Loading...
HomeMy WebLinkAboutGLENN VIEW ESTATES NORTH BLK 1 LT 17Glenn View Estates North Block 1 Lot 17 #051-821-30 Municipality of Anchorage Page 1 of 3 Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.el.anchorage.sk.us (907) 3417904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO40064 PID Number. 051.821.30 "7piS inell Homes Wastewater System: New A�: 1900 W. Northern Lights, Ste. 200 Anch., AK 99517 ABSORPTION FIELD 3 4-5678 " F ' 5°"" 5' Wide Trench LEGAL DESCRIPTION sa+ Rmlq Tow D*W *an orq r pb« .6 GPD/Fe 5 Ft. 81x Lot Bbdm Deph bpwM ham Wpm! grate. Gf. Mph h« nP" 1 17 Glenn View Estates North 2 FL 3 Fl Tawl«Iq: Ralgo: is m FA weMe rho. W" Vim. 45 mI L«pth: 1.3 FL 152 Fl. Well: AWM Water System .wI vnae. 5 Nw a I.»A. 2 D�Mrr" h«...n t.«.. >10 FL FL clpiiwf h (Pm«s. A B. CF TaM DeprrtCa rx aW am po «K pt I«W. Fl. Fl 1,310 Ft ASTM 3034 PVC prlM«: DM* DNW Smit W«« Lw ; Fl Pisano's Dirtworks 14Z209Z20Z4 ."" PWVbet ic `"WV H.Vt Aha Gta TANK GPM FI. Fl SEPARATION DISTANCES Septic To From Septic Tank Absorption .Field Litt Station Holding Tank ubtivPrivate sewer Line - Anchorage Tank r 1,500 vm >200' >200' NIA WA >25' Steel Two (2) s,on= Watt, >100, >100, WA WA LIFT STATION — NONE ON LOT Lau» >5' >10, WA WA Ga, Fordtllan >5' >10, WA WA � ..««« h h in, None Noted w M..aMwN iwv"hrpW p«+ &f.. cnanD.: BENCH MARK Finished Floor. 100.0 FL Engineees Stamp .���aaaag1 OF psi �P� ,,...__.,,,�• GJ�F ♦t �. Inspections performed by: T. Kimbrough Dates: 10 4129104 'i 49th 00 2n 4129104 Department of Health and Human Services approval j pn t MICHAEL E. ANDERSON 1 « •02: % r . No. CE-4381 ��lf ` : pFp`"�. Reviewed and approved by: ate: [Rw. rovpi �e -"� �.• 444 �FESSI�P.� aaaaaaaa��� t IF alxlalxlxl-ixpplm G ------------- 15'T.&E ESW. W O SHADY SPRUCE DRIVE____ A O " s l to m c � F� m Z m NO �s dIo Q —I < ms3m o N m $�?o• o V Z p � � Of U) 0 N y G �. m n SOD BmN 0 P. � m O m Z1 Z N ------------- 15'T.&E ESW. W O SHADY SPRUCE DRIVE____ L A O " l to m c � Q7 m Z m NO mz dIo Q —I < ms3m o _m m $�?o• o V a �Nlu p � � Of U) 0 N y G �. m n SOD BmN 0 P. � m O m Z1 M o L Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Page 3 of 3 Permit No. SWO40064 PID No. 051-821-30 93.1+- U x Geotextite r11 Dralnfietd Rock x H P n X U 290.25 onn X93.11 PROFILE AS -BUILT MEL E. ANDERSON No. EE -4381 ._ uiviw ..•• c ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX MEMORANDUM DATE: April 22, 2005 TO: Jeff Poet FROM: Mike Anderson, P.E. SUBJECT: Lot 17, Block 1, Glenn View Estates North Subdivision Certificate of Health Authority Approval The absorption trenches on the subject lot were placed in an east/west direction rather than the north/south direction as designed to accommodate the revised location of the new house. The lot is very flat and the trench alignment could have been in either direction and still remain parallel with the contours of the ground. Additional test holes were placed to verify the soils in the location of the new absorption trenches. These test hole logs were submitted with the as -built. The additional pipe shown on the property was a monitor tube for one of the test holes. It has since been removed. There is no lift station or high water alarm in the septic system on this lot. The Health Authority Approval Checklist has been corrected. Please advise if further information is required prior to issuance of the Certificate of Health Authority Approval. -\ Municipality of Anchorage • -- Development Services Department *A1 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 SUBMITTAL COMMENT SHEET To: Mike Anderson Legal description: Glen View Estates North Block 1_Lot 17 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results Inadequate. ® Discrepancy in information submitted. Trenches were not Installed perpendicular to drainaae pattern ❑ Topographic information missing or inadequate. ® Incomplete; missing _Unidentified pipe on property. ® Incomplete; missing High water alarm checked yes on HAA. but no lift station reported ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. _ ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ❑ Other. Name of reviewer: Jeff Date: 4/7/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE. AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION- LOT 17, BLOCK I, GLENN VIEW EST. NORTH PERFORMED FOR- SPINELL HOMER DATE: 4/25/2004 PROJECT No - PARCEL ID#- TECHNICIAN: T.L. KIMBROUGH DEM EST HOLE #11 (Icet) 1 2 3 4 5 •' '< •. 6 7 8 :�..... 9 '• 10-...A 11 . . r. 12- 13- 14-' 21314 " 51617 15- 16- 17] 18 19 A: • SILTY SANDY GRAVEL DENSE GM —n D H SITE PAN SEE SITE PLAN k WAS GROUND WATER ENCOUNTERED? No IF YES @ WHAT D[PIFR r FLAT DEPTH OF WATER AFTER MONTTORINO: 5/I/�L yytCi( DATE OF MONTTORINO: BOTTOM OF HOLE DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DWATERF (INCHES) NET DRO (INCHES 4/29/04 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 12:23 10.5" 2 12:53 30 8.25" 2.25" 3 12:54 10.5" 4 1:24 30 8.5" 2.0" 5 1:25 9.75" 61:55 30 7.75" 2.0" PERCOLATION RATE• I�/INCIi) FERC. HOLE DIA. CHES) TEST RUNBETWEEN:—§—YT. and --§ —FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE- 4/5/2005 • MUNICIPALITY OF ANCHORAGE • •••g&V*% uaay • • DEVELOPMENT SERVICES DEPARTMENT - •� P�E"'•••.., 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 Fi• ,'+ �•�. 4/29/0 z 4 th SOILS LOG - PERCOLATION TEST 1 :�t`IONEI. E AHOCRSGN��: LEGAL DESCRIPTION' LOT 17 BLOCK I, GLENN VIEW EST. NORTH •/•U• No. a �3s1�/'�: PERFORMED FOR' SPIN Lt HOMES••• atat,OESs,�:•.• DATE: 4/25/2004 PROJECT No T.L. KIMBROUGH ProTnsima En Me•z. Stam PARCEL ID#- TECHNICIAN: 12:41 DEPTH TEST HOLE # 2 7.25" (fee) OB/OG SLOPE SITE PAN 12:42 10.5" 2 y: 3 1:12 4 -n S 8.0" 5 •� % SILTY SANDY GRAVEL . r •, SEE SITE PLAN k C is•N DENSE 5 6 GM •d 7 8 1:43 30 7.25" 9 •.''''• WAS GROUND WATER ENCOUNTERED? N_ 10 ' :, IF YES ® WHAT DEPTii7 A'.4DEPTH OF WATER AFTER MONTTORMG: /1/ L FLAT DATE OF MONITORING: W'I :• 12 y A•'• 13 14—:.,,.: 15 ;. 16 BOTTOM OF HOLE 17 18 19 20 PERCOLATION RATE• 12 (NiNANCH) PERC. HOLE DIA.�INCHES) TEST RUN BETWEEN:�T. and —L—FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE' 4/5/2005 DATE READING GROSS TIM (MINUTES) NET TIf-�E (MINUTES) WA7ERF (INCHES) NST DROP (INCHES) 4/29/0 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 12:11 10.0" 2 12:41 30. 7.25" 2.75" 3 12:42 10.5" 4 1:12 30 8.0" 2.5" 5 1:13 9.75" 6 1:43 30 7.25" 2.5" MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040064 Legal Description: dGlennview Estates North Block 1 Lot 17, Design Engineer: 0014 Anderson Engineering Owner Name: Spinell Homes, Inc Owner Address: 1900 W. Northern Lights Blvd., Ste 200 Anchorage . A 99517 - Ljjz9joq-1z In' 3 Pr" Date Issued: Apr 19, 2004 Expiration Date: Apr 19, 2005 Parcel ID: 051-821-30 Site Address: 22433 Shadowy Spruce Drive Lot Size: 0 SO. FT. Total Bedrooms: 7 S Permit Bedrooms: This permit is for the construction of: ❑✓ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. EE,,,ej EK s�6l.t++ep Ars,9„I c6 noes 4a scri;c sysrE.-I_ %%e Ne.v Re v,sED DEV7AJ r_4AA,'ES fiRE 'Fon ^ S 6EGZpp„ Nous E. F.VI"Ueet will co-udvof 7 -CS -r NaIE> /VEEP o/uvrlry eoNf'/n.u,j:on) Of 5EP7.c sysrrt.. Received By: Date: A I zo t Issued By -.V Gr_ 1 1 ' Date: y I f o Municipality of Anchorage • -tel 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. nSl " �iZ f 3� Permit Number SW Property owner(s) Sainelt Homes, Inc. Day phone 3445678 Mailing address (1)1900 W. Northern Lights Blvd., Suite 200 Anchorage, AK 99517 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) _Lot 17, Block 1, Glennview Estates North Subdivision Legal description (Section, Township & Range) Lot Size 40,006 SF Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Three (3) Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. C-. (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment: `i Im Date of Payment: Receipt Number: Receipt Number: (Rev. 12/00) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMO DATE: 4/2712004 TO: Lot 17, Block 1, Glennview Estates North Subdivision WITH: MoAIOn-Site Water and Wastewater FROM: Mike Anderson SUBJECT: Lot 17, Block 1, Glennview Estates North Subdivision Septic System Permit Number SW040064 The homeowner has upgraded the house proposed for this lot to 5 bedrooms. We have revised the site plan and design for the septic system accordingly. Additional test holes will be placed prior to construction to verify the subsurface soil conditions on the lot. Please modify the permit to allow for a 5 bedroom septic system on this lot. Please let me know if you have additional questions. si ,Iti 6Sl 3,YY,6l b0 S 'I rqm m _ I 4 I o- . 0 m +SCO � his Yi1 —r OD xs I m (f) z ---------- -T---- 70 O / 1S' T. & E. ESWT. e w N 00'Ol'56Yl 181.39' • W O SHADY SPRUCE DRIVE pi of ,� kms'• •A�i, = x iI � i ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX April 16, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 17, Block 1, Glennview Estates North Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 17, Block 1, Glennview Estates North Subdivision intends to construct a three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home. The subdivision is served by a community water system and no conflicts exist with adjacent septic systems or wells. The attached Site Plan and backup documentation identify the location and configuration of the proposed septic system and alternate site. Existing spot elevations and the current drainage pattern are identified on the Site Plan. The drainage pattem 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 17 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 1,000 -gallon septic tank along with 2 - 44' 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 17, Block 1, Glennview Est. North April 16, 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 trench will be constructed parallel with the slope of the ground surface as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from the well proposed for the lot and on adjacent lots. It will also be constructed a minimum of 100' from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: 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 W MICHAEL E. ANDERSON No. CE -4391 y a ,H,aS� 31Y.e1� 5 tl N c; f'l N m z 0 1 k q= $I I m m co N a €i . i 1--1 „O / I --IDI N { R T I n p -` z / 15'T. e c ESUT. a = 8 x ovarx-v 1e1a9' w 0 SHADY SPRUCE DRIVE f O n M LOT 17, BLOCK 1, GLENNVIEW ESTATES NORTH SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom House 5' Wide Trench System Perc. Rate: 17 Min.Anch 1,000 Gallon Septic Tank Application Rate: .6 GPD/SF 3' Drainfield Rock 3 Bedrooms X 150 GPD/.6 GPD/SF (Application Rate) = 750 SF Absorption Area 750 SF/5 SF *.58 (Red. Factor) = 87 LF Trench Length THEREFORE: Construct Two 44' Long x 5' Wide x 3' Effective Depth Absorption Trenches. Flow Line Elevation in Trench to be 1' Below Original Ground Surface. Total Depth to be 5' 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. Natural Backfill Geotextite 6" Fabric 6" 4" Perforated PVC (Holes Down) 37 Drainfield Rock 5' 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. i Minimum 10' Separation From Water Services in the Area. Minimum 100' Separation From Surface Water or Streams: re Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 Ww .ci.anchorao ae k.vs (907) 343-7904 Soils Log - Percolation Test / LSF,,��NGINEFR Performed For: G L E N V I i� vU N �'RT N Date Performed: Legal Description: Lo i:J 'dK Township, Range, Section: 0 1. 2- 3- 4 5- 6. 7 8- 9- 10 11- 13- 14. 15- 16- 17 18- 20 - COMMENTS SATjb-j 5,L:,-- ML 1LjML Saat!Ay 5:14 w/rata • "a,z'N Ml_ DOT TOM of 140LEE' WAS GROUND WATER ENCOUNTERED? - 1 a Gross Time --.LAI S IF YES. AT WHAT DEPTH? t Depth to Water After Monitoring? D F St}� E Date:J 2V�OZ Reading Date Gross Time Net Time Depth to Water Net Drop FlI_t_ E St}� -3� 1)tz O2: z: 4s — ,i:l- 3 �� a pERrfx anrw Reye / TEST RUN BETWEEN 3 FT AND�L _FT PERFORMED BY: PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. THATDATE. T (Ii WA PERFORMED ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 17, BLOCK 1, GLENNVIEW ESTATES NORTH SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,000 -gallon septic tank at the location shown on the Site Plan. Work also includes the construction of 2 new 44' long X 5' wide X 3' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at V below the existing ground surface. Total depth of the trenches will be 4' below the existing ground surface. A flow diverter valve must be placed to insure even flow to each trench. The new septic tank and absorption trench must be placed a minimum of 10' from the water service on this and adjacent lots. In addition, a separation distance of 100' must be maintained between the septic tank and absorption trench and any surface water. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,000 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 17, Block 1, Glennview Est. North April 16, 2004 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield area 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 17, Block 1, Glennview Est. North April 16, 2004 Page 3 of 3 MATERIAL SPECIFICATIONS: Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, 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. 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. JQci�� �My Municipality of Anchorage -Y Development Services Department e Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 51.821.30 HAA# (150131 Expiration Date: % .5" 1. GENERAL INFORMATION Complete legal description Lot 17, Block 1, Glenn View Estates North Subdivision Location (site address or directions) 22433 Shadowy Spruce Drive Current Property owner(s) Soinell Homes, Inc. Day phone 3445678 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 1900 Northern Lights Blvd. Anchorage, AK 99517 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Five 5 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site 19 ❑ Individual Holding tank ❑ ❑ Community On-site ® Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) 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•TT73 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 4152005 RUI iiiaa«o c wmrx 5. DSD SIGNATURE •i:' *,."No a-.� _,Z Approved for r bedrooms. �ee�ej,," Disapproved. Conditional approval for bedrooms, with the fo`owing stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: _4 04& �.C�, �Original Certificate Date:— (Pe .12IW) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 198850 Anchorage, AK 995196650 www.ci.anctwrage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal - • I • ,•1 17, Block 1. Glenn View Esiates \ • [11 •moi. • ,Al-fiD 1 A. WELL DATA Well type _ If A, B, or C provide PWSID � _ Well Log (Y/N) Date completed _ Sanitary seal (YIN) _ Wires property protected (YIN) Total depth R Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Static water level R R Well production 9.p -m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mi. Nitrate mg.A. Other bacteria oolontes/100 ml. Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material SeWdSteel Date Installed 4011M Tank size 1.500 gal. Number of Compartments I Cieanouts (YM) Y Foundation cleanout (YM)1I Depression over tank (Y/N) ff High water alarm (YM) : p Data of pumping Pumper New Construction C. ABSORPTION FIELD DATA Data installed 4012M Soil rating (g.p.d he or fe/bdnn) .S GPDf$F System type S WIde Shallow Trench Length 152 ft Width S R Gravel below pipe 3 R Total depth 6-8 R Eff. absorption area x.310 R= Monitoring tube Y Depression over field tq Date of adequacy test Results (Pass/Fall) 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.) (YM & type) N If yes, give date D. UFT STATION Data installed 'Pump on' level at _ in. Datum E. SEPARATION DISTANCES Size in gallons 'Pump off" level at_ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO Manhole/Access (Y/N) High water alarm level at in. Meats alarm 8 circuit requirements? Septic tankHift station on lot WA On adjacent lots WA Absorption field on lot WA On adjacent kits WA Public sewer main WA Public sewer menhole/cleanout WA Sewer /septic service line WA Holding tank WA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >T Property line> .1 Absorption field >S Water main >10' Water service line >10' Surface water XIV Wells on adjacent kris >200' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >17 Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway. part ingNehide storage >S Curtain drain None Noted Wells on adjacent kris moa F. COMMENTS G. ENGINEER'S CERTIFICATION����p1;� ^�.••• e , I certily that I have determined through field inspedhns and Cu ; � review of Municipal records that the above systems are inr 49th conformance with MOA HAA guidelines in effect on this date. &� t ; rmuri c wmcamr Engineer's Printed Name Michael E Anderson. P.E. Vim;' ; No. a-4= ` Data 115!2003...... C eW_q��i f.9—NXI" Date of Payment Receipt Number (rev. 1200) Waiver Fee $ _ Data of Payment Receipt Number Z v = O D m � m D v m In, OD co (rN==C -P 4. (O. M . m m = c >;gin =i In'0 - z D -Nip'-D�G'""1 n0= n CCOOOm;o� 1z��omm. m = C:z D=D�m z � =moo-z+mm=�j o zm zN Ar. O C.) .m oc--10=0zm� o A wmnmMmm--i n z n Ova ;imx zmmj U mo-Ni0�Nmxv� N v ��PLO�m-FI--i�> N z A n 0- n{ m o_ g �z�'vzmoom= Jl m�pc�o i-lzzm zccv=�z y _11 m�o�c��.m�=c ym o -< z o m� n z m O>OZo �000 = ;u V. � m ** ILUMitf ���`°9� s ; • • '*ST �1 . •., q� �: :A••: Ar ■ ' • P : :O M D J _ %• ,• Ar♦ •40,41 INFO•' •' : 0 t0,ot z r En M C: 0 c A m m c E, 0 W O SHADY SPRUCE DRIVE _ D n D z r z D Q D J _ �1 OY O m 0 UD Q C)