HomeMy WebLinkAboutGLENN VIEW ESTATES NORTH BLK 1 LT 8Estates North
#051-821-21
Municipality of Anchorage •'
Development Services Department ��
Building Safety Division
- On -Site Water and Wastewater Program, 47DO S. Bragaw SL
P.O. Box 196650 Anchorage, AK 995196650 Page of
www.d.andtorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW050119 PID Number. 051-821-21
N. Spine]] Homes, Inc.
Wastewater System: ❑ New 0 Upgrade
'ear. 1900 W. N. Lts. Blvd., Suite 200 Anch., AK 99517
ABSORPTION FIELD
344-5678 Four(4) Na dseeaam
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s°'" a
Ta. o.w ray a"a.
LEGAL DESCRIPTION
.3 GPowe
+2 n.
Boar LO[ 6a,aawr
(bpNbpp eo0anlmm ap,a Otl•
CIM OWM esbmr Pip•
1 8 Glenn View Est North
0.5 Ft.
.5 Ft.
Tv -w" saraac
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CI LVVM
140
3` Ft.
n.
Well: [3New [I Upgrade
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is
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GPM
FL
FL
SEPARATION DISTANCES
❑septic ❑Holding ❑S.T.E.P. ❑Otter:
To
From
Septic
Tank
Absorption
Field
Lift
Station
HoldingublrJPrwate
Tank
sewer wm
" •a'•'•
Anchorage Tank
r
1,500 Ga
u.wr�
a
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>200'
>200'
>20V
N/A
>200'
Steel
Three (3)
sabr.waa
>100'
>100'
>IOU
N/A
LIFT STATION
to Lw
>5'
>10'
>6
NIA250
cr
�
Anchorage Tank/Orenco
v,ovarb.
-Pamarr.r«
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>10'
>5'
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42 b
44 k
None
Noted
Parp MaY & MOON
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AadaEleard
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Existing Septic Tank Removed and Replaced
BENCH MARK
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with 1,500 Gallon STEP Tank. Ov aeh t
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Development Services Department Approval
c CE .4331 : •r
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Conditional Approval by: Date:
01 Reviewed G
Approved by: 1
and Date:
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Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number. SW05019
98.
5
N / N S
1,500 Gallon
STEP Tank
Page 3 of 3
PID No. 051-821-21
a
102.0 p�p
11
Drainfield Rock
70'
3/16'Orifices O 12' 86.0
5 Holes per Lateral
EAST LEG
Drainfield Rock
70'
WEST LEG
98.5
per
?�..�4y9th��t�
So
PROFILE AS -BUILT �. •y HICKEL F_No.f
NO SCALE ���1.�?^L! a �•��
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTH
(foot)
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: Lot 8. Block 1. Glenn View Estates North
PERFORMED FOR
DATE: 5/10/200 PROJEGTNo.:
PARCEL ID#: TECHNICIAN: T. L. KIMBROUGH
TEST HOLE # A
SILTY ORGANICS/OB
SILTY -SANDY -GRAVELS
GM
�ma
0%
SITE PAN _
SEE SITE PLAN
WAS GROUNDWATER ENCOUNTERED? Ya
IF YES ® WHAT DEFIII? e�
DEFIII OF WATER AFTER MOMTORING. M 0/0
DATE OF MONITORING. yl VMS
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
Dy A ERF
(INCHES)
NET DROP
(INCHES)
5/10
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
14:02
10.25"
CHARGE
2
14:32
30
9.511
.75"
3
14:33
11.251
RECHARGE
4
15:03
30
10.511
0.7511
5
15:04
11.0"
RECHARGE
6
1 15:34
1 30
1 10.25-1
0.7511
PERCOLATION RATE 40 (MINANCII) PERC. HOLE DIA• 6 (INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: Test 1 tole Presoaked Prior to Percolation Test.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THATTHE TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 12/28/206
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTI l
(fml)
1 -
2
3
4
5'
6
7
8
9
10
11
12
13
14
15
16
17
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: Lot 8. Block 1. Glenn View Estates North
PERFORMED FOR:
DATE: 5/10/200 PROJECT No.:
PARCELIDa: TECIINICIAN: T. L. KIMBROUGH
TEST HOLE # B
_® SILTY ORGANICS/OB SLOPE
SILTY—SANDY—GRAVELS
GM
SITE PLAN
SEE SITE PLAN
WAS GROUND WATER EN000NTERED1 Y.
IFYFS®WUATTf
RV
DEOF WATERRAFTER MONITORING. 0 0%
DATE OF MONITORING. snvm
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER
(INCHES)
NET DROP
(INCHES)
5/10
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
16:13
6.38"
CHARGE
2
16:43
30
5.25"
1.13"
3
16:44
7.5"
RECHARGE
4
17:14
30
6.5"
1.0"
5
17:15
7.25"
RECHARGE
6
17:45
30
6.25"
1.0"
PERCOLATION RATE 30 (MINANCH) PERC. HOLE DIA,§--JINCIIES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: Test Hole Presoaked Prior to Percolation Test.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY TFIATTI IE TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON TIIIS
DATE: 121281206
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Renewal
Date Issued: May 13, 2005
Expiration Date: May 13, 2006
Permit Number: SWO50119 Parcel ID: 051-821-21
Legal Description: GLENN VIEW ESTATES NORTH BLOCK 1 LOT 8
Design Engineer: 0014 Anderson Engineering Site Address: 23525 NORTHWOODS CIRCLE
Owner Name: SPINELL HOMES, INC. Lot Size: 42137 SQ. FT.
Owner Address: 23525 NORHTWOODS CIRCLE Total Bedrooms: 4 Permit Bedrooms: 4
CHUGIAK , AK 99567 -
This permit is for the construction of:
0 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 specked 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:
Issued By:
Date:
zv�
\ Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program s r
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. 051.821-21 Permit Number SW 040080
Property owner(s) Soinelt Homes, Inc. Day phone 3445678
Mailing address (1)1900 W. Northem Lights Blvd., Suite 200 Anchorage, AK 99517
Mailing address (2) 23525 Northwoods Circle Chugiak, AK 99567 Zip Code
Legal description (Lot, Block & Sub'd.) Lot 8, Block 1, Glenn View Estates North Subdivision
Legal description (Section, Township & Range)
Lot Size 42,137 SF Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms _Four (4)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling
Jand is in accordance with applicable Municipal Codes.
Si
f�144UL �--�bit'_-4/
(Signature of property owner or authorized agent)
Permit Fees: ' cwA4+ Waiver Fees:
Date of Payment: 'S= 13—DS' Date of Payment:
Receipt Number: (11UIP1 ems— Receipt Number:
(Rev. 12100)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
May 12, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 8, Block 1, Glenn View Estates North Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer.
We hereby request the permit originally issued for Lot 8, Block 1, Glenn View Estates
North Subdivision be renewed for another year. Groundwater has unexpectedly risen
to approximately 4' below the surface on the subject lot and flooded the existing 5' wide
absorption beds. We are therefore proposing to reconstruct the septic system with a
new 500 -gallon lift station and 2 — 67' long by 15' wide absorption beds at the location
shown on the attached site plan. The distribution piping for the beds will be placed at
1.5' above the surface. Coarse sand will be placed to raise the beds a minimum of V of
the existing ground. Sand will also be used to level the area to provide a flat surface for
the bed construction. The existing trenches will be excavated to the distribution line
level. The pipe will be removed and the resultant excavated area backfilled with
coarse sand. The beds will then be constructed near the same location as the
trenches.
The ground surface in the area of the bed construction is fairly flat with only a shallow
slope from north to south. The beds will be constructed parallel to the contours of the
ground surface.
If the system is constructed in accordance with our design the following statements
apply:
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.
Lot 4, Block 1, Glenn View Est. North
'April 20, 2005
Page Two
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,
Michael E. Anderson, P.E.
Attachments
/ 49th
NCNAEE E. ANDERSON
k No. CE -4381 1
LOT 8, BLOCK 1, GLENN VIEW
ESTATES NORTH SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House Raised Bed System
Perc. Rate: 40 Min./Inch Existing 1,250 Gallon Septic Tank
Application Rate: .3 GPD/SF 500 Galton Lift Station
1' (Min.) Coarse Sand
4 Bedrooms X 150 GPD/.3 GPD/SF(Application Rate) = 2,000 SF Absorption Area
2,000 SF/15 SF (Width) = 133.3 LF Bed Length
THEREFORE: Construct 2 - 67' Long x 15' Wide Raised Absorption Beds as Shown Below.
Remove Existing Piping in Existing Absorption Trenches and Replace with Coarse Sand.
Place Distribution Piping at 1.5' Above Original Ground Surface. Provide 2" of Insulation
and 2' of Cover Over Bed or 3' of Cover. Place Topsoil and Seed on Outer 6' of Mound.
2' Insulation & 2' Cover (Min.)
.5' O O
5 Drainfield Rock
1. Clean Sand (See Specification)
Min.
Existing Ground
20
2.5' 5' 5' 2.5'
NOTE: See Specifications for Clean Coarse Sand.
1' PVC
TYPICAL RAISED BED SECTION
(NO SCALE)
NOTE: Grade Area Surrounding Bed to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 200' Separation From Wells in the Area.
Minimum 100' Separation From Surface Water or Streams
Minimum 10' Separation From Water Service Line.
—4
11
Level Existing Ground Area
with Clean Sand.
PRESSURE DISTRIBUTION
CALCULATION
Elevation at Highest Discharge Point
Pressure at Highest Discharge Point
Liquid Level in Tank (Elevation)
Diameter of Holes In Distribution Line
Diameter of Distribution Line
Hole Spacing in Distribution Line
Length of Transport Line
Diameter of Transport Line
Q = 12.4d h = 12.4(.1875)(.1875) 5
= .9748 GPM/Orifice
= .9748 * 32
= 31.2 GPM
TDH = (100-91) + .0192(31.2)(31.2) + .000995(15) (31.2)
(1.5)
9 + 18.7 + 1.2
28.9'
95'
5' Head
91'
1875" (3116")
1.0"
2.4'
15'
1.5"
Therefore 32 Orifices @ 11.6' Spacing With 28.9' of Total Dynamic Head.
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 8, BLOCK 1, GLENN VIEW ESTATES NORTH
SUBDIVISION
GENERAL:
1. The scope of this project includes the procurement and placement of a
new 500 Gallon Lift Station at the location shown on the site plan.
Work also includes the removal of the existing piping from the existing
absorption trenches and the replacement with clean coarse sand to
the existing ground surface. Work will then include the construction of
2 new 67' long by 15' wide absorption beds also shown on the Site
Plan. The distribution pipe for the beds will be placed a minimum of V
above the surface. Sand will be required to level the existing ground
surface to provide a level plain for the new beds. All components of
the new absorption beds, existing septic tank and lift station must be
constructed a minimum of 200' from wells in the area and 100' from
any surface water. Insulation will be required atop the trench to
prevent freezing. In lieu of insulation a minimum of 3' of cover must be
placed atop the trench. A minimum of 4' of cover is required over the
Lift Station.
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. Contractor is also responsible to verify the
separation distance from the well on this and adjacent lots.
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/LIFT STATION INSTALLATION
The 500 -gallon lift station must be constructed by a certified tank
manufacturer. Construction shall include an 18" manhole to provide
access to the lift station.
Lot 8, Block 1, Glenn View Estates North
May 12, 2005
Page 2 of 4
2. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
4. Tanks installed without 4' of cover shall have a minimum of 2" of direct
burial insulation.
5. A foundation cleanout shall be installed one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drain field.
6. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAIN FIELD CONSTRUCTION:
1. The drain field shall be constructed to the dimensions shown on the
design. The bottom of the bed shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a
level bed of drain field 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 drain field
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 drain field 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 trenches to drain away.
8. A minimum 2' of accepting soil is required below the drain field 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 8, Block 1, Glenn View Estates North
May 12, 2005
Page 3 of 4
MATERIAL SPECIFICATIONS:
The lift station must be constructed by a municipally approved septic
tank manufacturer. An Orenco 20 OSI 05 HHF-5 pump is
recommended.
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, Femco, 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.
FILTER SAND SPECIFICATION:
Material for Filter Sand must be classified as a masonry sand and
meet the following gradation:
50% or More Passing the No. 4 Sieve
2% or Less Passing the No. 100 Sieve
1% or Less Passing the No. 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.
Lot 8, Block 1, Glenn View Estates North
May 12, 2005
Page 4 of 4
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.
Municipality of Anchorage Page 1 or 3
Development Services Department
On -Site Water and Wastewater Program '..
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 9951945M
. www.a.onchorage.ek.us (907) 3437904
ON-SITE WASTEWATER DISPOSAL SYSTEM AI IOR WELL INSPECTION REPORT
Permit Number. SWO40080 PID Number. 051-821-21
""°`
S ineil Homes
Wastewater System: New
1900 W. Northern Liahts, Ste. 200 Anch., AK 99517
ABSORPTION FIELD
ph":8 Fpur
5' Wide Trench
LEGAL DESCRIPTION
soawanp:
TaWDapmhamaopin.tpaee:
6
.45 cPorFP
Fl.
Bkxk La 816aMebn:
Depth In pie bnom ham oNinal page:
C*MVW depth beleath pipe:
1 8 Glenn View Estates North
2 Ft.'
4 Ft.
Tewmhip: P"W: Section:
FM.eeee rbere cVnW Waft;
Gr" Length:
1-3 Ft.
134 Ft.
Well: AWWU Water System
widh:
5
Number of tinea:
2
b9t~ Gnes:
>10
Ft.
Ft.
Claesificelion (PnYete. A B. C):
TOW Depth:Geed 0a:
oW absorm: ption e
1,334
al:
ASTM 3034 PVC
R. Ft.
Fe
Dotter:
Date Drilled auric water Leve:
Palsano's Dirtworks
61512004
R
Ybld
puna am a
`esti'° " Omura:
TANK
GPM
Ft.
Ft
SEPARATION DISTANCES
I@ Septic p Holding I] S.T.E.P. ❑ Other.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
ldpitiate
sews, uns
Anchorage Tank '.
.
1,250
wen
>200'
>200'
WA
WA
>25'
Steel
Two (2)
tiuteoew.w
>100'
>100'
WA
WA
LIFT STATION - NONE ON LOT
Lot Lh,.
>5'
>10,
WA
WA
Gm.
Fawth,tem
>6
>10'
WA
WA
in.
unp
h.
we erm at
In.
CurWnOr:n
None
Noted`
mom
tiatawp.ane by.
nemerke -
BENCH MARK
Finished Floor.
1eu.g FL
Engineer's Stamp
•••��..ra�as�s 1
Inspections performed by: T. Kimbrouslh Dates: 14' 615104
-sit-n$
2nd 61510."...,
MICHAEL E ANDERSON Wa
Department of Health and Human Services a roval
P PP
Lac.
• -sNo. CE -4381 8 �=
��-iepeo
Reviewed and approved by: Date: I I /A,4S�Li i
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Municipality of Anchorage Page,3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK: 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit No.: SWO40080 PID No.: 051-821-21
THM = 100.00\
.18 //98.59 re -00 9.05
/ /
i N �
rt
U E
9
Geotextile Fabric
94.4
Dralnfield Rock
S
H
N N
S U
98.30
4,60
to m
E U
1
PROFILE AS -BUILT
Scale: 1" - 20' -
A
MUNICIPALITY OF ANCHORAGE
•'DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG : PERCOLATION TEST
LEGAL DESCRIPTION: LOT S. BLOCK 1. GLENN VIEW ESTATES NORTH
PERFORMED FOR, SPINELL HOMES
DATE: 6/5/2004 PROJECT No -
PARCEL ID& 051-821-21 TECHNICIAN: T. L. KIMBROUGH
DEPTH
(feet)
TEST HOLE # 2
OL/OG
Sandy Silt
Some Silt
ML
GGZoI:
0%
SITE PLAN
t
SEE FUTURE ASBUILT
WAS GROUND WATER ENCOUNTERED? No
IF YES ®WHAT DEPTHS SS
DEPTH OF WATER AFTER MONn'ORAIG: NONE
' DATE OF MONITORPIG: 6/15/04 SEPJ
DATE
READING
GROSS TIME
{MINUTES)
NET TIME
(MINUTES) I
DEPTH OF
WATER
(INCHES)
NET DROP
I (INCHES)
/14/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
13:00
8.63"
CHARGE
2
13:30
30
7.88""
.75-
3
13:30
8.25"
RECHARGE
4
14:00
30
7.5"
.75"
5
14:00
8.38"
RECHARGE
0
14:30
30
7.63"
.75
PERCOLATION RATE�.40 (MIN/INCH) PERC. HOLE DIA 6�� (INCHES)
TEST RUN BETWEEN. 4 FT. and_5 FT.
COMMENTS: Test Hole Pre Soaked Prior to Test.
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORME IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 1 1 7/2004
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
/ L S, '6b
Date Issued: Apr 26, 2004
Expiration Date: Apr 26, 2005
Permit Number: SWO40080 Parcel ID: 051-821-21
Legal Description:�GLENN VIEW ESTATES NORTH BLOCK 1 LOT 8
Design Engineer: 0014 Anderson Engineering Site Address: 23525 NORTHWOODS CIRCLE
Owner Name: SPINELL HOMES, INC. Lot Size: 42137 SQ. FT.
Owner Address: 23525 NORHTWOODS CIRCLE Total Bedrooms: 4 Permit Bedrooms: 4
CHUGIAK , AK 99567 -
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 specked 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.
I6. The following special provisions.
ALT
TEST HOLE AT THE NORHTEAST
T THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL
PORTION OF THE UPGRADE.
ABSORPTION FIELD AND SUBMIT THE RESULTS WITH THE INSPECTION REPORT.
Received By:
Issued By:
IiAr Y, Date: 4 1 t-1
1:);'AJ,0 JJJ
0 Date: 2 r —e
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 LD. _XJ -821 21 Permit Number SW040092
Property owner(s) Spinell Homes, Inc. Day phone 3445678
Mailing address (1)1900 W. Northern Lights Blvd., Suite 200 Anchorage, AK 99517
SITE
*Wing address (2) 2 35,25'NGR'r8W00DS CIR. f CIVI-IAK Zip Code . fM 7
Legal description (Lot, Block & Sub'd.) Lot 8. Block 1. GlennDlew Estates North Subdivision
Legal description (Section, Township & Range)
Lot Size 42,137 SF Acres/Sq.Ft. Number of Bedrooms Four (4)
THIS APPLICATION IS FOR:
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: p Waiver Fees:
Date of Payment: 4 " w — O `i Date of Payment:
Receipt Number:
(Rev. 12/00)
IV W /5'6 0
V07L Z-
Receipt Number:
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
April 18, 2004
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 8, Block 1, Glennview Estates North Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 8, Block 1, Glennview Estates North Subdivision intends to construct
a four-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 40 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 alternate site 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 1,250 -gallon septic tank along
with 2 - 67' 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 4' below the
surface. The distribution pipe will be 1' 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 8, Block 1, Glennvlew Est. North
April 18, 2004
Page Two
The ground surface on the lot slopes at shallow grades from west to east as shown on
the Site Plan. The absorption trenches will be constructed parallel with the slope of the
ground surface as much as possible in conformance with Municipalrequirements. 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 fallowing statements
apply:
I . 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,
Michael E. Anderson, P.E.
Attachments
LOT 8, BLOCK 1, GLENNVIEW
ESTATES NORTH SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House 5' Wide Trench System
Perc. Rate: 40 Min./Inch 1,250 Gallon Septic Tank
Application Rate; .45 GPD/SF 4' Drainfield Rock
4 Bedrooms X 150 GPD/.45 GPD/SF(Application Rate) = 1,333.3 SF Absorption Area
1,334 SF/5 SF' .5 (Red. Factor) = 134 LF Trench Length
THEREFORE: Construct Two 67' long x 5' Wide x 4' Effective Depth Absorption Trenches.
Flow Line Elevation in Trench to be 2' Below Original Ground Surface. Total Depth to be
6' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench. Provide Flow Splitter Valve to Assure Even Flow to Each Trench.
1'6"
6"
4-0-
Natural
Backfill
51
Fabric
4" Perforated
PVC (Holes Down)
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION
(NO SCALE) ,
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 10' Separation From Water Services in the Area.
Minimum 100' Separation From Surface Water or Streams.
Municipality of Anchorage (ENGINEIEg"S L)
Development Services Department
Building Safety Division
+.e On -Site Water and Wastewater Program
4700 South Bra aw SL -
g
P.O. Box 190650 Anchorage, AK 99519.6650
www.cl.anchorage.ak.us
(907)343-7904 °
C�-2325
Soils Log - Percolation Test v °•° y °''
Performed For: G L ENS/ I , �t ��� L•-: Date Performed:
Legal Description: L O'�'ijy 'g K Township, Range, Section:
I- ))1 $ILT, $201,,
2- ( _ _ M L
3- Sat ad.� 9;14
4- ML.
5 6.1-1
A. r
7
IV. ���III ML
11 L+, 6roy
12 —
13-
14-
15-
16-
17-
1 s-
19 -
COMMENTS
WAS GROUND WATER
ENCOUNTEREDI
p
No
Gross Time
S
IF YES, AT WHAT DEPTH?
L
Depth to Water Atter
0
Monitoring?
,�
tv E
Date:
! (7
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
ILL
jZ
So
it
r/i
1
301-4IN
10'116
1 D
�I
-b0
10 3/e
i1�w
3:21
3D
S/
rZ/r
PPRr.nI AnMM RST.
n
- --- r r.'U nULh DIAMETER to.,
TEST RUN BETWEEN �Z. FT AND ?S/i FT
PERFORMED BY: /, S I ) •,g CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: i i— Oz
ON-SITE WASTEWATER DISPOSAL SYSTEM'
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 8, BLOCK 1, GLENNVIEW ESTATES NORTH SUBDIVISION
GENERAL:
The scope of this project includes the procurement and placement of a new
1,250 -gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of 2 new 67' long X 5' wide X 4' effective depth
absorption trenches at the location also shown on the Site Plan. The
distribution line in the trenches will be placed at 2' below the existing ground
surface. Total depth of the trenches will be 6' below the existing ground
surface. A flow splitter valve must be placed to insure !even flow to each
trench. The new septic tank and absorption trenches 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
1. A new 1,250 -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 8, Block 1, Glennview Est. North
April 18, 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 perforationsdown 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 8, Block 1, Glennview Est. North
April 18, 2004
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. 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.
Municipality of Anchorage
-• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage. AK 99519-6650
www.muni.org/onsfe
(907) 343-7904
Parcel I.D.
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
os1-821-21
1. GENERAL INFORMATION
COSA # dq 000'
Expiration Date: I — 3 — 0 8
Complete legal description Lot E. Block 1. Glenn View Estates North subdivision
Location (site address) M525 Northwoods Circle
Current Property owner(s) Laura A. MdCenzie Day phone 952432-M9
Mailing address 23525 Northwoods circle Chuglak. AK 99567
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA 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
IZI
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System '
❑D
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -She Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Onsite Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 resufts:'"(Certificates may be'reissued for a'period of up to -one-year iift 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 engineers work.- - -
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Sfte 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 -she 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.
Name of Firm Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
Phone 522-7773
Date 12/282006
t'r'J/'/
�/ 49th
p�%1U0 � L t um¢nsw
5. DSD SI NATURE �� \ No. cr-net /
Approved for
bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
" COSA Checidist "
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
By:
(Ra.,,ft)
-" X Arsenic Advisory
Maintenance Agreements
Supplemental Engineers Report
Other
Original Certificate Date: /— 3 — 0-7
Municipality of Anchorage
e Development Services Department
Building Safety Division
On -Site Water 6 Wastewater Program • • •'
4700 Bregaw Street
P.O. Box 196650
Anchorage, AK 9951948850
www.rnunLorglonske
(907) 3437904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal DeSC*ian: Lac e. Block 1. Glerrk View EstOn Nary SubdrvWm ParCe1 JD,. 051421-21
A. WELL DATA
Well type —
Date completed —
Total depth R
Date of test
Static water level
Well production
df A, B, or C provide PWSID 0 —
Sanitary seal (YIN)_
Cased to R
FROM WELL LOG
WATER SAMPLE RESULTS:
Coliform cotoniesl100 mL
Arsenic: _ nW
B. SEPTICIHOLDING TANK DATA
R.
9 -p.m -
Nitrate mglL
Weil Lag (YM)
Wires properly protected (YIN)
Casing height (above ground) in.
AT INSPECTION
R
g.p.m.
Other bacteria colonies/100 mL
Data of sample: _ Collected by:
Tank TypelMaterial STEPIS W Date installed 5mMUM
Tank site 1500 gal. Number of Compartments Neaa Cleanout. (YM) Y
Foundation cleanout (YIN) Y Depression over tank (YIN) N High water almm (YM) y
Date of pumping 12M, 005 Pumper SwOwY PkenPara
C. ABSORPTION FIELD DATA
Date installed 5ms-17f w Soil rating (g.p.dJft= or ferocir n) .a GPD/sF System type Reload tled
Length 140 fL Width 15 R. Gravel below pipe .5 R
Total depth :t!A fL EftabsOMdm area &10o ft= Monitoring tube Y Depreaalon over Mid N
Data of adequacy test tar2rroe Results (Pass/Fall) Pau For Y bedrooms
Fluid depth in absorption field before test
0 in. Water added_ gal. New depth in.
Eiapaed Time: mina Final fluid depth in. Absorption rate " g.p.d.
_.Any- rejuvenation treatment (past 12 mo.) (YM 3 type) _ µ– _ _ _ df -yes. give date
D. LIFT STATION
Date installed 5Ms/2aos Shm in gallons 25D Manhole/Access (YIN) _ Y
'Pump on' level at 42 in. •pump air level at 42 in, High water alarm level at 44
in.
Dalian eatEan of Tu* Cycles tested 2
Meets alarm b circuit regtmemenb7 Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankilifi station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole%leanout
Sewer /septic service fine Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5 Property line >S Absorption field >S
Water main WA_ Water service line >tc' Surface water >1W
Wells on adjacent knts >2W
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property kne >iw Building foundation >1D' Water main >1a
Water Service fine 21D'
Curtain drain None Noted
Surface water >1W
Wells on adjacent lots >QW
Dmeway, Parking(vehide storage >25'
F. COMMENTS: SOPUC Mmrn In iso man 2 yem old and in good work ft cminkn. PMPerty k served by AWwu water syd&n.
G. ENGINEER'S CERTIFICATION1.aN`� e4e0
I certify that I have determined F>�+gh Feld inspections and ?.�,P�E �9
review of MrrnrrPal records that the above systems are M1 � ° 49th
cwdbirrnancs with MOA COSA gukWines in aAect on Iters date.
Engineer's Printed Name Michael E. Anderson. P.E. raACLtio a^.�
's
Data 1=9=6 •••e�M._FlRXESS1 i
L
COSH Fee S 3 C Waiver Fee $
Date of Payment 12 �� 9 O �j Date of Payment
Receipt Number O 2 3008 Receipt Number
. (Res. I ift)
NORTHWOC
CIRCLE
2003-42
GLENN VIEW ESTATES NORTH
LOT 8, BLOCK 1
42,137 S.F.
M AO'r Q'nA'C ono en'
. - .. 6 V. Lp I. FIN
AS -BUILT
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.S.
4726 WEST 88TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
GRID DATE
NW1559 1/2/2007
F.B. JOB NO.
04-09 GVEN81
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE
1 "=30'
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. 051.821-21 HAA # Qq bldg
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Lot 8. Block 1. Glenn view Estates North Subdivision
Location (site address or directions) 23525 Northwoods Circle
Current Property owner(s) Soinell 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 otherWse 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 ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
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
Ube (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 maybe reissued for aperiod of up to one year with
valid water samples.) Certificates are. validfor 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) in 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.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 1111812004
f �A 1¢CFMEL E ANDERSOW .
S. DSDSIGNATURE
1�
Approved for `I bedrooms. ��yW��.•
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By; Original Certificate Date: f
(Rsv. 12100)
' Municipality of Anchorage
r • '� Development Services Department
i` Building Safety Division "
On -Site Water & Wastewater Program s "
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 8, Block 1. Glenn View Estates North Subdivision Parcel ID: 051.821.21
A. WELL DATA
Well type If A, B, or C provide PWSID # _� Well Log (Y/N)
Date completed _ Sanitary seal (YM) Wires properly protected (Y/N)
I, Total depth ft. Cased to ft Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
i Date of test
Static water level ft. ft
i Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
v
Coliform colonies/100 mf. Nitrate mg./I. Other bacteria colonies/100 m1.
Date of sample: Collected by:
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Seotidsteel Date installed 6/5/2004
Tank size 1:250 gal. Number of Compartments; Cleanouts (YIN) Y
Foundation cleanout (YM) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping Pumper New Construction
C. ABSORPTION FIELD DATA
Date installed 815/2004 Soil rating (g.p.d./ftz or elbdrmy .45 GPDISF System type 5 Wide Shallow Trench
_- Eength-134 ft. Width -5 % Gravel -below -piped ft
Total depth 7-8 ft Eff, absorption area 1.34 fl? 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
M El M- YANOW
Date installed
"Pump on" level at in.
Datum
Size in gallons
"Pump off" level at _ in.
Cycles tested
Manhole/Access (Y/N) _
High water alarm level at
Meets alarm & circuit requirements?
in.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot NIA
On adjacent lots NIA
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:
Building foundation >5' Property line _2f
Absorption field >5'
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' Building foundation >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
G. ENGINEER'S CERTIFICATION �••��P�^U ' ••.., atij�.
certify that t have determined through field inspections and : 4 °
review of Municipal records that the above systems are in ••••• ••••.. ......•• •••• +•••
conformance with MOA NAA guidelines in effect on this date. 0,,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
� � ; MICHNEL E MlaQtSfJN ; � t
Engineer's Printed Name Michael E. Anderson. P.E. �1`: No, ce-4ae1
.'
Date 1111812004 ••• °j ���0.0
so
HAA Fee $ Waiver Fee $
Date of Payment 0' Date of Payment
Receipt Number k/ n Receipt Number
(Rev. 12/00)
