The URL can be used to link to this page

Home My WebLink AboutSKY RANCH ESTATES #1 BLK 5 LT 1Sky Ranch #1 Block 5 Lot 1 #015-301-37 Municipality of Anchorage Page / 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: SW970075 PID Number: Name: E—rN6I.y� Yp-r6SWastewater System: ❑ New ❑ Upgrade Address: 5'110 ABSORPTION FIELD vnone: 345 — 2162. No. of Bedrooms: ❑ Deep Trenc o Shallow Trench Deed ❑ Mou ❑ Other LEGAL DESCRIPTION Soil Rating: Total Dept Mro rlginal grade: P Ft. Lot:' Bloc: Subdivision: Depth to pipe bottom from original g Gravel to beneath pipe S� ��'�� Ft. F Township: ` Rang Sectio Fill added above original grade: r I length: Ft. O New ❑ upgrad Gravel width: Number of lin Oiatanp between lines Ft. Ft. Classification t A,B,C): To In: Cased To: Total absorption are Pipe material: Ft. Ft. SO. Ft Driller: Date Drilled: Static Water Level: Installer: Date Installed: Ft. TTId: Pump Set at: basin MAO Ground: TANK GPM Ft. t. SEPARATION DISTANCES ❑Septic Holding 0S.T.E.P. To Septic Absorption Lm Holding bnUP.ivne Manufacturer.�^-'V AA&tA Capacity In gallon: 4.000 From Tana Field Station Tana Sewe,Unes • 1�""f— Well N��, N IJ A —X' (05'� Material:s Number of Compartments; Water lob'+ icd+- LIFT STATION Lot 2��} Size in gallons: Ma urer, Line 30+ Foundation i y+ '.Pump on' level at: "Pump otr High water alarm at: Curtain _ (lei W . 1 Pump btate a Electrical lnspeetlons performed by. Drain Remarks: BENCH MARK rF77 —ro StSr p0U r.]..SS' Location and Description: -TW 1P) Or— COWV(�-V2- UMD Co9_-Jep� or- F�ousE l J Gt7a 61,io.t+ ��Sf(y i f3t,T- L1�i0 AssumedElevetlon: OO.0 0 CA8LF5 Ot26�-rTr/ CNr� -ra tY . C4-31I.b4 SLAPPJI�-D gw_�ZWNA / �p� .* S... �I INSeoe 1}aSE -ra PriarEc- ,a,tk ccsvnaG-, Inspections performed by: Dates: 1s Ft(o�6S 2nd 119'In t a A.Gamail 4W/ .7957_,' �e\ J1fF V�.�: Department of Health and Human Services approval �•. aFo.. �OFESS f�� Reviewed and approved by: Date: _W04e4. 72-015 (Rev. 9.91) MOA 25 WELL~ 75 FOOT WELL RADIUS~ SEPTIC TANK '~0 BE F[LdED WITP / "'/-NEW 4000 fiACLDN HD[ ,. /~INgTAL[.E~ P[R M,D,A T~NK, EGULATIDNg 10 FUOT UTILITY EASMENT TRENCH TO BE []LD SEEPAGE PIT, NUI'E, THE CONTRACTI]R SHALL HAVE] THE WELL RA]DIUS FLAGGED BY A REGISTERED LAND SURVEYOR, PREPARED FDR: PREPARED ~Y~ .SEPTIC UPGRADE~ LOT 1, BI< 5, SKY RANCH EST. CINDY TORKELSDN ALASKA WATER & WASTEWATER ABANDONED IN PLACE, I1 ~/,'l ,.,/A'/Prn'PYl A. ~m,rress,.' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT NUMBER:SW970075 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NAME:YATES JOHN D & ETHELYN L OWNER ADDRESS:5710 WHISPERING SPRUCE DR ANCHORAGE, AK. 99516 PARCEL ID:01530137 PAGE 1 OF PERMIT DATE ISSUED: 4/28/97 EXPIRATION DATE: 4/28/98 LEGAL DESCRIPTION: SKY RANCH ESTATES #1 BLK 5 LT 1 LOT SIZE: 15474 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: HOLDING TANK SYSTEM 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 (18A~%C80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED A_ND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: 8471 Brookridge Drive ~ Anchorage - Alaska 99504 (907) 337-6179 - Fax (907) 338-3246 Consulting Engineers April 20, 1997 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 ReP Sewer Upgrade for Lot 1, Bk 5, Sky Ranch Estate #1 S/D. HOLDING TANK To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic tank is collapsed and the drainfield is badly surcharged, consequently, an upgrade must be done immediately. A test hole was dug (Mike Blakeslee at A+ Home Services) in the southeast corner of the lot (outside the well radius), and we encountered water weeping profusely immediately below the organic layer. Throughout the test hole depth, approximately 8 feet, water could be seen weeping (profusely) out of sand and/or gravel pockets. Water immediately began to pool in the bottom of the hole and rapidly rise. It is anticipated that the water level will stabilize near the organic layer. In short, the soils were unsuitable for an onsite septic system. Due to the location of the well, existing structures, the old log crib, and the existing trench system, there is no spot (greater than 100 feet from the well) to put a new septic tank and drainfield. Given the site restrictions it is my recommendation that your depamnent allow us to install a 4000 gallon holding tank. ANCHORAGE FOR BOUYANCY FORCES: If the groundwater conditions in the area of the new holding tank are the same as in the test hole area, hold down anchors will be required to resist buoyancy forces. The buoyancy force on a 4000 gallons tank is approximately 33,400 pounds. The resisting force is the soil cover (assume 2 feet of unsaturated soil) and the weight of the tank. The weight of the tank is about 3000 pounds, and the weight of the soil (assuming 90 lb./fl3) is approximately 19,300 pounds, for a total force of 22,300 pounds. Providing a factor of safety of 1.5, the total resisting force should be 50,100 pounds. The anchors should provide a resistance of 27,800 pounds (50,100-22,300 = 27,800). We are proposing to use ten (10) Manta Ray utility model 88-DB utility anchors (literature attached), which are rated for 3000 pounds each. Rather than using galvanized steel cables, we will use stainless steel cable so that corrosion will be minimized. The tank straps will be provided by Amchorage Tank, and will be installed per the sti-P3 installation guidelines (copy attached). I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481 ~ 1162. Thank you for your assistance. Sincerely, Prir/~il~al iarness, P.E., M.S. LOT 3, ~K ;KY RANCH ;TATES ill ~£LL LBT 10 ,~K 4 SKY RANCH ESTATES fit UNDEVELBPED 11 ,NK 4 RANCH PRIVATE WELL AND SEPTIC LOT 7, 5 SKY RA CH ESTATE Ii! DPED UNDEVELOPED LAND TRAPPERS TRAIL LOT E, BK 3, RAVEN ~DDDS, PRIVATE WELL AND SEPTIC PER H,B,A, RECORDS, NOTEj THIS IS NOT A SURVEY. THE LOCATION DF' ALL WELLS, SEPTIC SYSTEMS, AND STRUCTURES IS APPROXIMATE. THE CONTRACTOR SHALL VERIFY THE SEPARATIBN DISTANCE FROM THE SEPIIC SYSTEM UPGRAgE TO ALL WELLS ON AIMACENT LOTS. SEPTIC UPGRADE, LEIT 1, BK 5~ SKY RANCH EST, #1 PREPARED F~R: CINDY TI]RKELSBN PREPARED BY, ALASKA WATER & ¥/ASTE¥/ATER WELL~ 75 FroOT WELL RADIUS ~,,,~,/// SEPTIC TANK ~0 SE FILISED WITF / · -'/-NKk,/ 4000 GALLON /' -" / INSTALLED M,D,A / TRENCH TO BE 10 FOOT UTILITY EASMENT OLD SEEPAGE PIT,' NOTE, THE CONTRACTOR SHALL HAVE THE \FELL RADIUS FLAGGED BY A REGISTERED LAND SURVEYOR, TANK, ABANDONED IN PLACE, SEPTIC UPGRADE~ PREPARED FOR: PREPARED DATE: LOT 1, BK 5,, SKY RANCH EST, CIN3Y TDRI<ELSDN ALASKA NFATER & NFASTEA/ATER 4/20/97 ! DRAA/N~ GARNESS ISCALE~ l~ = 20' Aneh~.W. elght and Weight 4/b~ ~ lbs. Up :oI~M fn ,~ur.~ eullt, An~h~r holding capag~ var[es wl~ moi~u~ coatent of soJf hard ~o[I ~ltlo~e or R Ifghffi~ Cap~=l~ ~ne~r (ufl~r 12~ Ib~,) ]n n~rmal pngum~[c hemmers. Complete g~d assembl~ cops ms of 8han~, ~enal~n., radluse~ dNve t p, Couplers, exlra~lor le~po~ D~kblJli ~r~ m~ af high ~tro~h ~lU~liflum incl.udl~g: basep!~te, hyd~uIl~ ram, o~l~l valve, haldltig capacity rea~.~ut gauge, adapter e~tl~g bar ll~ ~d c~Jng b~x. Potable Ga~otine H~draulic Power ~.~ni~ Model Number Weight Stand~ Pek ~PU-i e~ Ib~ 1 Utility Drive Ge~ For Duckbill YempomG' Anohom In,loller ~n ha~ Ur power drive module da.and [18, ar)¢ power drive moc/e~ 181} Into groun~ at de~ ~d angle unlll ~p oabl~ ~lrghtly ~e]~ gmda eno walk tway. ,~ fl. Ior~g v,'ilh I~rgf~ viriklrig hus~ 4'e' long. ~p~l~/ha~ma~ ch;l~k slzq wl Salaa offloe~{ tllroughout the UnlteU States, United Klflgdom, Lgtin AmerJoe, Europe, Canada, Au~trel{~ and ,Japan, Dlr~ot all Inqulrie~ to C]ll, Colorado 800~, PhOne '1-800.32~.83e0 or ~303~ 286.8988 In Co~rado, F~X (303) 2~868, Olllrlbuted I~y: REVISED: NOVEMBER 1995 1.0 Excavation and Bedding 1.1 The excavation shall be free from any hard or sharp mate- rial that may cause damage to the tank coating. (Care shall be taken during installation that foreign matter is not introduced into the excavation or backfill.) 1.2 Bedding and backfill shall be homogenous material consisting of compacted clean sand, pea gravel, No. 8 crushed stone (ASTMD 448) or equivalent. REMOVE LARGE OR SHARP ROCK FROM EXCAVATION 1.' MINIMUM 1' MINIMUM (3 (305 1.3 The bottom of the excavation shall be covered with bed- ding material to a depth of 1 foot (305 mm) suitably graded and leveled; and extend at least 1 foot (305 mm) around the perimeter of the tank and anodes for backfill opera- tions. 1,4 Where anchoring by means of a concrete slab is required, the tank must not be placed.directly on the pad. A layer of bedding material at least 6 inches (152 mm) deep must be spread evenly over the dimensions of the pad to separate the tank from the pad. The tank shall not be placed on any other hard or sharp material that can cause deformation of the tank or damage to the coating. ~['~ ~....~1~_....~-~-~ OPTIONAL ~.?, ANCHOR~ ~ THREADED [~ STRAP ~ ~ ADJUSTMENT ~¢~ ~ INSULATING//~~ %NROD ¢~MATERIAL ¢ k"%~] : ~'~, ~; I 6"MINIMUM (152mm~ ~ , ,~,~ ~..~ ~, s...~:,..:..~:~..~.,,~. ~,~... ~..~. ~....~,., ~,, .. 1.5 In a tidal area, backfill or bedding material composed of small padicles, such as sand, can migrate into native soils, where larger aggregate, such as pea gravel or crushed stone, exists. Resultant voids can create an uneven sup- port for the tank. Use of filter fabric should be considered. 2.0 Above Ground Air Test 2.1 The temporary plugs and thread protectors installed by the manufacturer shall be removed. Apply compatible, non- hardening pipe sealant to internal bushing threads. Permanent metal plugs shall be installed at all unused openings. 2.2 The dielectric bushings in sti-P3® tanks shall not be removed from the unused openings. Plugs used to tem- porarily seal the tank for the above ground air test but later removed for pipe installation shall not be over-tightened. Care shall be taken not to crossthread or damage the non- metallic bushings when replacing plugs or installing required tank piping. NYLON APPLY U.L. APPROVED ~ ~ NOTE: FULL INSERTION PIPE SEALANT TO THE ~ OF PIPE OR PLUG TO ENTIRE SURFACE OF ~. X~ CREATE "ELECTRIC,A,L THE FEMALE NYLON ~ ~ ISOLATING GASKET BUSHING THREAD ~ ~"~/"~ // 2,3 An air test of the tank above ground is required. Pressure should not exceed 5 pounds per-square-inch (PSlG) (2.26 kg/2.54 sq cm) while a soap solution is applied to weld seams and fittings to assure that no leaks exist. ABOVEGROL 2.4 Dual wall tanks will require different air pressure testing procedures. Do not connect a high pressure air line direct- ly to the interstitial monitoring port. Vacuum testing of the interstitial space on some dual wall tanks can be used in lieu of or ir~ addition to the air test procedure. Consult tank fabricator for air test recommendations. Do not apply a vacuum to the primary tank or a single wall tank. PEI/RP 100-90 also provides guidelines. 2.5 Take necessary safety precautions during air tests. Do not leave tanks unattended. 3.0 Before placing the tank in the excavation, all dirt clods and similar foreign matter shall be cleaned from the tank, and areas of coating damage shall be repaired with a touch-up coating provided. 3.1 Clean damaged coating areas through removal of surface rust, dirt, contaminants and disbonded coating prior to application of touch-up coating (See SSPC SP-2 "Hand Tool Cleaning" or SP-3 "Power Tool Cleaning" for additional guidance). TANK SURFACE TOUCH-UP 4,0 If the tank is shipped with protective plastic covering over the weld-on anodes, remove only the plastic covering to assure proper anode operation. Verify integrity of anode connection prior to backfill. 5.0 Tank Handling §.1 Equipment to lift,the tankshali be of adequate size to lift and lower the tank without dragging or dropping to prevent damage to the tank or the coatingi 5.2 Tanks shall be carefully lifted and lowered by use of cables or chains of adequate length attached to the lifting lugs provided. A spreader bar should be used where necessary. Under no circumstances use chains or slings around the tank shell. ' 6.0 Anode Integrity 6,1 sti-P3etankS may be equipped with either zinc or magne- sium anodes. Whereas magnesium anodes are designed only for installation in soil resistivities of 2000 ohms-cra or greater, zinc anodes are effective in all soil resistivities. 6.2 After an sti-P3®tank has been placed in the excavation, if anode is connected by a lead wire, attachment to the tank shall be checked to assure this connection has not been damaged. Where damaged, the connection must be reestablished in strict accordance with sti-P~® specifica- tions. 6,3 To assure immediate operation of cathodic protection sys- tem, each anode shall be thoroughly saturated with water at time of backfill operation. 7.0 Anchoring 7.1 High water tables or partially flooded excavation sites exert significant buoyant forces on tanks. Buoyant forces are partially resisted by the weight of the tank, the backfill and the pavement atop the tank. Additional buoyant restraint when required is obtained by using properly designed hold down straps in conjunction with concrete hold or deadman anchors. The use of steel cable a/Ed/or rpunc~ bar as hold d0wn straps is prohibited. 7,2 Special care vhen g hold down straps to taht the straps are separated from the tank )arating pad made of inert insulating dielectric rial. The separating pad should be wider than e the hold down straps would come.into direct vith the tank shell. The use of steel cable bar as hold down straps is prohibited. '~"--. HOLD DOWN STRAPS SHOULD BE SEPARATED FROM THE TANK BY AN INERT INSULATING DIELECTRIC MATERIAL. 8,0 Backfilling 8,1 Homogeneous backfill, similar to bedding material, shall be placed around the entire tank to create a uniform homoge- neous environment. 8.2 Special care shall be taken when installing backfill along the bottom sides of the tank to ensure that the tank is fully and evenly supported around the bottom quadrant. SPECIAL BACKFILL -- PLACEMENT REQUIRED ~.~-._.~,.'~SPECIAL CARE i~%~ ~>~ ~ AND TAMPING 8,4 backfilling to top of tank, all openipgs shall be t inspected to assure that the sti-P3® dielectric nylon bushings remain ir{ place. Where flanged openings have been used, the dielectric isolation shall be con- firmed with a continuity tester. No current shall pass through the factory installed dielectric flanges. Dielectric isolation is required to assure tank integrity. If tank is to be installed in the presence of an impressed current cathodic protection system, consult "Impressed Current Warranty Addendum for sti-P3®,'' for additional instructions. 9.0 Final Air Test 9.1 Install required tank piping using compatible non-harden- lng sealant, taking care not to crossthread or damage the nonmetallic bushings. Torque of 400 to 1,000 ft-lbs 48-305 m/453 grams may be required to fully insert pipe. 9.2 Where air or hydrostatic testing is required after installa- tion, the pressure applied shall not be in excess of 5 pounds per-square-inch (PSIG) 2.26 kg/2,54 sq cm as measured at the top of the tank. 10.0 Tank Monitoring System Installation 1 0.1 Each tank shall have a cathodic protection monitoring station (PP4, PP2®, PP1 or other) installed in such a way so that there will be at least a tank structure lead easily accessible and identifiable at the finish grade and provide easy placement of a reference electrode during monitor- ing. 10.2 If your tank is equipped with a Protection Prover 4 (PP4) remove the unit fi'om the shipping carton and inspect for damage. (See the separate manufacturers installation instructions for specific details regarding installation.) Figure 2 Remove PP4 Carton from tank end. Open and inspect all compon,~ Remove Plastic Bag! TEST REFERENCE HEAD CELL ELEMENT Note: Remove plastic outer bag on reference cell element on the same day it is to be intalled, DO NOT remove or cut inner Filter Fabric bag, 10.3 Prior to installation of the PP4, remove the plastic bag from the reference cell element. After the tanks have been placed in the excavation place the reference cell element midway from front to back between two tanks so that it is covered by 6" (152 mm) of moist bedding material. 10,4 Drape the flexible pipe up to the top of tank and tem- porarily secure to prevent damage during backfill opera- tions. Backfill the excavation until the tanks are almost covered. Figure 6 -- Note that Reference Cell element has been covered with at least 6" of approved moist backfill ---~ 10,5 Position the PP4 test head in its approximate final position and support with a wooden stake or other similar device. Connect the appropriate tank test wire from the reference cell element to the black test lead already installed on the tank using the hardware supplied or by performing a field splice, 10.6 Assure that the wire connection is strong by simultane- ously placing tension on the wire at either side of the connection point. Protect the wire connection from corrosion using the material supplied with the PP4 or by wrapping the connection in half lapped layers of rubber and PVC electrical tape. 10,7 10.8 10.9 10.10 10,11 10,12 10.13 Figure 1t -- Insulating of test lead wire splice using 2 each half lapped layers of rubber and PVC electrical tape TO TEST STATION UNIT OF ~UBBER ANO PVC ELECTRICAL ~ ' S (2 EACH) -~ TAPE The test head may be placed in a small grade manhole to protect it from vehicular traffic o'r set directly in the concrete covering for'the excavation. During pouring of the at-grade slab protect the metal contact points on the test head from being covered by concrete. If your tank is equipped with a Protection Prover 2® (PP2®), prior to completion of the backfill, the monitoring terminal located near the top of the tank must be posi- tioned as follows: Select a terminal location on a pipe near grade that will be accessible through a grade manhole upon completion of installation. Loosen the black nylon pipe lashing by releasing the locking tab. Uncoil enough lead wire from the tank mounting lug to reach the terminal location with an additional 4 feet (1.2 meters) of slack. Secure the PP2® terminal to the pipe by tightening the black nylon pipe lashing. The lead wire terminations shall remain sealed. · PP2® TERMINAL (LOCATION TO BE ACCESSIBLE THROUGH GRADE MANHOLE) VAPOR RECOVERY, PUMP SUCTION, PUMP DISCHARGE, ~ L/"-IIIIIII FILL, OR OTHER ACCESSIBLE PIPE ~/ ~__--~_~, MOUNTING ,---..~. ~~=~ LUG~ ' ........ ~TANK SHELL Route wire to avoid strain or breakage during backfill. Do not cover PP2® terminal with backfill material. If the tank is equipped with a Protection Prover (PP1) monitoring system, which includes a monitoring test station mounted at the end of the tank, prior to any backfilling, extend the monitoring system to 4" (102 mm) below grade level without pulling it out of the mounting bracket. The PP1 test station shall be protect- ed by a grade manhole of 71/2'' (1.91 mm) minimum diameter. ~~ TERMINAL X I /-- PLATE_,.~ STRUCTURE ANODE 11,0 12,0 13.0 Contact between the steel tank and all other structures, such as external and internal piping, pumps, valves, gauge and monitoring equipment, and grounding systems will nullify the cathodic protection design. Prior to backfill, a simple continuity test between the tank lead wire and each connected system will verify the electrical isolation. Continuity shall not be present. After backfill, continuity can be checked with a high impedance (mini- mum 10 megohm) voltmeter by fixing a copper/copper sulfate reference cell in the soil and contacting all struc- tures with the other voltmeter lead wire. Do not move the reference cell. Potential differences between the tank to soil and all other structures to soil.must exceed 10 milli- volts to verify electrical isolation. :'~:?[~ :. ..... .... V;.:, '?'.'.( 18 Earh," ,,,:;~, (~)~'~'~,,:~,.s~¢',~ .,., ...:,'¢. '' "~'~,~,' I -:'t '~::!:'*'.:.''.` 6" RE NFORCED ,.~,~!~ ~ z.:~',~:'¢¢: ~. ,,.',:~'~,~'~'..:'.':.: .... :.'.'...'.', :!~,.~:~.:,A':~4¢~i ~;;~!'~t; ' :'{ :F'.,~~ ::.~ :::~ CONCRETE ,'.~.'.,.?~ ~¢ :;~. 2~.'i..~;, :.v.:l '..~: .~ .','OR 8 ASPHALT .'".¢Z~;~:¢~':i,~.'¢'~,'!¢.',,~ :~f&': v.'., .:...¢..:~' ~.:'~-~ ,: ~,,' ~ ."' i. · ,,.,,,, Homogeneous backfill shall be deposited carefully around tank and to a depth of at least one foot (305 mm) over tank to avoid damage to coating especially where tamping is required. (See NFPA 30 and state or local codes for a minimum depth of cover required.) All tanks must be monitored to assure proper installation and ensuing cathodic protection of the tank. Before pour- ing concrete or asphalt pad atop tank, a tank to soil potential reading with a high impedance voltmeter and copper/copper sulfate reference electrode must be taken. Reference electrode shall be placed in moist soil directly above the tank, A minimum reading of -850 millivolts should be obtained to indicate that the tank anodes are activated. Record reading on Installer Information Card and other permanent files. OUTER ~ TANK TERMINALS REFERENCE CELL TERMINAL ;HED GRADE 13,1 If the tank is connected t~ a PP4 Test Station the cathod- ic protection can be easily verified using a high imped- , ance digital volt meter, Touch the meter probes to the appropriate test head terminals as shown in the diagram above. As stated in 13.0, a minimum reading of - 850 millivolts should be obtained. 14.0 Single wall sti-P¢ tanks must be monitored for protection at installation and every 3 years thereafter and whenever there is maintenance or construction, sti-P~® tanks with FRP laminate which meets STI's ACT-100® specification, do not require monitoring. Follow applicable local, state and federal regulations for additional requirements. Reference NACE RP-02-85 for more specifics on protec- tion criteria. NOTE: Cathodic protection effectiveness of sti-P3~ tanks will be Impacted by contact w~ structures including piping LOCATION OF TANK: Date Handling Equipment is of adequate size and capacity to lift and lower the tank without dragging or dropping the tank. Repair of all damaged coating areas such as scratches and holidays has been made with compatible coating. Plastic wrap has been removed from the weld-on zinc anode. Excavation The site has been excavated deep enough to enable 1 foot of compacted clean sand or gravel to act as bedding material between native soil and tank when anchoring is not required Burial depths meet minimum code requirements (such as NFPA 30). Testing The tank has been air-tested at 5 PSIG while applying soap solution onto weld seams and fittings to check for leaks. -or a vacuum test has been performed in accordance with the fabricator's instructions. All local and state testing requirements have been performed. Anchoring (Check one) Not applicable to this site Deadman anchors used Concrete pad Soil and pavement overburden will hold down tank (Ref. PEI/RP 100-90) When anchoring with a concrete hold down pad, a minimum 6" layer of pea gravel, compacted clean sand or No. 8 crushed stone has been spread evenly over the concrete pad dimensions to separate tank from pad. When deadman anchors or hold down pads are used, hold down straps have been separated from the tank by an inert, insulating dielectric material at least 1" wider than the steel hold down straps. The tank is electrically isolated from the hold down strap. INITIAL Backfill Homogeneous backfill consisting Of compacted clean sand, gravel or other non-corrosive inert material has been used. Backfill has been placed along sides of tank to ensure full suppod along the tank's bottom quadrant. Pipe Connections Electrical isolation of flanged connections has been verified with a continuity tester. Prior to backfilling over tank top, but after piping to the tank, electrical isolation of tank from all equipment has been verified. No continuity shall be present, Tank Monitoring The cathodic protection monitoring station has been installed and brought to grade and access to the soil above the tank has been provided. Verify operation of the cathodic protection system by: A tank to soil potential reading obtained with a high impedance voltmeter and a copper/copper sulfate reference electrode installed with the tank or placed .immedi- ately above the tank in soil. Record reading: -. millivolts. The tank owner has received the information above. All other facets of tank installation have been made in accordance with sti-P~® instructions. Signature and Title of Installing Foreman and/or Project Engineer. Installing Contractor NOTE: This checklist Includes certain key steps In the proper Installation of the atI-P=e tank and Is Intended only es an aid to tank Installers who are knowredgeable and experienced in underground tank Installation, Compliance herewith does not necessarily meet the requirements of all applicable federal, state and local laws, regulations and ordinances concerning tank Installation. INITIAl. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ~HONE 'L~ NEW LEGAL DESCRIPTION W~ ~ ~ Absorption a~a Dwelling PERMIT NO, ~ ~ Manufacturer Matorial ~o. o~ compartments ~ ~ kiq. capacitg in ~allons IF HOMEMADfi: Inside length Width kiquid d~pd~ 0 ~ ~ Manufacturer~U Material NquiO caOacitg in ~allons ~ ~11 Foundation ~0arest lot Hne PEBMIT ~0. ~ ~ DISTANCE TO: ____ ~ ~0. Ol lines [eh,th o[ each lin, Total len,th of lines Treach wid~ ~ ~istanc. bet~e,n lines ;~ ~op of tile to finish grade ~ ,Material beneatE tile ~ inches Total effective ab~rea ----- Length Width Depth PERMIT NO. ~ ~ Type of cri~ Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: .~ ~s ~ . ,~ Depth Driller Distance to lot line PERMITNO, ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER INSTALLER I - REMARKS ~ . APPROVED~ ~ % OATE LEGAL I;::l ':::;1'31 II:::]l:;;:li!] .'" c: I:: I TH[i: i...EJ',t(TJlT'I'I [:' :Il HE:iI",I:!~; ]: Efi",l ]: :~i; 31"1[~; I...[:::hll;3'l'H ':; :!: i"4 F:'IE[}!:'I" ;:' OI::7 THE 3"Hli!: DEi:F"I'H O1':' I:::1 'I"[;;:I:!3qE:HElf,:: I:::'];"f' .1;:!i!; Tl"l[!i; [';' :l: ¢::;TI;::ll",lE:l:i}: i3[ii;Tl.'.ll:i;I;!~N 'l"Hli:i; :!i!;I...ll:;i:[::'l:::lC:[:; O1:::' TI"IIE (3J:;i:l:)l...I[",t[::, f::li",lE:' TI"II!!}: 13OTTEli'q 1:3F" TIlE [.!i:::.::l;;:;l:::l¥1'::lT];(3t'.,I ::;;Il'.,! 'T'HtEF:fi:; :!; ¢i; l'.40 '.:;E'f' I.,.1;[ DTH FOR: 'iq.E:.: GI:;;:I:::I',,,'E:L. [::,h]:[::'TII ;{ '.E; THE: J"i :[ ?.,[ ;[ I"lLIl"l E:,f!!:F:'"I'H ElF G[;?.R',,,'[EI... li:[i}:"l'l.,.lli::J!:}:J'.,I TIDE: E~l..r'l'l:::'R!.:.f. F::' :!: !:::'Ii!; lqJ'.,ll;:, THE}; I!!!',ECf"FEJf'I OF' TilE; li}~::'::E:l::l',,,'l:::l I']: J:~ll'.,I ,:: :[ I'q l;::'[ii;[ii;T ::,. TER ANCHORAGE AREA BOROI.' H Q..ceARTMENT OF ENVIRONMENTAL QUALI,, 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: MAJLINGADDRESS DISTANCE FROM WELL__ ~/~.~' d.) / LIQUID CAPACITY~.~'~ '}~---)~/2-(~' ____GALLONS. NUMBER OF MATERIAL ,,~,,;~ ',~:';~7~ - COMPARTMENTS "~/ .~',,~'~.~,,~' ~ //~J' /~~/ LIQUID INSIDE LENGTH ~ INSIDE WIDTH ~ DEPTH.~- SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS.. / NEAREST LOT LINE_~,.~ OUTSIDE DIAMETER · DISTANCE FROM WELL__./''~''7''~'''~' / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)____ , LENGTH ,z~-L~_~') , DEPTH ~';/ · __, BUILDING F O U N D A T I O N ../~'~ ,~~ /,?'~'~ ~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL_. ~"~~N /- NUMBER OF LINES_ / DISTANCE BETWEEN LINES. ABSORpT~mhJ'"~EA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE__ ,'~EST LOT LINE_ 1 WIDTH TOTAL LENGTH , OF LINES. IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILL IN. ABOVE TILE__ WELL: ~ Typ~~ DEPTH_~ ~ / DISTANCE FROM WATER , BUILDING FOUNDATION ~ SAMPLE ~ ~' NEAREST ~/~;/~ /NEARES~ . / SEPTIC ~ / SEEPAGE /~- / OTHE~'"-- LOT LiNE __~/~, , SEWER LINE~/ , TANK , SYSTEM____~, , CESSPOO/~'~ , SOURC~~ DISTANCES: .~,~,, .-- ~, ,' '0 DIAGRAM OF SYSTEM GREi,~FER ANCHORAGE AREA E~OF,,,JUGH DEPARTMENT OF ENVIRONMENTAL C)UALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE. ALASKA 99502 TeLEPhONE 279-8686 PERMIT NO. SEWAGE DISPOSAl. SYSTEM -- APPLICATION AND PERMIT MAILING ADDRESS PHONE INSTALLATION OF: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD j OTHER TYPE AND SIZE OF FACILITY TO BE SERVED r/' ~ TO BE INSTALLED BY /¢/ _/~--X~ NOfE~/ ~HI~'PERMIT iS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY BYSTEM WITHOUT FINAL INSPECTION BY THE: HEAI..TH DEPARTMENT AUTHORITY WILL BE SUBJECT TO pROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEEPAGE PIT ¢¢:~'--"~'/ DRAIN FIELD SEPT]C TANK TO SEEPAGE PIt WALL //. S~PTIC TANK , SEEPAGE PIT ~ Z ..~,, / / / WATER MAIN TO SEPTIC TANK SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN F,ELD DIAGRAM OF SYSTEM GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. ~---J: ~ -c 6/ .///..d'_ ..~:..-:~-~ ,-- ~ c~- I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE DATE" APPLICANT'S ~]gNatuRE ~ ~" ~~ ~ ~ ~ Municipality of Anchorage Development Services Department Building Safety Division / On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907).343-7904 Parcell.D. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 01j-501-37 __815-2S9-e9— COSA# 0 03-57 Expiration Date: / - a - / O 1. GENERAL INFORMATION Complete legal description Sky Ranch #1, Block 5, Lot 1 Location (site address) 5710 Whispering Spruce Current Property ownerDevin Rush s) Day phone 748-9142 Mailing address 5710 Whispering Spruce Lending agency Day phone Mailing address Larry Ross 561-2227 Real Estate Agent Day phone Mailing Address Buyers Real Estate Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site ❑ Individual Water Storage ❑ Individual Holding Tank (x] Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site 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 On -Site 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 results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 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 Certificate of On -Site 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-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 NorthRim Engineering Phone 694-7028 Address P.O. Box 770724 Engineer's Printed Name 'Upve Eng Date c)/a5/nq 4P�E o! A4q�^�r � ••••N.•ye4e V ............................. Steven W. Eng 5. DSD SIGNATURE 1 Approved for_3 bedrooms. �� s �.. PE 6256 • . i Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ,!ft Original Certificate Date: (Rb. t11e5) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Sky Ranch #1, Block 5, Lot 1 parcel ID: 015-283-09 A. WELL DATA Well type P If A, B, or C provide PWSID # Date completed 1971 Sanitary seal (YIN) Y Total depth 213' ft. (MOA) Cased to 40' ft.+ FROM WELL LOG Date of lest N/4 Static water level N/A ft. Well production N/A 9.p -m. WATER SAMPLE RESULTS: Coliform 0 colonies/100mL Nitrate ND mg/L Arsenic: 1.3%g/L date of sample: 9/17/09 B. SEPTICIHOLDING TANK DATA Well Log (YIN) N Wires properly protected (YIN) Y Casing height (above ground) 18'+ in. AT INSPECTION TankType/Material Holding Tank (steel) Tank size 400 gal. Number of Compartments 1 Foundation cleanout (YIN) Y Depression over tank (YIN) N Date of pumping N/A Pumper N/A C. ABSORPTION FIELD DATA Date installed N/A Soil rating (g.p.d.lftZ or ft'/bdrm) N/A 19n ft. 1,5 9.p -m. Other bacteria 0 colonies/100 mL Collected by: ` NRimEng Date installed 7/97 Cleanouts (YIN) Y High water alarm (YIN) Y System type N/A Length N/A ft. Width N/a ft. Gravel below pipe N/A ft Total depth N//Rt. Eff. absorption area N�Aft: Monitoring tube N/A Depression over fieldN/A Date of adequacy test N/A Results (Pass/Fail) N/a For N/Abedrooms Fluid depth in absorption field before test —ii/ -k Water added N/�al. New deptt��A in. Elapsed Time: N/r�n. Final fluid depth N/Rn. Absorption rate >= N/A g.p.d. N/A Any rejuvenation treatment (past 12 mo.) (YIN 8 type) If yes, give date D. LIFT STATION Date installed —� 'Pump on' level at _ in. Datum ------ •Pump off _ n. Iarm level at Cycles tested Meets alarm & circuit In. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank lift station on lot P A 100' + On adjacent lots Absorption field on lot N/A On adjacent lots 100' + Public sewer main NA Public sewer manhole/cleanout NA Sewer /septic service line 25' + Holding tank 75'+ Animal containment areas 100' + Manure/animal excrete storage areas 100' + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5' + Property line 10' + Absorption field N/A Water main NA Water service tine 10' + Surface water 100' + Wells on adjacent lots 75' + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections and 0 %'V 1 review of Municipal records that the above systems are in j * �Q.gTH k' conformance with MOA COSA guidelines in effect on this date. j "' "'•` ••• ••••'•'...... ' Steve Eng P„e,, 11......11.. Engineers Printed Name d �, ; Steven W. Erg ; .w Date 7/27/09 �P s, : PE 62r6 ' .4 U: COSA Fee $ 90 Date of Payment L) —S - 0 Receipt Number L% 0^1 S G (Rev. 11/05) Waiver Fee $ _ Date of Payment Receipt Number J oa J7 ?O G R�cE�rl F l� p SCO/C /,r.W" bSEMENTS OF RECORD, OTHER THAN IOSE SHOWN ON THE RECORDED AT ARE NOT SHOWN HEREON. "7, 79- 50 AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a AfortagWs In. spection of the following described property: _ L P f /, �//t'. S. Sary�ua7cfi EJ>`afeS Uijif Anchorage Recording Precinct, Alaska, and that the improve• menta situated thereon are within the property linea and tlo not overlap or encroach on the property lying adjacent there- to, that no improvements on property lying acjjocent thereto encroach on the premisea In question and that there are no roadways, transmission lines or other visible easoreonts o.. #aid proforty ""opt a. indieaten hereon. Dated a�Anchorage. Alaska tt s. ?.Pas,nL A �guJ!° 29 b� FLIED WALATICA 3 ASSOCIATFI7 I 8ngineers and Surveyors Municipality of Anchorage •. Development Services Department }JjJQ • Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ek.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-301-37 HAA# Aae_ 1. GENERAL INFORMATION Expiration Date: u/ZI ��s i Complete legal description SKY RANCH ESTATE S/D #1; LOT 1, BLOCK 5; i Location (site address or directions) 5710 WHISPERING SPRUCE Current Property owner(s) ETHELYN YATES I Day phone 345-2162 Mailing address 5710 WHISPERING SPRUCE'DR. 99516 Lending agency Mailing address Real Estate Agent Mailing address MICHAEL PIKE w/ PRUDENTIAL VISTA 4241 "B" ST. ANCHORAGE,IAK. 99503 Day phone Day phone 529-2400 i Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 j 3. TYPE OF WATER SUPPLY: 1 TYPE OF WASTEWATER DISPOSAL: I Individual Well ® Individual I On-site El 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 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 engineers 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 j 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 riles 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 ALASKA WATER & WASTEWATER CONSULTANTS. INC. Phone 337-6179 Address 6901 DEBARR ROAD. SUITE 2B • ANCHORAGE. AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date I , tJ Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, 400�00p 0 conscientious engineering analysis of the system in accordance with ADEC and MOA o Q DSD Guidelines 8 Regulations. The reported results described the performance of the op �F! • SOQO system under the conditions encountered at the time of the test, and separation 0 - •..'�- distances measured to readily identifiable features. The operational life of all wells and OQ_ '••�¢�� septic systems depend on the local soils condition, groundwater levels that may . • • • • • • • • • • • • • • • • • • ! fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test 0... :.... results do not guarantee future performance of the system, nor do they guarantee that OOP A. Garn ss.- a there are no hidden defects or encroachments. AKW WC, Inc. can therefore not provide Q o C 7 53 e p any warranty or future estimate of how long the system will continue to meet the q�co0 operational requirements of the ADEC or MOA DSD. The content of this report is for 4�0°°a,otessto�°oma the sole benefit of the owner listed above. Any reliance upon or use of this report by any 1�COO0000 other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stiputetions: y ON-SITE ct ; Z. W,ATE AND Attachments: i HAA Checklist Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other By: Original Certificate Date: 1/Z (Rw. =) Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water b Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 www.cLanchorage.ek.us (907)343.79W HEALTH AUTHORITY APPROVAL CHECKLIST LegalDeacAptiwt: SKY RANCH ESTATES S/D N1: LOT 1, BLOCK 5: Parcel ID: 015-301-37 A. WELL DATA *PER 1971 INSPECTION REPORT Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 1971 Sanitary seal (Y/N)4- Total depth '213 R. Cased to 40+ ft. FROM WELL LOG Date of test N/A Static water level N/A ft. Well production N/A g.p.m. WATER SAMPLE RESULTS: Well Log (YIN) NO Wires property protected (Y/N) YES Casing height (above ground) + in. AT INSPECTION 11/05/02 ft. 1.36 g.p.m. Coliform 0.0 colonies/100 ml. Nitrate 0.6 mg./L. Other bacteria N/A colonies/100 mi. Arsenic: 0.00220 mgJL. Date of sample: 11/14/02 Collected by: AKWWC, INC. S. SEPTIC(HOLDING TANK DATA Tank Type/Materlal HOLDING/STEEL Date installed 7/97 Tank size 4000 gal. Number of Compartments ? Cleanouts (YIN) YES Foundatlon cleanout (YM) YES Depression over tank (YIN) NO High water alarm (YIN) YES Date of pumping N/A Pumper N/A C. ABSORPTION FIELD DATA N/A Soil rating (g.p.dJft'or ft'/bdrn)_ System type Length Width Total depth ft. Eff. absorp Date of adequacy test ft. Gravel below pipe ft. fe Monitoring tube _ Depression over field Fluid depth in absorption field before test _ in. Water Elapsed Time: _ min. Final fluid depth _ in. Absorption rate For 3 bedrooms New depth _in. Any rejuvenatlon treatment (past 12 mo.) (YM & type) If yes, give D. LIFT STATION Date installed Size in gallons "Pump on" level at _in. "Pump off E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankilift station on lot N/A Absorption field on lot N/A Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank 75'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field N/A Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 75'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water service line F. COMMENTS G. ENGINEER'S CERTIFICATION Building Wells on adjacent kits Driveway, paridnglvehide storage I certNy that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS "0:a Y7953' Date I /c73 �•^�°1Pr.r..sw� � 1 HAA Fee $ 375' Waiver Fee $ Date of Payment — 17— Q3 Date of Payment Receipt Number 3D 2i5 e -,I. Receipt Number (Rev. 12101) E Town ........... MORE am MMMW t IV ,f7 Town ........... unjs)pjU ' -- MORE am MMMW unjs)pjU ' -- REQUEST FOR APPROVAL OF INDIVIDUAL~ATER AND SEWE~~IES DIRECTIONS= Complete all parts on page 1, Incomplete reques~ will not be processed, Please allow ten (10) days for processing. , ~ PHONE 1. PROPERTY OWNER ~ MAILING ADDR'ESS P~OPE~TY ~$1DENT {If different fr~m above) · · - PHONE PHONE 2, BUYE~ MAlt. lNG ADD~E~ MAILING ADDRESS ~ ~ ' ~ / PHONE MAIUN~ AP6ff~S~ 5, LEGAL I~SCRIPTION 3T/~.EET LOCATI ON TYPE DF~IDENCE [~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROCMS [] One [] Four .. .~wo [] Five hree [] Six [] Other 7. WATER SUPPLY [~ INDIVIDUAL* [] COV1MUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE~* [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells ~ rilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) .g...~ ~./ **If individual/on-site, give installation date/??J~. If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. , 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONL~ ' · DATE RECEIVED . ' INSPECTION APPOINTMENTS . , TIME TIME ----' TIME -- '~ATE DATE DATE TCISPECTO R l NSPECTOR INSPECTOR DIRECTIONS; 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE E~ FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2, WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY [] PUBLIC UTI LITY DATE DRILLED Connection Verified_ LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified -- INSTALLER []Septic Tank or []Holding Tank Size, ~E~) If Tank is homemade SOILS RATING - give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank AbsorptionArea ISewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest t.ot Line [~APPROVED FOR . _~ BEDROOMS [J~ONDITIONAL APPROVAL (letter must acc. l~l,~pany certificate) 72-010 (Rev. 3/78) Date ALAS' "EPARTMENT OF HEALTH AND SOCIAL ICES DIVISION OF PUBLIC HEALTH Lab. No. _ BACTERIOLOGICAL WATER ANALYSIS Office PLEASE MAIL RESULTS TO: NAME. ADDRESS CITY ZIP CODE __ Sample collected by. Phone No, Date Collected Sampling Address Time Specific place of collection REASON FOR SAMPLE SUBMISSION: [] Illness suspected [] Health Regulated Establishment [] Other WATER SAMPLE SOURCE [] Well Type of casing __ [] Improved (Enclosed, Covered) Spring [] Surface (Reservoir, stream, lake) [] Holding Tank [] Other Sanitarian's Signature: Analysis shows this WATER SAMPLE to be: [] Satisfactory [] UnsaQsfactory [] Questionable [] submit other sample [] Sample too long in transit to indicate reliable results. Sample should not be over 48 hours old at time of examination. [] Bottle broken or leaked in transit. [] Other SANITARIAN'S REMARKS ~7EAD INSTRUCTIONS _BEFORE COLLECTING SA~ 06-1220 (b) Bev, 1978 Date Collected ' / '" ' · " Date Received.. " - ; ' BACTERIOLOGICAL WATER ANALYSIS RECORD Presumptive 24 Hours 48 Flours Confirmatory 24 Hours 48 Hours EMB Multiple Tube Report: Membrane Filter: Direct Count Verification: LTB. Final Membrane Filter Resu'lts, Reported By ' Source Time Received ~,~ ? ';p.m~ Lab( No, Broth 24 hours: Broth 48 hours: 10mi Tubes Positive/Total 10mi Portions .Coliform/lO0ml AU~$ust 1, 1978 Oscar Lar lvi..re Dox ].627 SRA Anchorage, Alaska Subject: Lot 1 Block 5 ,~kf Ranch Estates )~on~e~ are es~rowe(l 5'emporary approval ~-,~ay be granted if ' for the following,~ lo Ui,'~qrade the existing seepage area. Tl~e up~rad~ ~,~ould incl~a(~e includ~ 3~ feet of tronoh '._~ith 6 zeer, of gravel beIow th the ~rain pipe. The excavation shoilld, be no de~l?~r than 10 feet. 2. Install a cteanout to the septic tank. · " 12 i~che~ above ground level. 3o Raise t!~e ~,~ell casing ~ Ail the items mention~l sho'uld be complet(~-d by August 30, 1979. A permit has been issued for the upgrade. l'f yo%l hav(t any further ¢~%estions call t:his office a't 264~-4720. Robert C. Prat:t R o So ,~anttar3-an 'ilCP/daa July 31, 1978 R&M No. 851569 Alaska Mutual Savings Bank 601 West 5th Avenue Anchorage, AK ATTN: Alan Ward/Larviere Property RE: Adequacy Te~t on Existing Sanitary Sewer System; Lot 1, Block 5; Skyranch Estates Subdivision; Anchorage, Alaska. Dear Mr. Ward: Per your request of July 21, 1978, we conducted a test of the sanitary sewer system on the above described property. The septic tank had been pumped prior to the test. During the test the liquid level in the crib was measured before and after the addition of 100 gallons of water. The total depth of the crib was 8.7 feet. All liquid levels were measured below the top of the standpipe and are summarized in the following table~ Liquid Level Before Water Added Liquid Level After Water Added Total Rise in Liquid Level 4.7' 4.0' 0.7' The water level rose 8.4 inches with the addition of 100 gal- lons of water, indicating an acceptance rate of 11.9 gallons per inch. Twenty-four hours later the liquid level was again measured and found to be 4.7 feet. It had dropped .7 feet or 8.4 inches. This indicates an average effluent acceptance rate of 100 gallons per day for the surrounding soils. If the 3 bedroom residence on the property is to house 6 people, the average load on the system can be expected to be 450 gallons per day. We can therefore conclude that the system is not disposing of effluent at an adequate rate for a 3 bedroom residence. Alaska Mutual Sav~lgs Bank Page 2 July 31, 1978 We appreciate this opportunity to be of service to you. Please contact us if you have any questions regarding this letter or we can be of additional service to you. Very truly yours, R&M CONSULTANTS, INC. Lynne Kosikowski Staff Geologist Gary .~mlth Proj~'ct Manager GS:LK/dkd Enclosure Fedaral l~uil(li 399 /\[mhorac,'~-~, &l~ska Sub,iect;: Lo'i: I, I~loxk 5, Sky Ranci~ Es'~at, us Subdivision. Gert'i;] e.r~lc, n: Public sewer and wa[:er are not availab'lc Co tile subject .sO ~;~1~I[; '.~(:',l~qC ~IS)uS,]] lilU5~ be Uy ' ~" and ','/a~er sup?ly !;rov'i,:icd by individual well. Soils iule. Ne currently do no~ nave w~'I1 il]formation on Chis subdivisioh, S i n (:i: r.'.] '1 y, .~:~l[Or l:ilVJ rC, il~';l:~ii'Ca] '.heC I~1] isl; cc: i)on Hail/ st