HomeMy WebLinkAboutMANN BLK 3 LT 1AMann
Block 3
Lot 1 A
#020-041-05
y Municipality of Anchorage
Department of Health and Human Services
Building Safety Division
On-Site Water and Wastewater Program, 4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519.6650 Pagel of 4
www.d.anchorage.ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW SW0302170 PID Number: 020-041-05
Nacre:
Johan nuer'ninti
Wastewater System: ® New ❑ Upgrade
Address:
ABSORPTION FIELD
Phere: Nueeer Of Bedroarr:
144-7757
O Deep Tremh ® shmow TwMr O Bed O Mound D Other:
LEGAL DESCRIPTION
sa Rabng:
Tcl* Depth from morel grade:
Bork: L*: &AGM*":
Depth b Pipe bmorn from odgMal grade:
Gravel depth beneath p'pe:
Towwwp: Range: Becbm:
FA added above mdnel grade:
Gravel Length:
Well: ®❑ Upgrade
New
G a * w O n.
Nu Ae *Mea:
qs erKa DeMeen tines:
Ctasalicabon (Pdvete. A 8, Q:
Prival
Total Depth:
.107
cased to:
Ila
Tdel abaerpeon oma:
750 F?
Poe Materiel:
3034 PVC
Dnnx
Alpine Drilling
Date Domed:
914120�
—F,
stabs water Lav*:
WM~.
Const.
Date horned:
91712003
YMId:
Perp S* *: Q*ng 11elgM ADMe GMU M:
2.5 Geo
F,. 2 Ft,
TANK
SEPARATION DISTANCES
❑ Septic [:]Holding O S.T.E.P. Q Other.
To
Septic
Absorption
uft
Holding
ubno ovate
M-0-t—
capaetr
Fran
Tank
Field
Station
Tank
Sewer Lina
Anch Tank
1250"
wen
207.3
211.8
210
95
Material:
N nt d0aps1nMn131
Steel
2
sadaawaten
100+
100+
100+
LIFT STATION
L° n'
23.3
21.0
23.3°
250 cel.
lae"d""""
Orenco
FaaM*en
118.6
155
128
p"'°m•"""t:
Two err Wet M:
high water "M at:
44 M
41 M
46 M
codon oran
100+
100+
100+
Nnp Make&Model
posil
Eleddcal hapecaae Wont ed tr.
Green
Renerks:
—Mike
2e Rigid Insulation over field
BENCH MARK
Loabm and Deampum:
Back Door Threshold
Assured FJevabm:
150 FL
Engineer's Stamp
'&����wwaaa,
•••••�.
Inspections performed by: Pannone Eng. SVC Dates: 1"8/6/2003
� �:� Q�TH � � ��
2nd08/07/2003
er.....7 ... ..........I.....00
Department of Health andf Iluman Services approval'
,
•' "......•••...
♦ fk :Steven R. ;Jnrone.-'i
Reviewed and approved by: Date: it
(rsev. toss)
�� °• No. CE P/J49 •'C\w.
.r
♦##aes551�� ���
PERMIT NO- SWO30170
I I
I
I I
I
I SEPTIC
I AREA
I
I I
I
I
EXIST'd
WELL 11
Cl\
4
AS -BUILT
WASTEWATER ABSORPTION SYSTEM
LOT IA, BLOCK 3 MANN S/D
4
RESERVE FIELD
2EA, 73'x5'x0.5'
1 I
�II1I1II�IIi
FI LS
�n� F2
III IIITFqIIl
TF4
14.7
F3
I I z
1
I I
I
I NO WELLS OR SEPTIC
I I WITHIN 100 FT OF
PROPOSED WELL
R.
EXIST'G
� WELL
162nd AVE
P.I.D. NOt 020-041-05
LA
Q
SEPTIC
AREA
1B
I
AREA
LIJ
` 9
BR
MANN.DWG Cl
y
10 .8
a
C2
108.5
10.0
DESIGN.,
SA1
TI
118.6
118.4
4 BEDROOM HOUSE
T2
J
125.2
PERC RATE 9 MIN/IN
IJJ
128.0
SEPTIC
AREA
1B
I
AREA
CO
A
B
MANN.DWG Cl
105.9
10 .8
C2
108.5
10.0
DESIGN.,
TI
118.6
118.4
4 BEDROOM HOUSE
T2
125.8
125.2
PERC RATE 9 MIN/IN
LS
128.0
127.3
SOIL RATING, 188 SF/BR
Fl
143.8
142.6
750 SF ROD
F2
163.7
161.9
5 -WIDE TRENCH, 0.5' EFF. RF=1.00
0
io
F3
155.3
138.6
TOTAL DEPTH = 2.0'
0
F4
172.9
157.1
150' LONG,TOTAL AREA=750 SF
PREPARED FOR,
PANNONE ENG, SVC, LLC
Mr. Johan Overland
P. O. BOX 102954
7500 Old Seward
Anchorage, AK
Highway
99518
ANCHORAGE, ALASKA 99510
(907) 344-7757
272-8218 Phone & Fax
DATE, 8-24-03
AS -BUILT
PERMIT NO, SW030170
AS -BUILT DETAILS
WASTEWATER ABSORPTION SYSTEM
LOT 1A, BLOCK 3 MANN S/D
M
Ln
m
1nONV31O
C1\Work\DRAWING\IA-3MANN.DWG 1nONV313
R.
Mr. Johan Overland
7500 Old Seward Highway
Anchorage, AK 99518
(907) 344-7757
1nONV317
NOILVaNn0!
P.I.D. NO, 020-041-05
S
U
Z
W
U F
W =
U
N W
PANNONE ENG. SVC., LLC
P. 0. BOX 102954
ANCHORAGE, ALASKA 99510
272-8218 PHONE & FAX
1T Q 8-24
pT Tp SC LE DESIGN
- 4DESIGN
ina
c
c
a
+
W
0.5 da
Z0.
z
d
W
Ix z
tl
y
y
~
LQ
L
$A
W
O
V
T
H
J
C3�
1� 7)
O
of
c
Z
�z
v�
d
C7
L
.J-. A
�„�
A
<U
W
P"QN3
HOV3 ltl
39nl 21011NOH
Of
U
LLI
W
a ,
W N
N
m
H
C3
30
z
Qa
a a
Vi
J
cc
m
LLj
044
W
W
r -
1nOP
a
?
0.5
3
o
'
N
Lai
a
�
N
N
ri
I
CD
1nONV31O
C1\Work\DRAWING\IA-3MANN.DWG 1nONV313
R.
Mr. Johan Overland
7500 Old Seward Highway
Anchorage, AK 99518
(907) 344-7757
1nONV317
NOILVaNn0!
P.I.D. NO, 020-041-05
S
U
Z
W
U F
W =
U
N W
PANNONE ENG. SVC., LLC
P. 0. BOX 102954
ANCHORAGE, ALASKA 99510
272-8218 PHONE & FAX
1T Q 8-24
pT Tp SC LE DESIGN
- 4DESIGN
FROM : RLPINE DRILLING
FPN NO. : 907 345 0202 See. 01 2003 02:46PM P2
Municipality of Anchorage
Department of Health and Human Services
825 V Street
P.O. Box 19(3650 Anchorage, Alaska 9961MO53
heo:rr•wvdeMChomya.&c us
Permit Number. *SW 020144 Date of Issue: 6-4-02 Parcel Identification Number: 0
Date Started: 9-4 Date Completed: Is well located at approved permit location? 9yleSE No
legal Descriptio■: Mann Blk 3 tt 1A
Property owner Name & Address: John Overland
7500 Old Seward HYK
Anchorane Alaeka no -in
Borehole Data:
Soll'type, Thickness sit Water Strata
Depth (it)
From To
Method of Drilling Flair rotary ❑ cable tool
Casing typo steel
stick-up
0 2
Wall Thiclmess: IN incites
gravelly slit
2 18
Diameter: Q inches Depth: La feu
Bedrock
18 187
Liner Type:
Diameter. inches Depth: feet
Casing stickup above ground: 3 feet
Static water level (horn ground level): ,Zfeet
Pumping level: -J_87 feet after
Z hours pumping LA gpm
Rmwery Rate: L2 Spm
Method of Testing: pir
Wall Intake OpeningTypr.
❑ Open End ® Open Hole
❑ Screened Start fat Stopped feet
❑ Perforations Stan feet Stopped feet
Grout Type: lgNgniik * 8 Volume: l hgs
Depth: Stan D fat Stopped feet
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Compledoa? ® Yes ❑ No
Method of Disinfection: ghlorme tablets
Comments:
Well Dt11br. Alpine Drilling & Ertteryrlses
PO Boz 110496
Anchorage Alaska 99511
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
..................n a.116...s.11 .....:1.. .. J.. •1... .rTV..Ul. O .c...... n._..... ..•...
FROM :JOR4 WGIMER NaES FAX NO. :9072486434 Nov. 02 20ar 09:32P.1 P2
�.r
� L•i
A18StFax 10128l200b 4:04 PACE 111 Rlghtlax
"Unklpallty of Anohe , AWlrih/ go"4YQGOlvltiO:1
Imow
UWPBCMMI VQSCI 343-8300 lPWPWMNl r#X (VgnZ4MT77 IMPO1843-7003
t4snlo
Addrue
Legal
OukdlVlOw
Commonte or Dirocdom
2kr1'4 MW= / clq
16200 t'iMBM ST
BK 3 LT 1A
MANN
P"ll oz -0791
Mesa 441.1058
441.3559
zopoellon Data 10/30/2003
Inpasr:tlon o/ UR station
9nspoeved Wor nmtriwl ANn4powen Y .
NO NONCOMPLIANCE OBSEItVW
13 COPMC170NS t'.l1S MMLAS Cowh2O BELOW
0 W:LLM-DtAMINe AT.N=T C3 00 NOT CONCI AL UNTIL RGNSPB=ON
INCPEC=N
COMMar M (for kwoectoo use only)
u1CrlE �-''vr 1� f x:1,1%
LnspeetOr�f__,_-,•rL U� ?�-1--� D�h��r'�•% '%:.�
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Permit Number: SW030170
Legal Description: MANN BILK 3 LT ' 1A
Design Engineer. 0062 Pannone Engineering Services
Owner Name: John Overland
Owner Address: 7500 Old Seward Hwy
Anchorage , AK 99518 -
Renewal
Date Issued: Jun 06, 2003
Expiration Date: Jun 05, 2004
Parcel ID: 020-041-05
Site Address: 016200 ELIZABETH ST
Lot Size: 44961 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either. A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
1.) ENOUGH APPROVED FILTER SAND SHALL BE IMPORTED TO RAISE THE BOTTOM OF THE SEWER
ROCK AT LEAST 1 INCH ABOVE GROUND SURFACE TO MAINTAIN A MINIMUM OF 4 FEET OF SEPARATION
TO THE SEASONAL HIGH GROUND WATER TABLE.
2.) THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COARSE SAND WITH 4% OR LESS PASSING
#100 SIEVE AND 2% OR LESS PASSING THE #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE
SAND USED OR OBTAINED FROM AN APPROVED SOURCE.
Received By:
Issued By:
�/_/Iawjor AJZJ
Date:
• Date: 6 D
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ek.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 020.041-05 Permit Number SW 0 30/70
Property owner(s) John Overland Day phone 3447757
Mailing address (1) 7500 Old Seward Hwy. Anchoraae, AK 99518
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) Lot 1A Block 3 Mann
Legal description (Section, Township & Range)
Lot Size 44961 Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms 4
Sewer Only ❑ Weft 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.
(Signature of property owner or authorized agent)
Date of Payment:
Receipt Number: 350 / t Receipt Number:
(Rev. 12/00)
flF,uFw 6-¢ -03
MUNICIPALITY OFANCHORAGE
Development Services Department
Onsite Water& Wastewater Program
4700 South Bragaw Street
P.O. Bax 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Renewal
Permit Number: SW020144
Legal Description: MANN BLK 3 LT 1A
Date Issued: Jun 04, 2002
Expiration Date: Jun 04, 2003
Parcel ID: 020-041.05
Design Engineer: 0062 Pannone Engineering Services Site Address:
Owner Name: John Overland Lot Size: 44961 SO. FT.
Owner Address: 7500 Old Seward Hwy Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage . AK 99518 -
This permit is for the construction of:
[Vj Disposal Field [D Septic Tank ❑ Holding Tank Privy Q✓ 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.
Received By:
Issued By:
pco��- - Date:
Date: io i Lo 2
Pannone Eneineerine Services. LLC P.O.Bm10 VA
(907)227-3522 - - v - (90702-8213 Pax
May 14, 2000
Municipality of Anchorage
r
--,«1 Human Services
. '...- Gwu• �w.
On -Site Services Section
P. O. Box 196650
Anchorage. Alaska 99519
Subject: Lot IA, Block 3 Mann Subdivision
Well and Septic Permit
Gentlemen:
My firm was contacted to investigate the possibility of installing of a new system at the
above referenced property. Currently the lot is undeveloped. A single test hole was
excavated on April 13, 2000. The soil report and percolation test results are attached.
Ground water was monitored for seven days. Ground water was encountered at 12 feet
and stabilized at 47 inches below ground surface after monitoring through the spring
high water. No bedrock was encountered in the test hole.
The lot is approximately 1.03 acres in size. Lot I slopes to the west at a rate of
approximately 3 to 4 percent. The proposed installation will be located in the north west
corner of the lot on a relatively flat area. The proposed location will be greater than 100
feet away from the proposed well serving this property and 25 feet from the water service
lines. The surrounding systems are located greater than 100 feet from the proposed
installation, the lots to the north, south and east are developed, but do not conflict with
the proposed installation. The proposed installation will not impact the future
development of the surrounding or existing lots. See attached design. The new system
will maintain over six feet vertical separation to the bedrock and over four feet vertically
to the ground water. The owner is an experienced excavator, and may install the system
himself. He may install both the primary and reserve drain -fields at the time o
installation. Renewal cr-5�—
Please contact me at 272-8218 or 227-3522 if you have any
questions.�..`� ( _,44
Sincerely,
Jam.•'' Ly7 i
= #
40TW
teven R.Pannone, P.E.
00a(�Ven R. Pufmonef :
�1�'
•• t, CC 814!1
�� J
Attachments:
. ....S/?''
PERMIT NO DESIGN
WASTEWATER ABSORPTION SYSTEM
LOT 1A, BLOCK 3 MANN S/D
41
SEPTIC
AREA
EXISTS
EXIST'G
WELL
^ 'WELL
PROPOSED RESERV� FIELD
2EA, 73'x5'x0.5* EFF; 162nd AVE
PROPOSED PRIMARY FIELD
EA, 7'x5'xA5' EFF.
M<Z
>
PROSED
4 ERP13HOUSE
r
TPI
LLJ 9m
n
A%._........ . ........... ....
SEPTIC
N ARrA-".,
)ObBLE
IL
_I�POSED
CLEAN-CUTS PROPOSED I ___�PR
_j
Lli
IV E �VALVE SEPTIC TAN WELL
NO WELLS OR SEPTIC
WITHIN ice FT Or
PROPOSED WELL
SEPTIC
SEPTIC
AREA
AREA
Co\Worl<4
10RAWING\IA-3MANN.I)WG TI;7TTr.N,
I
""Milea
4 BEDROOM HOUSE
P'* OF
PERC RATE 9 MIN/IN
SOIL RATING, 188 SF/BR
750 SF ROD
♦TOTAL
5-WIDE TRENCH, 0.5' EFF. RF=1.00
492Mi
DEPTH - 2.0'
150' LONG,TOTAL AREA=750 SF
----- -PREPARED
Stepen R. Pannonei 0
FOR,
PANNONE ENG. SVC, LLC
No E 8 9
Mr. Johan Ov ertana
P. C. BOX 102954
♦
7500 Did Seward Hlghway
ANCHORAGE, ALASKA 99510
Anchorage, AK 99518
(907) 344-7757
272 -8216 Phone L Fox
DATEA 4-24-00
DESIGN
1
ISCALEt 1'=60'
rcnnat nu-
, o7 iZ� T (— A 1 7) CT A T I 'Cl ?.i.D. Nu.
WASIEWAIER ABSORPTION SYSTEM
LuI IA, BLOCK 3 MANN S/D
1 rC Lk A%'!l,
SOILS LOO - PERCOLATION TEST I�!�Pi�'" ""+�..�c-�1.
PANNONE ENGINEERING SERVICES
P.O. BOX 102954
ANCHORAGE. AK 99510
(907) 272-8218
PERFORMED FOR: Mr. Johan Overland DATE PERFORMED: 4-13-00
LEGAL DESCRIPTION: lot IA. Block 3 MANN S/D
1
2
3
4
7
8
9
10
11
12
13
14
is
16
17
is
19
20
OR
ML
BOH
Organic-
Topwil
Brown silt
Poorly Grade
Sands & Gravels
W/ little to m
811ts. Cobbles.
8' diem.
SLOPE
raormn arm
em n�
n®
TEST HOLE
w WEBS a sorra
'1r Us R w
INLTptE➢ 1x31
WAS GROUND WATER
ENCOUNTERED? Yes
IF YES. AT WHAT
DEPTH? 12'
DEPTH TO WATER AFTER
MONITORING? 4T
DATE: 5-14-00
49TH
No. CE 8149
162nd AVE
TEST HOLE
RPJ3DM DAIS GROSS
Tulm
NET
rut
DEPTH OF
WATER
NET
DROP
4-13-M 8-45
6 1/4•
—
8,55
le
51/8•
11/8'
655
6 112'
--
955
to
5 Will
1 Val
945
6 V4•
—
913
w
5 Va.
I V8'
PEROLATION RATE 9 (min/inch) PERC HOLE DIAMETER 6 Inches
TEST RUN BEW 7M 5 PT and 6 FT
COMMENTS: Test hole excavated by Owner. Test Hole Was presoaked before pets test.
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
MUNICIPALITY OFANCHORAGE
Development Services Department
On-SiteWater& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Renewal
Permit Number: SW020144
Legal Description: MANN BLK 3 LT 1A
Date Issued: Jun 04, 2002
Expiration Date: Jun 04, 2003
Parcel ID: 020-041-05
Design Engineer: 0062 Pannone Engineering Services Site Address:
Owner Name: John Overland Lot Size: 44961 SO. FT.
Owner Address: 7500 Old Seward Hwy Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage , AK 99518 -
This permit is for the construction of:
❑✓ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy Q 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.
Received By:
Issued By:
Date:
(P L�— 42—
Date: 6 Z4 G 2
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWERMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. t)qn Oc-i I a 5 Permit Number SW Oo1o/1/y
Property owner(s) 70— ka A (fit e f Ia Ad Day phone ��I -/—%7S7
Mailing address (1
Mailing address (2) !-fnir Itnfck gj Zip Code 99 s/S
If
Legal description (Lot, Block & Sub'd.) MaAyi
Legal description (Section, Township & Range)
Lot Size tlq q 6 I Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms
Sewer Only ❑ Well Only ❑
Sewer and Well Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: b�� i • O Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number: 9(Z ) %lQ Receipt Number:
(Rev. 12/00)
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SW000104
Legal Description: MANN BLK 3 LT 1A
Date Issued: May 15, 2000
Expiration Date: May 15, 2001
Parcel ID: 020-041-05
Design Engineer: 0062 Pannone Engineering Services Site Address:
Owner Name: John Overland Lot Size: 44961 SO. FT.
Owner Address: 7500 Old Seward Hwy Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage , AK 99518 -
This permit is for the construction of:
G Disposal Field Q✓ Septic Tank F� Holding Tank [] Privy Q,/ 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 DHHS at least 2 hours prior to each Inspection. Provide notification by calling
(907) 3434744 ( 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 By:
Date: �;- 6l0%
Pannone Engineering Senices, LLC
(`nnodtino engineers
May 14, 2000
Municipality of Anchorage
Dent. of Health & Human Services
On -Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Lot 1A, Block 3 Mann Subdivision
Well and Septic Permit
Gentlemen:
PD. t3rn10M
Anc"raae. Alaska. 99510
ign,_nn-82ls rax
My firm was contacted to investigate the possibility of installing of a new system at the
above referenced Property. Currently the lot is undeveloped. A single test hole was
excavated on April 13, 2000. The soil report and percolation test results are attached.
Ground water was monitored for seven days. Ground water was encountered at 12 feet
and stabilized at 47 inches below ground surface after monitoring through the spring
high water. No bedrock was encountered in the test hole.
The lot is approximately 1.03 acres in size. Lot lA slopes to the west at a rate of
approximately 3 to 4 percent. The proposed installation will be located in the north west
corner of the lot on a relatively flat area. The proposed location will be greater than 100
feet away from the proposed well serving this property and 25 feet from the water service
lines. The surrounding systems are located greater than 100 feet from the proposed
installation, the lots to the north, south and east are developed, but do not conflict with
the proposed installation. The proposed installation will not impact the future
development of the surrounding or existing lots. See attached design. The new system
will maintain over six feet vertical separation to the bedrock and over four feet vertically
to the ground water. The owner is an experienced excavator, and may install the system
himself. He may install both the primary and reserve drain -fields at the time of
installation.
Please contact me at 272-8218 or 227-3522 if you have any questions...!' '46!7_u_
Sincerely,
Steven R. Pan one, P.E.
Attachments:
PERMIT NO, DESIGN P.I.D. NOi
WASTEWATER ABSORPTION SYSTEM
LOT 1A, BLOCK 3 MANN S/D
A.
SEPTIC
AREA
EXIST'd
EXIST'G
-WELL
---WELL
PROPOSED RESERV� FIELD
73'x5'xD.5' EFI\
f2EA,
162nd AVE
PROPOSED PRIMARY FIELDX7
EA. 75'x3' F.
r
Lli
>
PROPOSED
4 ER Hcuse->�x
..............
3 \.
TPI
:.A
<
47 . . .....
N
SEPTIC
AREA
DOUBLE
CLEAN -OUTS PROPOSED I 1'
jjJ
PROPOSED
L
!!VERTER„VALVE SEPTIC TAN
m
NO WELLS OR SEPTIC
WITHIN 100 FT OF
PROPOSED WELL
SEPTIC
SEPTIC
AREA
AREA
Ct\Wot -k
11rstru,
I
4 BEDROOM HOUSE
PERC RATE 9 MIN/IN
SOIL RATING, 188 SF/BR
750 SF ROD
5 -WIDE TRENCH, 0.5' EFF. RF=IMO
492i nA0
TOTAL DEPTH - 2.0'
150' LONGJOTAL AREA=750 SF
FPREPARED
%Steven R. Pa n n
FOR,
Mr. Johan Overland
PANNONE ENG. SVC, LLC
P. 0. BOX 102954
No. I IV
7500 Old Seward HIghway
Anchorage, AK 9951B
ANCHORAGE, ALASKA 99510
%
(907) 344-7757
272-8218 Phone L Fax
DATEi 4-24
11104%ulk
DESIGN
rcnnai nu.
0
U
C W
U
2
C W
ix
N K
W
N
y O
L J
L .J-.
ar
otH W
L
11 W
U
Z Q
J
o_
orn un.
ti II.Al I& al 11
%,incTEWATER ABSORPTION SYSTEM
LOT 1A, BLOCK 3 MANN S/D
Cj \Work \DRAWING \ 13-H K N I K.D W G
z
aUN3 KW3 1V
39M. kIDIDgMU
W
C4
1
N
ri nj
i
3A1VA V31Y3AM
irX3NV=
irOW313
L1oNV313
Inm4v=
lrcNv313
NouvaNrGJ
49TM
No. CE 8 49 1" 7Johan Overland
500 Old Seward H Ahway
Anchorage, AK 99518
92ticclQ ��� (907) 344-7757
x
U
W
Uf
W U
N W
N L7
S
Z
U O
J
Ld
H n
WL:
W
W
3�
. 0
PANNONE ENG, SVC., LLC
P. ❑. BOX 102954
ANCHORAGE, ALASKA 99510
272-8218 PHONE & FAX
9F' n crni p-1 DESIGN
d
0.5
L
6
e
d
d
N
L C
L
O
J2
L
U
4
L�a
�a
e
C
d
tl
p
l� �Y
q
N
U
tEoc
D
W
O
J
W
R7
W
0.5
3
..
of
i
u
C3
H
d
IMI
fU
Cj \Work \DRAWING \ 13-H K N I K.D W G
z
aUN3 KW3 1V
39M. kIDIDgMU
W
C4
1
N
ri nj
i
3A1VA V31Y3AM
irX3NV=
irOW313
L1oNV313
Inm4v=
lrcNv313
NouvaNrGJ
49TM
No. CE 8 49 1" 7Johan Overland
500 Old Seward H Ahway
Anchorage, AK 99518
92ticclQ ��� (907) 344-7757
x
U
W
Uf
W U
N W
N L7
S
Z
U O
J
Ld
H n
WL:
W
W
3�
. 0
PANNONE ENG, SVC., LLC
P. ❑. BOX 102954
ANCHORAGE, ALASKA 99510
272-8218 PHONE & FAX
9F' n crni p-1 DESIGN
k'.
Q- AJh.3
f
SOILS LOO - PERCOLATION TEST ��%�Q " •. 111
P.4NNONE ENGINEERING SERVICES J" � � � � X11
945
P.O. BOX 102954 sm 1 49L++ s 1
61/4•
ANCHORAGE, AIC 99510
T
(907) 272-8218 1j.��jt.5teven R. Pannone
No.CE 8149
8�55
�
:=I
PERFORMED FOR.
Mr. Johan Overland DATE PERFORMED: 4-13-00 ratio,,
LEGAL DESCRIMON: Lot lA. Block 3 MANN S/D
SLOPE SITE PIAN
OR
Tom I,�vxcs s n=
I
WA"�'°' 6t\ 162nd AVE
ML
11To.Dsnt m mIU
t 1/8•
3
./•/i 1 - -v.C�� 4 W �46F
4
.:x
TEST HOLE •. _..
5-
413
6—
6
Poorly Orade i n .
1 1/e•
Bands h Oravels
7— Sp-
W/ KUL- to DoOp I
B
Silts. Cobbles, , M
B• yam, c ntwlwn '�`
2Ttlra VKVE TIC T
1R�
9
L
10
/
w0 VDLS 0e mTE
V T 0 m R V
11
I.Av¢l VOL ..-
12
BOH
A4G
13
WAS GROUND WATER SLOPE
14
ENCOUNTERED? Yee
IS
IF YES, AT WHAT
DEPTH? 12' TFST HOLE
16
DEPTH TO WATER AFTER �=
17
MONITORING? 47•
Is
DATE: 5-14-00
19
NP/.DiNO DAR aF08S NEI' DEPTH OP NET
Tom
20
PEROLA71ON RATE 9 hnln/inehl PERC HOLE DIAMETER 6 Inches
TEST RUN BEWTEEN 5 FT and 6 FT
COMMENTS: Test hole excavated by Owner. Teat Hole was presoaked before pert test.
PERFORMED BY:
Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
7'D!E
WATER
DROP
4-13-00
945
61/4•
--
8�55
10
5 1/B•
t 1/8•
855
6 1/2•
9a5
10
S 3/B•
t 1/8•
9-0S
--
6 1/4•
413
30
3 1/0•
1 1/e•
-. ..
Lo Tr JA leLe- t 3 Mkwl
Sv TZ)
oc 0 N r 3
cco
ccaq 2S
.(40) Y "6
j-7
00 o W t 0
000s cq
rZ
6t
000507
vL"
SI
00Os-06Z'
Si
SY
OooS (-6
Ems .,
s7..
.`
SOILS LOQ - PERCOLATION TEST
PANNONE ENGINEERING SERVICES
P.O. BOX 102954 ; 492
ANCHORAGE, AK 99510
(907) 272-8218
�. 1Steven R. Pannone.{ i
No. CE 8149 a
PERFORMED FOR Mr. Johan Overland DATE PERFORMED: 4-13-00
LEGAL DESCRrMON• Lot lA, Block 3 MANN S/D ,aaaa
at.OPa arts PUN i
OR Orralo- r.vmo srm rma 1
1 Topsotl ITA, QW DT. 162nd AVE /
rwvsen rvnvx. rale
TZ= HOLE
3 m
� t
6 Poore Orsde f �` i ;
Bands le to m .I
/ k
gp- aaru i+ruaa+rLR J// max•_-....,...__.....
uttle
7 OP Silts. Cobbles,-nc,ares vKvc Irma
a• dLm m jr
B j
9
to
W vnas OR avr¢
vmm, m rt Ir
11
BOH
13
WAS GROUND WATER Blots
14 ENCOUNTERED? Yea
IS IF YES, AT WHAT
16 DEPTH? 12' TP.BT HOLE
17 DEP M TO WATER AFTER
MONITORING? 7.S
18 DATE: 4.24-00
19
RBADINO fU7s Ok088 a= DFPI7I01 NCr
p IQi.h 2 y RDIt[ TO¢ 1i�ATER DROP
�. , �J
PEROLA77ON RATE 9 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BEWI'EEN 5 FT and 6 FT
COMMENTS: Test hole hole excavated�Owner. Test Hole was presoaked before�testTest Hole wae�oaked before test.
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
20 4-13-00 845 6 1/4'8-53 1a s w 1 ve•
B�33
6 VY
993 10 3 3/B• 1 VB•
993 6 V4•
94310 3 L/8-
1 VB•
Municipality of Anchorage
On -Site Water & Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcell.D. 020-041-05
1. GENERAL INFORMATION
Expiration Date:
Complete legal description MANN S/D; BLOCK 3, LOT 1A
Location (site address) 16200 ELIZABETH STREET, ANCHORAGE, AK, 99516
Current Property owner(s)
Mailing address
Real Estate Agent
JOHAN OVERLAND
9792 W. SAMMY PLACE, PEORIA, AZ, 58383
Day phone
DANIEL POTTS W/ KELLER WILLIAMS Day phone
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
C/O AGENT
907-322-3267
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
Individual Water Storage]
Individual Holdinq tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
NIA Distance: -
Received by: '� Il r` Date: f
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ d 5-;!x "
Date of Payment y/5 /1 '4
Receipt Number /11a�.5 j 7-6-7
COSA a i's (2 A/139 og
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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. l 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
GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 `ANCHORAGE, AK, 99507
Engineer's Printed Name
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
In conducting this evaluation, GEG, Lt). attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
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
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal tight whatsoever.
6. DSD SIGNATURE
System #1 Approved for bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
Phone 337-6179
Date 8 / Zlluq-
0
pROFESS�C,�*
bedrooms. lli;lli(iI ( ill,
t
t)Fg1yCryrios�r
bedrooms, with the followingsti ulatiogsJ� ONSITE
P WATER AND
WASTEWATER
T PROGRAM
Original Certificate Date:
The Adnicip&Wroctiiorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS: /
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory _.. Other
ear„ mnm»i
if
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description:
A. WELL DATA
Well type PRIVATE
Date completed 9/4/2002
Total depth 187 ft.
Date of test
Static water level
Well production
MANN S/D; BLOCK 3, LOT 1A
-BEDROCK @ 18 FEET.
If A, B, or C provide PWSID# N/A
Sanitary seal (YIN) YES
Cased to x28 ft.
FROM WELL LOG
9/4/2002
WATER SAMPLE RESULTS:
01
2.5
Coliform 0 colonies/100 ml.
Arsenic: ND ug./L.
Nitrate 2.62 mg./L.
Date of sample: 7/2/2014
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEP/STEEL
Tank size 1500 gal. Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Date of pumping '7/1kAt Pumper
C. ABSORPTION FIELD DATA VBELbw EXISTING GRADE
Parcel ID: 020-041-05
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 18+ in.
AT INSPECTION
7/24/2014
34
0.84 g.p.m.
Collected by: GEG, Ltd.
Date installed 816-7/2003
Cleanouts (Y/N) YES
High water alarm (YIN) YES
A+ HOME SERVICES
Date installed 8/6-7/2003 Soil rating 6ZDr ft2/bdrm) 0_8 System type SHALLOW TRENCH
75 & 75
Length 150 TOTAL ft. Width 5/5 ft. Gravel below pipe 0.5/0.5 ft,
Total depth *3.0+/3.0+ ft. Eff. absorption area 750 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test `x7/24/2014 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test DRY in. Water added 714 gal. New depth DRY in.
Elapsed Time: min. Final fluid depth DRY in. Absorption rate >_ "600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date -
**TESTED EAST TRENCH ONLY. WEST TRENCH HAD 5.5' ON LIQUID IN IT UPON INSPECTION.
SEE ATTACHED LETTER REGARDING ADEQUACY TEST AND CONFIGURATION OF SYSTEM.
D. LIFT STATION 'PER INSP REPORT. 42" TO TETHER CLAMP (-2" LONG) FOR ON/OFF FLOAT.
Date installed 8/6-7/2003 Size in gallons 1500 Manhole/Access (Y/N) YES
"Pump on" level at "44 in. "Pump off' level at '40 in. High water alarm level at 46 in.
Datum BOTTOM of BASKET Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 1004
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/cleanout NIA
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 1004
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 51+ Property line 51+ Absorption
Water main N/A Water service line 10'+ Surface water_
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
10'+
5'+
d4 100'+
Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water '* 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
SEE ATTACHED LETTER. * eoaD L)17rGu>✓S
G. ENGINEER'S CERTIFICATION
i certify that i have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date
(Rev. 10112/12)
OF
41 I. -1.. W .
treyrness;:�=
,E 53
pROFESSION�:�•.
Municipality of Anchorage Q of
Development Services Department
Building Safety Division a z
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # 141382
During a recent COSA on-site inspection and test of the potable water
supply well on Block 3, Lot IA of mann subdivision, the well's productivity
was determined to be 0.84 gallons per minute. The minimum well
productivity required by this Department (AMC 15.55) for a 4 -bedroom
residence is 0.41 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
August 4, 2014
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road,
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
REFERENCE: Mann S/D; Block 3, Lot IA: Adequacy Test Results and Configuration of System.
To whom it may concern,
The subject property is served by a private well and a septic system consisting of a 1500 gallon S.T.E.P.
tank and a dual trench type drainfield with an effective depth of 0.5 feet. GEG, Ltd. made a site visit on
7/2/2014 and found the S.T.E.P. tank to be non-functional. A+ Home Services was retained by the owner's
real estate agent to pump the tank and perform repairs. See the attached invoices from A+ Home Services
and Capstone Electric, LLC.
We returned on 7/24/201.4 to perform an adequacy test on the system. The west drainfield was found to
have 5.5 inches of standing liquid in it. The east drainfield was found to be dry. The adequacy test was
performed on the east drainfield. Over the course of 282 minutes, 714 gallons were introduced into east
trench, which caused no appreciable liquid level to develop. The monitoring tube was dry within 2 minutes
after the introduction of water was stopped. In short, the east drainfield is performing adequately at this
time to serve a 4 bedroom house. It is unknown why the west drainfield was this full at the time of
inspection.
NOTE: Each trench was installed with a monitoring tube at the north end and the south end. The south
monitoring tube of the east trench could not be located during inspection.
If you have any questions, please contact us at 337-6179.
Sinc��y, hl
j,
iu
)e£f3ey A Garne'ss, P.E., M.S.
President '%
J
3701 East Tudor Road, Suite 101 " Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 ` Fax: (907) 338-3246 ` Website: www.garnessengineering.com
Description
Underground repair andjrmction relocated.
1 Journeyman Electrician Dispatched.
Repaired under wiring and relocated junction box to outside of tails.
Thank you for your business!
Capstone Electric LLC
22356 Whispering Birch
Chugiak, AK 99567
P.O. No. Terms Project
Due on receipt 514013 16200 Elize...
Qty Rate Amount
1 1,995.00 1,995.00
6 95.00 570.00
Total
Payments/Credits
Balance Due
Office 907.688.2751 Fax 907.688.2752
info@capstoneelectricak.com www.capstoncelectricak.com
Lic No. 38752
$2.565.00
$0.00
$2,565.00
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Watar o -a ewater Program
w Street
4K 99519-6650
ek.us
CERTIFIC
R
Parcell.D. 020-041-05 _
1. GENERAL INFORMATION
Complete legal description Lot 1A Block 3 Mann
zPP
ORITY APPROVAL
..y
)WELLING
HAA # O 3 o SS S
Expiration Date: a— 4 —o:3
Location (site address or directions) 16200 Elizabeth street. Anchorage. AK 99516
Current Property owner(s) John Hagmeler
Homes
Day phone 248-6789
Mailing address 2204 Cleveland Ave.. Anchorage, AK 99517
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
2. NUMBER OF BEDROOMS:
4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
PUblic Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water
supply system. DSD 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 Hre 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.
(R.,,. i VAe)
S. 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. 1 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 Pannone Eng. Svc. Phone 272-8218
Address _P.O. Box 102954, Anch, AK 99510 ,J
Engineer's Printed Name Steven R. Pannone, P.E. Date
Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious
engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. TheOF
........ . 44'04
the test, and separation distances measured to readily identifiable features. The operational life of all i �,.•'
wells and septic systems depend on the local soil condition, ground water levels that may fluctuate : v ; 49 _ ••:
during the year, and the water usage of the family being served by the system Tconditions are r"
hese
outside the control of the evaluator of this system All systems eventually fail and satisfactory test results 0
do not guarantee future perfomance of the system, nor do they guarantee that there are no hidden dcfcctr
or encroachments. PES can therefore not provide any warranty for future performance nor give any j � y• ' Pon"ne
estimate of how long the system will continue to meet the operational requirements of the ADEC or 0 C) . No. CE 8145
MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon �� •'•. J
or use of this report by any other person or party is not authorized nor will it eonfcr any legal right �� •••., - 6
whatsoever.
6. DSD SIGNATURE
_� Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
M
13
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
Expiration Date: Reissue Date:
tne, west
Municipality of Anchorage *A9
Development Services Department Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot JA Block 3 Mann SIE Parcel I.D.: 020.041-05
A. WELL DATA
Well type P
If A. B, or C provide PWSID #
Date completed 91412002 Sanitary seal Y
Total depth J31 --ft Cased to _9—fl
FROM WELL LOG
Date of test 91412002
Static water level 30 ft
Well production 2.5 g.p.m
WATER SAMPLE RESULTS:
Coliform "Q7— colonies/100 ml
Date of sample: O 2 L t3
B. SEPTIC/HOLDING TANK DATA
Nitrate 16mg/I
Well Log Y
Wires properly protected Y
Casing height (above ground) 24 In.
AT INSPECTION
ft
g.p.m
Other bacteria � colonies/100 ml
Collected by: Laura Pannone
Tank Type/Material Anchorage Tank Steel
Date installed 81612003 Tank size 1250 Step gal Number of Compartments 2
Cleanouts Y Foundation cleanout Y Depression over tank ki High water alarm Y
Date of pumping Oe -0i Pun oer—_
C. ABSORPTION FIELD DATA
Date installed 81712003 Soil rating (+1;4� or ft2/bdrm)18 ..5 System type Shallow Trench
Length 75175 ft Width 515 It Gravel below pipe 0.5 It
Total depth 2& It Effective absorption area Z&f? Monitoring tube Y Depression over field N_
Date of adequacy test .L2g10 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before lest �fwln Water added= gal. New depth_ in.
Elapsed Time: 0 min Final fluid depth _ in Absorption rate >= _ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) JJ � ori If yes, give date &W+
(Rev. 71/98)
D. LIFT STATION
Date installed $17/2003 Size In gallons 250 Manhole/Access Y
"Pump on" level at 44 in"Pump off" level at
41 in High water alarm level at 46 in
Datum Bottom of Tank Cycles tested UJ Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 207.3
Absorption field on lot 211.6
Public sewer main NIA
Sewer /septic service line _50+
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout N/A
Holding tank _NIA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 116.6 Property line 23,3 Absorption field 10'
Water main 100+ Water service line 100+ Surface water 100+
Drainage 100+ Wells on adjacent lots 100+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 21.1 Building foundation 155 Water main 100+
Water Service line 50+ Surface water 100+ Driveway, parking/vehicle storage100+_
Curtain drain NIA Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION 4
I certify that I have determined through tleld inspections and : z f n
review of Municipal records that the above systems are in o ••••••••••••+••• 0
conformance with MOA HAA guidelines in effect on this date. ,,, ,,,
� E :S:cvc-' R. rQ9 ,orc y /
Engineer's Printed Name Steven R Pannone P E +� f: n cF. P t n
l 3
Date 4 c ••,��
?ro�.:
HAA Fee $ 3/ Waiver Fee $
Date of Payment]l c3 Date of Payment
Receipt Number 04 5 Z Receipt Number
(Rev. 71x99) "
Municipality of Anchorage
Development Services Department
+r Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Waiver Review Worksheet
WR#: 030100 PIDN: 05172117 HAM 030556 Perm
Date r'�
Legal Description: Thunderbird Heights Blk 3 Lot 6
Engineer. Alaska Water - Wastewater• Ic - 1 Its1.
Applicant: Joe R Sallie LeBav
Criteria:
•.._I •1 a•.r •1 i n 1.'
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Points:
...............................................................................
Waiver Is Granted: l/ Waiver is not Granted:
List Conditions or Reasons for above:
Date: I I — 4 " t7 3
By:
........• .................•....0
Red#: 4= Amount: S1S0.00 Date Paid:1IM003
Mwiieipality of Anchorage
Mark73egich, Mayor
Building S. &ety Dix isimi
1 .0. Ik)x 1W650 • 147(x) I)ragaw Street
Anchorage, Alaska 51`)519-V)50 • (4X)7) 343-8:101 • Pier (4x)7) &13.82(x)
litil)://%%i%iv.niiiiii.org
AK Water & Wastewater Consultants, Inc.
ATTN: Jeffrey Gamess, PE
6901 De Barr Road, Suite 2B
Anchorage, AK 99504 -
November 03, 2003
Subject: Waiver Request forTHUNDERBIRD HEIGHTS BLK 3 LT 6
Waiver # WR030100 Lot Line Request for Parcel ID 051-721-17
Dear Engineer:
Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater
disposal system to the lot line has been approved. The approved separation distance is 1 feet.
This waiver approval applies to the current on-site wastewater disposal system and lot line
separation only. Any future upgrade to the on-site wastewater disposal system and lot line will
require all separation distances to be met or another waiver approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office at
343-4744.
Sincerely,
Jeff Poet
Engineering Technician III
On -Site Water Quality Program
10-26-03 01:1 TW FR00-C &E ESI. SGS ENV SEWICES PC75615301 T-432 P.01i0: F-634
-SG$-.
SCS Rota 1036987001 All Datuirnow are Alaska Standard Tlok
i\ame PaaacneFxi.Srv. PriatedDatamme 1028/2003 12.C6
gNat
prom pauLot IA 130c 3 Matta Collected Data'rime 10242CO3 12:13
U11eatsmp!tLD Lot IABlk3Mam plecyredDate?law 10/24/2003.
024/20.Ed# !
Matrix DrnkinS Water lubtical Dlrsirttor ,StcpAea C. EM
PMSID 0 Released Dy�ii
-Sark Ramarks:
AauwsNe 14'ip Analirtr 111:1
Parmaer Oxine s Reu:u PGL tlnm meeva Conufner ID L:rmu
ltataro Dapartaunt
Nivate-N 1.39 0.100 myL EPA 300.0 (<"10) 1026103 UB
1llorobiology Laboratory
Tom[Calltorm 0 eoV10CM:. SMI392228 A (--l) 1W24703 DKC
1
� t(,1
1
_ . MANN ss=.
LOT I AsE
4+.961
BUILDING DETAIL
SCALE.
1 =20
I
FlSTRUCTU
RE AS—BUILT
PROPS p'FY THAT_I HAI
ENCROAOHM
DEPICTED D ABOVE AND THE
IT IS THE RESP�p &I IXLIFY �� AS W':ARVEYED?-
CO :A? -
DETERMINE THE D(ISTENCE OF E Ol 10
THEIS
S OR A ra� DSO NENTS '
JAN15PEAR ON fER or
M No USED FSTAN SUBDIVISION PLAT..
STABLISHINO g«JNORCONSTRUCTION Q4TA
DARY OR FENCE LINES. FOR
ANCHORq,E RECORDING DISTRICT
NOTE; NO CORNERS SET
THIS DATE.
IALDI L D SURVEYING
JEFF
-4726-WA' • R- LS
ANCHORAGF, AVENUE _
PHONE 2 �4�502I
GRID pl
3238
F.S.
03-04
�4p
•
N
0
N 00'03'00'W 149.87'
1
�
r
------10'UTILESAff.
Z
------
AV':AW
• •
�; p'
• ,
; :or
a
rt
O
rn
.O'00
•
•AV
# sz•.•• :
#W
•�'PO,
• ^
•*��+ 4
��.i
obi
•
N
0
N 00'03'00'W 149.87'
1
�
r
------10'UTILESAff.
Z
------
Z
rn
i
obi
�
C'7
/
—
Z
z
g
g
26.4'
CD
c Q °
6�
czi
v
rn
N 00.03'00"W 149.87'
W
O
OZABETH ST E —
30'
IA
z
�m
,9
Z
Z
rn
i
'yrf�
O
�
C'7
/
—
Z
• �..
MUNICIPALITY OF ANCHORAGE Incn ts w
Development Services Department ;.
Building Safety Division
On-site Water & Wastewater Program apartment ^
COMPLAINT FORM
Date Received: /, 1n Received by. _ Wm
Officer Assigned:
Complainant Name: — �Chn anC'(1tLa Phone: 5 —% p 9 rg cS
Address: I1CA _
Parcel ID: ("-�, I1U I —P,\C:�
Subdivision: n(1 Block �"2)_ Lot —16_ Grid:
of Complaint:
Investigation:
Follow Up:
Disposition:
Notify Complainant of Disposition: Yes
r Case Closed Enforcement Officer. _
On -Site Supervisor:
M
Date:
Date:
Complaint form V14/02