TM RzaRe'• so i I 45,684 S.F. SITE PLAN -444wrLFMl ulls'aw*W- — SCALE 1' = 50' LOT 5, BLOCK 1, GLENNVIEW ESTATES NORTH 80' ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) April 16, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 5, Block 1, Glennview Estates North Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 5, Block 1, Glennview Estates North Subdivision intends to construct a three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home. The subdivision is served by a community water system and no conflicts exist with adjacent septic systems or wells. The attached Site Plan and backup documentation identify the location and configuration of the proposed septic system and alternate site. Existing spot elevations and the Current drainage pattern are identified on the Site Plan. The drainage pattern will be maintained after development of this lot is complete. A test hole placed on the lot during the subdivision phase indicated silt with some gravel in the area of the absorption trenches. The accepting soils were tested and found to have percolation rates of 44 minutes per inch. No groundwater was found during excavation and none was noted during the monitoring period. The test hole is more than 30' from the new trenches and we are proposing to provide acceptable test hole data prior to the construction of the new system. Acceptable soils logs and percolation test data will be provided along the inspection report and certified as -built for the new system. Our design includes the placement of a new 1,000 -gallon septic tank along with 2 - 50' long by 5' wide by 4' effective depth absorption trenches to collect and treat the sewage generated in the house. The bottom of the trench will be 5.5' below the surface. The distribution pipe will be 1.5' below the surface. A flow splitter valve will be placed to assure even flow of effluent to each trench. A minimum of 3' of cover will be placed atop the trenches and a minimum of 4' of cover will be placed atop the new septic tank. Lot 5, Block 1, Glennview Est North April 16, 2004 Page Two The ground surface on the lot slopes at grades sometimes greater than 25% from east to west as shown on the Site Plan. The absorption trench will be constructed parallel with the slope of the ground surface as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from the well proposed for the lot and on adjacent lots. It will also be constructed a minimum of 100' from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells . in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, 74'1� Ea4' Michael E. Anderson, P.E. Attachments MICHAEL E. ANDERSON No. CE -4381 _+ NORTHWOODS CIRCLE 0 M 100' N W58b4'E R, 27.04' l�lB 15' T. R E. _ 4ftso 00' =—J —_�QV N.52' 5/8' REM (TYP PER PLAT) o � I s .I Thee Bedroom } Nome to 91 Cot ® Ne=ptlen Tnn'Lr p� 711 U ` W N O I e' J 45,684 S.F. PSE•'""' • N� � ss.ao• a to '' 1 .�SITE PLAN lksn trr SCALE V = 50' LOT 51 BLOCK L GLENNVIEW ESTATES NORTH LOT 5, BLOCK 1, GLENNVIEW ESTATES NORTH SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom House 5' Wide Trench System Pero. Rate: 44 Min.Anch 1,000 Gallon Septic Tank Application Rate: .45 GPD/SF 4' Drainfiekl Rock 3 Bedrooms X 150 GPD/.45 GPD/SF (application Rate) = 1,000 SF Absorption Area 1,000 SF/5 SF • .5 (Red. Factor) = 100 LF Trench Length THEREFORE: Construct Two 50' Long x 5' Wide x 4' Effective Depth Absorption Trenches. Flow Line Elevation in Trench to be 1.5' Below Original Ground Surface. Total Depth to be 5.5' Below Eodsbng Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Provide Flow Splitter Valve to Assure Even Flow to Each Trench. 1'0" 0 4'0" YPICAL Natural Backfill Geotextile Fabric 4" Perforated PVC (Holes Down) Drainfield Rock DE TRENCH SECTION .err..•--••.�,�t NOTE: Grade Area Over Trench to Drain Away. Minimum 0' Separation From Bedrock. 4 Minimum 4' Separation From Groundwater... Minimum 10' Separation From Water Services in the Area- i`'`;{�• Minimum 100' Separation From Surface Water or Streams:No. CE.,,, Depth 7 DIL&ANi a -PT- Lr, PTLT, ML 9- 1 '5- 14- SILT ML WAS GROUND WATER Municipality of Anchorage 6(ENS( Development Services Department Ni ER's; l' Building Safety Division 11 _ Depth to Water After o 0 On -Site Water and Wastewater Program 9r� P E 12 Date: 12.4 01- L 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 o�,,.,.,, www-ct.anchoraceaku$ Tcb 1-�u�ztond (907) 343.7904 - 4 ii�•.r� Cc -'1125 Soils Log -Percolation Tests;�,`p �c ay oval ,\ Performed For: %'LEJJVIEt>' Nr�RTF-ir) Date Performed: f f 6 0 Legal Description: _L07 - Township, Range, Section: Depth 7 DIL&ANi a -PT- Lr, PTLT, ML 9- 1 '5- 14- SILT ML WAS GROUND WATER Drop ENCOUNTERED? ND 10 -Vat, �l IF YES, AT WHAT DEPTH? s L 11 _ Depth to Water After o - Monitoring? 9r� P E 12 Date: 12.4 01- L 1'5- 14- Reading Dale 1s- FILL 71 16- b'7/e, 17- _ 3L- 19 - PERCOLATION RATE COMMENTS TEST RUN BETWEEN (minuleYiMn)PERC HOLE DIAMETER FT ANDJS '/2- FT PERFORMED BY: � � s ( ^S PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DACERTTE. FY THDATE: AT !S TE_122.9'/02- WAS Drop b oNetTimeDe4WaterNei IOx'11 (minuleYiMn)PERC HOLE DIAMETER FT ANDJS '/2- FT PERFORMED BY: � � s ( ^S PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DACERTTE. FY THDATE: AT !S TE_122.9'/02- WAS ONSITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT S, BLOCK 1, GLENNVIEW ESTATES NORTH SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,000 -gallon septic tank at the location shown on the Site Plan. Work also includes the construction of 2 new 50' long X 5' wide X 4' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 1.5' below the existing ground surface. Total depth of the trenches will be 5.5' below the existing ground surface. A flow diverter valve must be placed to insure even flow to each trench. The new septic tank and absorption trench must be placed a minimum of 10' from the water service on this and adjacent lots. In addition, a separation distance of 100' must be maintained between the septic tank and absorption trench and any surface water. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,000 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 5, Block 1, Glennview Est North April 16, 2004 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. • "' Lot 5, Block 1, Glennview Est. North April 16, 2004 Page 3 of 3 MATERIAL SPECIFICATIONS: Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer.' 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. MUnicipaIity of Anchorage It j16) •, '-f Development Services Department Building Safety Division ° On -Site Water and Wastewater Program ` 4700 South Bragaw St. ' • FTT 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. C51.821•18 HAA # 1. GENERAL INFORMATION Expiration Date: u=/ a jg' Complete legal description Lot 5 Block 1i Giennview Estates North Subdivision Location (site address or directions) 23500 Northwoods Circle1�5Lo� Current Property owner(s) _Spineil Homes. Inc Day phone 344-5678 Mailing address 1900 Northern Lights Blvd. Anchorage AK 99517 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2.- NUMBER OF BEDROOMS: Four 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: individual Well ❑ ' individual On-site Individual Water Storage 0Individual Holding tank Community Class Well 171. Community On-site El Public Water System ® Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 less than 30 days old, (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. 4. 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 Health Authority 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) iri compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522.7773 Address P 0 Box 240773 Anchorage AK 99524 Engineer's Printed Name Michael E. Anderson P.E. Date 111312004 _ .$+r �n, 5. DSD SIGNATURE V Approved for 4_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments ,1006.. ? , AN.SffE Ea WATER .� '.•° ereeTLSS1A7 v�Tc PROGRA J i �. �. - JI�J/J111111F11 Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: ��j:C/� Original Certificate Date: (Rev. 11/00) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water& Wastewater Program i 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.c7i.anchorage.ak.us (907) 343-79D4 HEALTH AUTHORITY APPROVAL CHECKLIST I Legal Description: Lot 5 Block 1 Glennview Estates North Subdivision Parcel ID: 051.82118 A. WELL DATA Well type If A, B. or C provide PWSID # _ Well Log (Y/N) ? Date completed _ Sanitary seal (Y/N) _ W resro erl P P y Protected (Y/N) Total depth ft, i, Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test t Static water level ft. Well production ft. g.p.m. 9_P.m. f WATER SAMPLE RESULTS: s Coliform colonies/too mi. Nitrate mg./I, Other bacteria colonies/100 mi. Date of sample: Collected by: U. SEPTIc/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 512012004 Tank size 1.250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 5/2112004 Soil rating (g,p.d./ft2 or ft%drm) .45 GPD/SF System Y type 5' Wide Shallow Trench ' Length 136 ft. Width 5 ft. Gravel below pipe 4 ft, Total depth 7 ft. Eff. absorption area 1y360 ft' Monitoring.tube Y Depression over field N Date of adequacy test Results (Pass/Fail)' For ` bedrooms Fluid depth in absorption field before test _,_, in. Water added_ gal. New depth_ in, Elapsed Time: _ min.. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date th Date installed ,,Pump on" level at_ in. Size in gallons ,,Pump off' level at_ in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? Septic tank/lift station on lot NIA On adjacent lots AYA Absorption field on lot NIA On adjacent lots NIA Public sewer main NIA Public sewer manhole/cleanout NIA Sewer /septic service line NIA Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Property line >5 Absorption field >5' Building foundation >5' P y Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots >200' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Buildingfoundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >5' Curtain drain None Noted Wells on adjacent lots >200' F. COMMENTS Property is Served by AWWU Water System,OF y��♦.r------- G. 'ENGINEER'S CERTIFICATION 1 certify that l have determined through field inspections and 4` •` 49th `'• „i review of Municipal records that the above systems are inr, ..:�.. : r conformance with MOA HAA guidelines in effect on this date. r� c'R .etcr+�a. rr �;�RsoN ♦I No, cc3e Engineer's Printed Name Michael E. Anderson P.E. �j s ��, -4 1 �1� pR�FESS1ai+�+• Date 111312004 RTA��+++ HAA Fee $ S7 �° Waiver Fee $ Date of Payment //, V a Date of Payment Receipt Number G0.7 Ts- Receipt Number (Rev: 12100) i i 0 2003-94 GLENN VIEW ESTATES NORTH _ LOT 51 BLOCK 45,684 S.F. NORTHWO�_CIRCLE_ 0 N 89'58'04"E R-50 27.04 L=32. js. Rc50.00' 15' T. & E. ESM . _ 4--44.52' r 0 2 � m 29.7 29.3' EXISTING 3A 2 . SUIUDING N .�. • �(p,• LA I SEPTIC SYSTEM at .• > - m � u fn rn LA co -A tr > , > -40 S 84'11'55"E " 158.00' FINAL STRUCTURE AS -BUILT .p♦jj� AS — BUILT PROPERTY DEPICTEDHABOVE AND THAT AT I HAVE YN THE y OF q� �� GASTALDI LAND SURVEYi ENCROACHMENTS EXIST EXCEPT AS INDICWNE ED. i►��s••••••.,•• I R.L. IT IS THE RESPONSIBILITY OF THE OWNER EASE ENTS c""49L yV 54 '641 JEFF A. GASTALD , ETERMINE THE EXISTENCE OF 4726 WEST 88TH AVEN C,(�,[�VENANTS OR RESTRICTIONS WHICH DO OT r�` :•••+ �•.:..a ANCHORAGE, ALASKA 99 VC • oury A. Gostaldl Mir PHONE 248-5454 APPEAR ON THE RECORDED SUBDIVISION LAT•Ar UNDER NO CIRCUMSTANCES SHOULD ANY DATAP� .�,••c• �s-soar i'' DATE HEREON BE.USED FOR CONSTRUCTION 0 FOR Ar ••. e° GR)D ESTABLISHING BOUNDARY OR FENCE LINEap°ofessiono\�o�0�`♦ NW1559 8/10/2004 ANCHORAGE RECORDING DISTRICT, ALAS A �a�!>d®�'♦ F.B. JoB No. ' NOTE: NO CORNERS SET THIS DATE. 04-08 GVEN51