HomeMy WebLinkAboutNORTH WOODS PHASE 2 BLK 1 LT 10Northwoods #2 Block 1 Lot 10 #051-801-03 Municipality of Anchorage Page I of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number:- Sk/pyo 3'S� PID Number: —OS/- 8'ei—c)t Name: U.c 0.911 Wastewater System: ❑ New Xupgrade Address' ABSORPTION FIELD Phone: No. of Bedrooms: 81,- S/•r/ z ❑ Deep Trench ❑ Shallow Trench VBed ❑ Mound O Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: Lot Block: Subdivision: • GPD/SqFt Depth 10 pipe bottom from original grade. Gravel depth beneath pipe Township/SN Range / /✓ Section: /. ;? FI. Fill added above original grade: C91 r Ft Gravel length: Ft. GO FI. WELL: ❑ New ❑ Upgrade Gravel width: Numberorlines: Distanalbetweenlim: Classification (Private. A.B.C): Total Depth: Cased To: PHQL+1-G /'T Fl. Total absorption area: ��.r Ft. Pipe material: Fl. — Ft. Driller:Date Drilled: Static water Level: O/2 SO. FI. Installer: P G 1 ar Date Installed: ...r Ft. i //Odc N .�✓•✓ q 1 O Z. Yield: Pumpset at; Casing Heigh Above Ground. -- GPM — Ff. — FI. TANK SEPARATION DISTANCES ❑Septic ❑Holding XS.T.E.P. To From septic Tana Abavptan Lill Holdingubhc/Pa,ala Manufacturer. CapaGily In gallons: Field Station Tank Sower Linn L WBII 4-100, '1.100r i"lona *100 y Malarial: Number of Compartments: D/F6G 3 Surface ' fivo y/ao' -r.eal 4-100, LIFT STATION Lot Line /� /D /$ tip Size In gallons: / 2- SO Manufacturer: ✓r Foundation 3 . / 7 a • O "Pump on" level at: a "Pump till" level at: High wafer alarm at: r T y yo r. CDrainnal +So y +501 4 -Sol +SD r Pump Make 6 Model Electrical Inspections Performed by: Remarks: kat)o -AT-,,j bR4rV5 BENCH MARK Location and Description: C R 1✓ Assumed Elevation: leiEN L &V Gff2i t /„ Ivob Inspections performed by: Dates: 1s 9 a2 oN 2nd 9 10 Pi MSTOPHEaa.Wool) /— �y Department of Health and Human Services approval CH Reviewed and approved by: 1 Date: -cP�� ... ���;;a;pi... 72-013 IF" 9/911 MOA as Permit No. SW040337 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: NORTH WOODS PHASE 2 LOT 10 BLOCK i PID No.: 051-801—n3 LOT 10 a1" � yh ®TH2 LOT 9 SWINGTIES \ A I D WATER NEYSOX C I 19.1' 29.9' PROPOSED LEACH FIELD D 129.5'154.1 * EXISTING LEACH FIELD wv DQ - WATER NEYSOX -------- - PROPOSED LEACH FIELD EXISTING LEACH FIELD ®- DRIVEWAY • - MONITOR TUDC c - SEWER CLEAN OUT f - WELL - EASEMENT A - DNERTER VALVE 0 - TEST HOLE LOT 12 y pF• SCALE: 1"=50' LOT 11 0� •�, .: ' mss. 15' T k E EASEMENT ,.�;:�.. 10•'0 G� 9� e��G 11 / 5/04 ELEVATIONS a NAIL IN TREE ENGINEER'S SEAL 00000pp (NOT TO SCALE> ASSUMED ELEV - 100.00 0 pF q��00�� /LIrT STATIM ORIGINAL GROUND p� ,..... •.• .. •.•-I f LEVE4 97b' O'`P' '•,'.F / NT 99.3' NT TESTA OC7. �O 2' INSULATI*90.6' 6' HSE 3 *.'... v0 CHRISTOPHER• WOOD O 6.4' 6.4' GVT 69.9• QQ cam•.. CE -10387 v 955' 93.9' 93.9• Q f Opo q•�..�. �`�� x`67.6'INN EDS ELECTRIC INC September 20, 2004 907 272 4590 09/20/04 11o44a P. 002 ED'S ELECTRIC INC. P.O. BOX 210767 ANCHORAGE, AK 99521 Midnight Sun Excavating Eagle River, AK To Whom It May Concern: ANCHORAGE: (907)272-4591 Fax: (907) 272-4590 Subject: Septic lift station 22416 Whispering Birch Dr. Lot # 10 Block # 1 Northwood #2 Ed's Electric Inc. installed electrical on subject project to the requirements of the 2004 National Electrical Code and the Municipality of Anchorage. Thank you, MUNICIPALITY OFANCHORAGE 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 Upgrade Date Issued: Aug 12, 2004 Expiration Date: Aug 12, 2005 Permit Number. SW040337 Parcel ID: 051.801-03 Legal Description: 'NORTH WOODS PHASE 2 BLK 1 LT 10 Design Engineer: 0848 Eagle River Engineering Services Site Address: 022416 WHISPERING BIRCH DR Owner Name: WARREN & KIM ULRICH Lot Size: 60582 SO. FT. Owner Address: 22416 WHISPERING BIRCH DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567 - This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 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 Issued Date:/�� ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OSI 4?0 I D 3 Permit Number SW Property owner(s) Day phone 6 Qi lcb " S/ 41 y Mailing address (1) (30 807' 472!/ ` -41%4!12" l �� Pairing address (2) •� � _ _ _ -, 11577 Legal description (Lot, Block & Sub'd.) AAoRTt4Wcrah5 P14'+S6 1L /-to ,3 1 Legal description (Section, Township && RRaannge) I 15:A) r2) t..1 SSG y Lot Size _`5ZV— Acre�S�ft� J Number of Bedrooms 3 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 Fam}ly Dwelling.andjs,in accoydance wVapplicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment: 6I9IOt/ Date of Payment: Receipt Number: �L9 Receipt Number: (Rev. 12/00) m Municipality of Anchorage 1 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. OSI 4?0 I D 3 Permit Number SW Property owner(s) Day phone 6 Qi lcb " S/ 41 y Mailing address (1) (30 807' 472!/ ` -41%4!12" l �� Pairing address (2) •� � _ _ _ -, 11577 Legal description (Lot, Block & Sub'd.) AAoRTt4Wcrah5 P14'+S6 1L /-to ,3 1 Legal description (Section, Township && RRaannge) I 15:A) r2) t..1 SSG y Lot Size _`5ZV— Acre�S�ft� J Number of Bedrooms 3 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 Fam}ly Dwelling.andjs,in accoydance wVapplicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment: 6I9IOt/ Date of Payment: Receipt Number: �L9 Receipt Number: (Rev. 12/00) m Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD. Suite 201 Eagle River, AK 99577 August 6, 2004 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Northwoods #2, B1 L10 Narrative & Permit Application Dear Mr. Roth: (907)694-5195 tel (907) 694-3297 fax Eagle River Engineering Services (ERES) was contracted to evaluate a failing system at the above referenced property, and found the septic system in a state of failure, and in need of upgrade. The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are all connected to city water, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance, and no private wells within 200'. 3. This permit is for replacement of the septic tank and leachfield system. 4. Drainage will not be affected and is not a major consideration in our design. The existing leachfield will be abandoned in place. Two test holes in the back yard indicated soils that were very marginal for the installation of an on-site septic system. A third test hole in the front yard yielded soils that were free -draining, but due to water table will require a lift station. This work will not affect the reserve septic areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerely, c>z� tstopher R. Wood'P. E. Principal V003\04-0IISEvncNARRAnvE 8/ e LOT 10 LOT 9 LOT 13 yk ®7142 INSTALL NEW 1250 W S.T.E.P. TANK LOT 12 SCALE: 1 "=50' 4� y 4$1x LOT 11 0�' .., :.•.. .mss. �UTIES Y. IN NgNITY wv p pQ - WATER KEYBOXyy�' * CREEK 'q :--- - PROPOSED LEACH FIELD +Fy HOUSE J TH3 EXISTING LEACH FIELD 90 ® - DRNEWAY / S�• ' • - MONITOR TUBE 0 - SEWER CLEAN OUT + - WELL 15' T t E EASEMENT - EASEMENT 1. NO KNOWN CURTAIN DRAINS TEST ® - TH B - EST HOLE R VALVE 2. NO SURFACE H2O +200' WELL/SEPTIC SITE PLAN LEGAL: LOT 10, BLOCK 1, NORTHWOODS PHASE II OWNER:WARREN ULRICH CONTRACTOR: MIDNIGHT SUN EXCAVATION JOB# 04-056 1 DATE: 8/6/04 SCALE: 1" = 50' EAGLE RIVER ENGINEERING SERVICES 10421 VFW RD. SUITE 201 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3291 P!5iP OF • T•1r• .:fly�ii��� : . 4 CE -10387 z 0 H� W V) ry U 9 W a CL W O Q J W Q K W N a r U CL W a a 3 0 W CQ z vi C3 k>r Z A LLJ a W i:.•� �wA i N yWj � ✓ Yaj f11 W a a 3 0 W CQ Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD Suite 201 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM—MOA CERTIFIED INSTALLER LEGAL: Northwoods Phase 2 BI LIO August 6, 2004 A. GENERAL 1. The replacement septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. A licensed surveyor should locate the utility easement and exact 100' radius from the existing and neighboring on-site wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK WITH LIFT STATION 1. The septic tank shall be an Anchorage Tank 1,250 gallon septic tank with integral OSI lift station pump model OSI -05-20-111117. 2. A receipt from a licensed electrician shall be provided to the engineer verifying lift station wiring to all applicable codes. C. BED 1. The bed is to follow the natural land contour to maintain uniform total depth of the bed bottom. 2. The bottom of the bed shall be level, plus or minus 1.5". 3. The depth below grade of the gravel layer is not to exceed 1.7' as measured at the monitor tube. 4. Coarse Sand shall be utilized where necessary to build up the bed to grade if deep topsoil is encountered and excavated. 5. The effluent lines (3) are to be 1" PVC lines with 1/8" holes drilled 36" OC within the leachfield, placed face down, or up with orifice shields placed over holes. Line from tank to field is to be 1-1/4" HDPE. 6. The bed gravel is to be covered with typar fabric material. 7. Soil or combination of soil and extruded board insulation to a depth of Y or equivalent is to be placed over the bed. Mounded side slopes not to exceed 3:1. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: BOTTOM OF GRAVEL LAYER= 1.7' Below Grade at monitor tube GRAVEL THICKNESS = 6" under pipe, 2" over pipe BED LENGTH = 60' BED WIDTH = 15' SOIL RATING = 0.5 GPD/ft5 BEDROOM CAPACITY = 3 SEPTIC TANK = 1,250 Gal S.T.E.P EFFLUENT PIPE =1" PVC with 1/8" holes oriented down, or up with orifice shields spaced at 36" OC. Twenty-four (24) hours notice required for all Inspections. \2003%04-056Bed-lift-spec EAGLE RIVER ENGINEERING SERVICES 10421 VFW RD Suite 201 Eagle River, Alaska 99577 (907) 6945195 ERES Project No.: 04-056 Calculated By: CW Date: 08/062004 Legal: Northwoods Phase 2 BLK 1 LT 10 TEST HOLE 3 Single Family 3 Bedroom Dwelling Bed Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 9 minutes per Inch Wastewater application rate = 0.5 gallons per day per square foot Required absorption area = 900 square feet Bed width (W) = 15 feet Gravel depth (D) = 0.5 feet Required length = Required absorption area / Bed width Required length = 900 / 15 Required length = 60 feet Total Excavation Depth = 1.7 feet -Al CNWYOPHM P- WOOD + `fk h o� Q`ESS10114 Gc� 04-056 drainfieldCalc.xls 12:17 PM08/062004 13 N N r b 0 1eo1'iHaD PBeH oiweuAa ieio1 ry N t� E I � _T- i N-1 13 N N r b 0 1eo1'iHaD PBeH oiweuAa ieio1 ry N Municipality of Anchorage Development Services Department Building Safety Division a„r On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www,cl anchorage.sk.us " (907) 343-7904 / Soils Log - Percolation Test Pa rrned For. _ 114Ae•r4C/ G1 L/r,✓ Date Fenonnea: 7' //GL y Legal Description: _ A? y- 7,,Yl✓ro J7Tr.2 � / 13 ,,9 Township, Range, Section: T/J''.y .P/al ,3tC Sl Depth (Feet) G // /S�/ 'OrrY u r3Cr70r'r Ox v Are �'rnrmec 1 18- 19- WAS GROUND WATER ENCOUNTERED7 g IF YES, AT WHAT DEPTH? L Depth to Water Agar 0 Monitoring? .^,f, E Dater Reading Data ML 01A.ie a did l Net Tune ' 2 RQc J,.YOY RlA�i[ 3- 3100 30 pDepthtoWater A. Cec y sf1M1�c� c. vr, 5- 6 i' .. 7 •. G // /S�/ 'OrrY u r3Cr70r'r Ox v Are �'rnrmec 1 18- 19- WAS GROUND WATER ENCOUNTERED7 g IF YES, AT WHAT DEPTH? L Depth to Water Agar 0 Monitoring? .^,f, E Dater Reading Data Gross Time Net Tune NetDrop 3100 30 pDepthtoWater A. PERCOLATION RATE 6!.5 rmiutev i1 PERC HOLE DIAMETER ++ tt ee TEST RUN 9E WEEN ��FT AND 4 FT COMMENTS �/rL(C PERFORMED BY: ���y p � l /,/.ty/j CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: slew t( Municipality of Anchorage Development Services Department Building Safety Division • ye On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995198650 www.d.anchoraae.ak.us (907) 343-7904 Soils Log - Percolation Test Performed For. ! Z .n?F,t7 r le Al Date Legal Description: Alr"Vlll •nna B / 4/0 Township, Range, Set TN -Z Depth e PAF' 1�t ML ..i. 1 1 16- 17 - JI Fy jrLT /�.evy ien)r Aorr { $O'r7CM OF {,r�Jni ,d Ar we ij, o 0 .uo 8rneer4f WAS GROUND WATER ENCOUNTERED? e IF YES. AT WHAT DEPTH7 L Depth to Water After o P Uonftwing? e Date: Reading Date Gross Time Net Time Depth to Water Net Drop / Ole 11 .t r./ — y'06 %. 1 lee PERCOtAT10NRATE on -.3 (mimA"4K,) PERC HOLE DIAMETER 60 �• TEST RUN BETWEEN � l FT AND -f— COMMENTS_,A._4!C,(C y,41Qb PERFORMED BY: �s./� /�•....-�i.�'rr! y,� I __e1;;eAtjs CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage Development Services Department Building Safety Division • Ye Onsite Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995195650 www. el. anchorage. ek.us (907) 343.7904 Soils Log - Percolation Test Performed For. �GC�A�rrlt/ l�•vrr1 Date Legal Description: �/PN1Nn N/�D z.,o Township, Range, Section: rjJ.d -r t4 - 5 Depth 7 1 RUT71-- "I o? ICK( ff..r 0-/-( eFFY .SQL? JAtlf, F.PA Jft ,Vo 9Eoracr WAS GROUND WATER ENCOUNTERED? I. 8 IFYES, AT%MtAT DEPTH? /� • L Depth to WaterAhar Moneorlrq? % c E Date: Reading Date Gross Time Net Tune Depth to WaterNet Drop � moi.,LIC rcnuuu &"nmm c e . Co PERC HOLE DIAMETER lr , `n TESTRUNBETW£EN�FT AND �_FT w COMMENTS F'%Lg,,�Jj t> PERFORMEDBY: //�/� /:^�•rJy^„�� I A,'~0 CERTIFY THAT THIS TE3 WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �j 6 MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILIN ADDRESS a iE�ka// t PHONE ((''��'�''�'�(�''s EW (,��fSi�.S �/ ❑UPGRADE LEGAL DESCRIPTION,, LOCATION -t} (\� NO. OF BEDROO DISTANCE TO:W E1 Absorptlop areg�! / V 1 Dwelling//( V P IT NO. W Q F Manufacturr/7 __�� �X I No. of c partments u Lig. ca a y in gallons IF HOMEMADE: Inside length Width Liquid depth Dy 2 DISTANCE TO: Well Dwelling PERMIT NO. 0 Manufacturer Material Liquid capacity in gallons O W = DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. „WW Z j Hzw No. of lines Length of each line Total length of lines Trench width inches Distance between lines H o Top of the to finish grade Material beneath tile inches Total effective absorption area W Length VV,dlb Depth / PERM an W Type of crib Crib diameter Crib depth Building f n ar on Total effective absorption area Nearest lot line 16 DISTANCE TO: Well 0 '.,S` U( a J J Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MAT RIALS l�L SOIL TEST RATIN INSTALLEB R S REMARKS Ik If I Ilk 11 fli. 1— Al PPHOVE DATE LEGAL 724179E (Rev. 3/78) V MUNICIPALITY OF ANCHORAGE 1: L) Department^,f Health and Environmenta'"�Protection CJ 825 .. Street, Anchorage, AK. 79501 Q pus 9-1 i-Sa 264-4720 Permit # * * * HANDWRITTEN PERMIT WELL AND/OR ON-SITE SEWER PERMIT Applicant: S,� �,�� Mailing Address: Location: Phone Number: �(^�i� r'� Legal Description: L//� 6 ) nnytl)_ � n � 51� Lot Size: Type of Soil Absorption System Is: ` Trench: Drainfield: Seepage Bed: /f Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is:' DEPTH LENGTH 3/X 3 / , GRAVEL DEPTH ��tWIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth'is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ / n1V n GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * *.* TWO(Z) INSPECTIONS ARE REQUIRED * " Backfilling of any system without final inspection.and approval by this departure; will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fe, for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 2 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. n Signea: /ffo," O" Issued by: A-4 AV Applic t w Date: T SWP/024(1/81) • O & E ENL.NEERING & DEVELO, MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2260 Performed for. Name:-57-4✓EN LSK�l- f4-S -0 NS % - /Tel.No. 49SL ''F -Y Mailing Address: /9,0. &)C r D •r / Ca�y�i K, /Q K • `! 4 SL 7 Legal Description: GOT 10, /3 Lo c!c /, A/,0/2 -7W w o oy SlIB D t, 121116C .- Depth (feet) Soil Characteristics 0 1 I1L 5ic.7— sy 3 62AVEcc.y 5 6- 7 7 D E.tISE 8 sj 10 _ POT PLAN o SGRLE 12 — /> 13— PERC. TEST 14- 15 4_1516 _ _—' OF 4,f Ground Water Encountered: Yes �No If yes, what depth ,:;F' j x 4gL • : *, Proposed Installation: Seepage Pit_ Drain Field 00... ...... ......... �I ��� Earl P. Ellis W Comments: • �, Performed by:/!��%/(.�/ Y '(C��icC ✓ Date: 2-7IcPZ O TV 10 _ POT PLAN o SGRLE 12 — /> 13— PERC. TEST 14- 15 4_1516 _ _—' OF 4,f Ground Water Encountered: Yes �No If yes, what depth ,:;F' j x 4gL • : *, Proposed Installation: Seepage Pit_ Drain Field 00... ...... ......... �I ��� Earl P. Ellis W Comments: • �, Performed by:/!��%/(.�/ Y '(C��icC ✓ Date: 2-7IcPZ Municipality of Anchorage . -- Department of Health and Human Services Division of Environmental Services On -Site Services Section 825 "V Street Room 502 P.O Box 196650 Anchorage AK 99519-6650 low www.cl.enchorage.ek.us P (907) 343-4744.Ipl� l CERTIFICATE OF HEALTH AUTHORITY APPROVAL' FOR A SINGLE FAMILY DWELLING Parcel 1.D., 051 -801 -03 -- HAA # c. Expiration Date: 1.GENERALINFORIUATION ,: • °, Complete legal descnption `North Woods #2. BlockJ r Lot 10 - � Location (site addressor directions)' 22416 Whispering Birch Drive, Peters Creek, AK Current Property owners) I I Ll �IDYI'y • ��► ua lJi ` WUy-ft USD Day phone Mailing address o?a�� (o' f CtxdXinntnfl IC1Cp�j n� :�`QQS�Q� ,.. Lending agency :.: Day phone :Mailing address Real Estate Agent.. Bonnie King Day phone 688-5889 Mailing Address: - Unless otherwise requested, HAA will beheld by DHHS for pickup. HAA picked up by: 2., NUMBER OF BEDROOMS: - .. " _......3._ �INV 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 Department of Health and Human Services (DHHS) 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also Issues HAAs upon request to home owners. 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 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. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for this Health Authority Approval application shows that the on-site water supply and/or wastewater. disposal system is safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on- site water supply and/or wastewater disposal system is In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation..'., Name of Firm'_KND Fngheering Phone Address �oAd� ata..,,toan Fagtn Rtver AK 99677 Engineer's Printed Name Kenneth guff is Date IGM419nnA �1. ��P�� OF A`AS!!!! ENGIPSEER'S STAM? 6.: DHHS SIGNATURE I 1 Kenneth M Duff W/ •.•, �I NS '.CE 7176 -� '''Approved for 3 ' ; bedrooms.. ff �9 •'••... �:•����� .. Disapproved. Conditional approval forbedrooms, with the following stipulations: Additional Comments Attachments:. HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other gy Lf% • j�o- ems{ Original Certificate Date:. /0 - 9-o a Expiration Date: % b q' % Reissue Date: (Rev. l IM) Municipality of Anchorage Department of Health and Human SerRcrmC E IV E Division of Environmental Services On -Site Services Section 825 `L' Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 OCT 0 5 2000 www.ci.anchorage.ak.us (907)343-4744 MUNICIPALITY OF ENVIRONMENTAL SERVICES PAGE HEALTH AUTHORITY APPROVAL CHECKLISTDMSION Legal Description: North Woods #2. Block 1. Lot 10 Parcel I.D.: 051-801-03 A. WELL DATA Well type Public Date completed _ Total depth ft Date of test Static water level Well production WATER SAMPLER Coliform col to of sample: _ If A, B, or C provide PWSID # _ Sanitary seat Cased to ft FROM WELL LOG g.p.m S: nles/100 mi Nitrate mgA Collected by: B. SEPTICIHOLDING TANK DATA Well Log Wires Casing Other bacteria ground) In. ft g.p.m Tank Type/Material Steel Date Installed 7L27 /982 Tank size 1000 gal Number of Compartments 2 Cleanouts y Foundation cleanout y Depression over tank n High water alarm n/a Date of pumping 9/1/2000 Pumper JR's C. ABSORPTION FIELD DATA Date installed V-22 / g2 Soil rating (g.p.dJfl? or ft?/bdrm) 215 System type Bed Length 32 ft Width 32 ft Gravel below pipe .50 ft Total depth 4 ft Effective absorption area 645 ft2 Monitoring tube y Depression over field v— Date of adequacy test 101OV20X Results (Pass/Fail) Pass For 3 bedrooms Fluid depth In absorption field before test 0 in Water added 450 gal. New depth 3 in. Elapsed Time: 1440 min Final fluid depth 0 in Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) Y Terralift If yes, give date 91112000 (Rev. 11199) D. LIFT STATION Date installed 'Pump on, level at Datum Size in gallons in'Pump off" level at — Cycles tested E. SEPARATION DISTANCES E Manhole/Access — in High water alarm level at SEPARATION DISTANCES FROM WELL ON L�TOSeptic tank/lift station on lot Absorption field on lot Public /septic service line On adjacent lots Meets alarm & Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation +n'+ Property line 1n'+ Absorption fieldJn•+ Water main 2s'+ Water service line ?s'+ Surface water 10n•+ Drainage -lnn'+ Wells on adjacent lots -200!* — SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation In'+ Water main 15'+ Water Service line 91;'+ Surface water Inn+ rkin Driveway, y pa gNehicle storage 95•+ Curtain drain Inn'+ Wells on adjacent lots 7nn•+ F. COMMENTS±t OF G. ENGINEER'S CERTIFICATION I certifythat I have determined through field in g inspections and Kenneth M. D review of Municipal records that the above systems are in CE 7116 conformance with MOA HAA guidelines in effect on this date. fa[EER'g Engineer's Printed Name —Kenneth Drdtum Date HAA Fee $ b &-Q -V '' Waiver Fee $ Date of Payment Po/c��&7-) Date of Payment Receipt Number 51 S Receipt Number (Rev. 11/99) _ MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcell.D.# (lei-S�h}- �� HAA# 6)AOng (­�� 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 10; BLOCK 1; NORTH WOODS #2 Location (address or directions) 211 Wh.Lapea.ing Si.hch (b) Property owner Telephone: (home) Business 561-1900 Mailing Address 520 East 34th Avenue Anchorage, AK. 99503 (c) Lending lnstitutien Mailing Adaress Telephone (d) Real Estate Company and Agent 14CK DUZIE C0912AUV ATTNr Lehi; Cnewde+- Address 10928 Eagfe Riven Road, Eagte R.i.vert, AK. 99577 Telephone 694-5500 (e) Mail the HAA to the following address: (or check here if hold for pick up.) List contact person and day phone number below: 5 & 5 ENGINEERING -17034 E Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family QCX Number of bedrooms �- 3. WATER SUPPLY Individual Well ❑ Community ❑ Public CKX Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site XX Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72msfnw.7/881 Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION . - As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is In compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Telephone ` 7 17034 Eag • Address Eagle River, Alaska 99577 Date 6. DHHS APPROVAL Approved forbedrooms by Date 7 N, 25���1 ApprovedDisapproved Conditional Terms of Conditional Approval . _ CAUTION, . The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible forerrors or omissions in the professional engineer's work. 72-025 (Rev. 7/88( Beck Page 2 of 2 MUNICIPALIT.Y.OF,ANCHORAGE (MOA) • .. Hea_Ith, puthority,Approval (HA)) CHECKLIST- FEBRUARY 1984 '2 i?39 343-4744 Legal Description: _Z,/0 Q RECEIVED Nae-ry G�ivoe r x z A. WELL DATA Well Classification If A. B. C, D.E.C. Approve(Y/ ) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Casing Height Above Ground Pump Set At Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot %C90 'I- ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot 200 4 ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by ; Date Water Sample Test Results Comments B. SEPTIC/HAtD#46 TANK DATA Date Installed Size /OOO No. of Compartments Z Standpipes©Y N) Air -tight Cap (Y ) Foundation Cleanou (Y/ Depression over Tank (Y N) /Date Last Pumped —r /ole 9 Pumping/Maintenance Contact on File (Y/N) /J �t'a ; for Holding Tank High -Water Alarm (Y/N) AL Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTICAieI!9tR6-TANK: r To Water -Supply Well ?A To Building Foundation �G To Property /D /� r p y Line. To Disposal Field �� 'To Water Main/Service Line ;7 S 'J- 'To J'To Stream; Pond, Lake or Major Drainage Course 'd Comments rnma (A". riaa) Frmi Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata L/3�/ /ff AC Type of System Design f T Date Installed 42 ZZ A? 2 Length of Field Width of Field 3Z / Depth of Field Square Feet of Absortion Are Depression over Field (Y(N) Results of Last Adequacy Test Gravel Bed Thickness 19 ",Y f- G o✓ t� 06 I ,E Statndpipes Present (Y/ ) ✓t/ Date of Last Adequacy Test 8 r.Ai � ri 2 1447 SEPARATION DISTANCE FROM ABSORPTION FIELD: / To Water -Supply Well 2 O 0 14- To Property Line �D To Building Foundation /- L To Existing or Abandoned System on Lot N 4t-1- ; On Adjoining Lots —z7 r To Water Main/Service Line ZS f To Cutback (if present) Af 0 AJE To Stream, Pond, Lake, or Major Drainage Course ^J To Driveway, Parking Area, or Vehicle Storage Area -ry ` A Comments D. LIFT STATION Date Installed — Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Me!!!_MW Comments Codes (Y/N) "Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and inspection. - Dimensions Off' Level at Vent(Y/N) Signed b ,. a gNUINhhKING Company 1 P 034 0-910 olrx LOOP Road W2% Date Eagle River, Alaska 99577 9A0 /B T MOA No. Receipt No. (9 J c 7 /VP7c -/ Date of Payment =20 ,-�/ Amount: $ f ?M • 00 77-M8 (A". 7/88) Beck Receipt No. Pumping Cycles during Adequacy Test. Waiver Fee: $ Date of Payment Page 2 of 2 ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 DATE: September 20.-1989 PWSID: 213001 Requested By: S & S Engineering 563-6775 According to the records on file in this office, the Chugiak Utl./ Northwoods/Deer Horn Water System is in compliance with the State of Alaska Drinking Water Regulations. sincerely, Cindy Thomas -EnVMn—si;iriEaZ': nginecr. N, APPLICANT FILLS OUT UPPER HAL''^ONLY Property Owner 1ery Zl/- Phone Mailing Address C/o . �, t I � /�! ,[ r Zip Code Date Buyer Date Address Inspector Zip Code // �__ Lending Institution A/a st /IcLA,(a C .a L)/n�S n4:.� Phone Address G61r Zip Code Realty Co. b Agent Field Notes: D J/ Phone Address ( ) DISAPPROVED - Zip Code ( ) CONDITIONAL APPROVAL' DAT Legal Description -�Ot /�� �✓OCt�. / �� /1Lc•[JCrLs "5ti /P1)rj SC 77- Soils Rating DaleSewer Installed Well To Absorption Area Street Locallon q_ 7-y- S 1- Type ,, of�f Residence t.. ryZ5 y-amgle Family ? ❑ Multiple Family No. of Bedroom _ ❑ Other Water Supply ❑ YuUvidual ATTACH WELL LOG. A well log Is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log If available). ❑ Public Utility Sewer DIposal 17 O ndividual / Year Individual Installed: / � ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank , NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. - G) L� a I LO U "nc�y- Time Time Time Time c Date Date Date Data Inspector Inspector Inspector Inspector iL©6AS. Field Notes: D J/ APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DAT BY: Soils Rating DaleSewer Installed Well To Absorption Area Well Log Received q_ 7-y- S 1- Well to Tank Septic Tank Size A400 72 a4�