HomeMy WebLinkAboutNORTH SLOPE #1 BLK 3 LT 4North Slope
Block 3
Lot 4
#050-511-15
Municipality of Anchorage
Development �ervices Department
Building Safety Division
On-site water and Wastewater Program, 4700 S. Bragaw St.
P.O.BOX196650 Anchorage AK 99519-6650
wvm,,CJ.anchorage.ak.us (;07) 34X7904 Page tof
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
SW040 PID Number —050-S.
"u .. 0
Wastewater System: New Upgrade
Ave.,Fagle R" B
iyer, AK 99S77 ABSORPTION FIELD
Nmbw od;rBd�r:: NOP T.�h E tun�
13 Dp T..h 03 Shal. T� 0 Sod
mou"(1
LEGAL DESCRIPTION ScOill RaWV: — —
tank & field insulated
field hydro -seeded
Top of
BENCH MARK
Inspections performed by: K6D--En9ftMCf09----Inr.Dates: "'2L16LZQD-4
Development Services Department Approval 2 nd Balamr-
3' 5/2612005
Reviewed and approved b�
�'�Date:
P":
.9
FBI
13 Other
;=,�y
1000".
100 FL
Engineer's Stamp
M.
In.
2.84-3.19
Well: 0 New
Upgrade
Ft.
N.6w
ol k,,,-
c4as.katim (Frimita. & a. c):
TOW D.O:
Cow b:
Ft. 2
Ft Ft
P"Mw~
S70 Fe D4nQA
Owe Dr&.d:
Swk Wow L"..
hr�.
Martin Const. D" ln�,
9/
"SON:
6
CIPM
k
wn
z Ft
TANK
SEPARATION
DISTANCES
To
Septic rphon Lift
0 Septic E3 Holding 0 S.T.E.P.
Frem
Tank
Field
Stabon
ding pubirjpmat
Tank
Se�Lk-
Anchorage Tank
W04
100'+
1001+
NA
NA 25'+
'"Steel
sud,ic,i, WSW
100'+
1001+
NA
NA
LIFT STATION
W Lkw
5'+
10'+
NA
NA
Fouws�
5'+
10'+
NA
NA
'P� Gal
C,~O D�
NA
*50'+
NA
NA
In in
Pury 1,01"Oke & MOXI'O,1
tank & field insulated
field hydro -seeded
Top of
BENCH MARK
Inspections performed by: K6D--En9ftMCf09----Inr.Dates: "'2L16LZQD-4
Development Services Department Approval 2 nd Balamr-
3' 5/2612005
Reviewed and approved b�
�'�Date:
P":
.9
FBI
13 Other
;=,�y
1000".
100 FL
Engineer's Stamp
M.
In.
AS—BUILT SYSTEM DETAILS/SITE PLAN Permit SW 040273
NORTHSLOPE SUBDIVISION, LOT 4, BLOCK 3 PID# 050-511-15
............ 00
11 KI/
K D
)N //"�LOT 4
X
ofli
A -C= 58.71
B -C= 14.71
A -D= 61.1'
B -D= 22.6'
t�
A-E= 33.71
I 1000 G
B-E= 48.11
TANK
A -F= 81.31
B -F= 56.7'
91.08 <
A -G= 42.4'
E -G= 62.0'
A -H=93.2'
B-H= 69.01
9
FINAL GRADE
SEWER ROCK
TRENCH I
FINAL GRADE
SEWER ROCK
TRENCH 2
PREPARED FOR,
Jim Bickman
4316 UPPER KOGRU DR.
EAGLE RIVER, AK. 99577
(907) 694-9694
0— 100, �wrtt
I Qof� �'�
txrsr
LOT 3
...............
SCALE�-* 50'
WK , "�
V�
I SCALE, NTS
FIELD BOOKS C0&ftXD.
MAW. HKI41D ENGINEERING
STAMM CHECKM KMQ 20441 PTARMIGAN BLVD.
ASMAT-. OAT, 6 5 EAGLE RIVER. AK 99577-8736
ow� F&E. — _n�_SE0703
AVSf'_AS13LT.DWG I Joe �: 04031
I (907)696-6111/FAX (907)696-8111
(farfiffeb 3DdIting 109
U0,
by
DOCCO.dbe
SULLIVAN WATER WELLS
P.O. UM670272, CHUCAK, ALASKA 92M a '--- ' . * -_
OVMMOFIAMM *'JIM- &�Kow;q*_3
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(�mft,r)w vwmyxictim d2m
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climmimpmomemalm —fed
Sta&Vglhwlewk 6t fed
P=Owpe.,M__L_wn
mawaviesew Ae-
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MUMWCIFNI- , -- C 14 4 A --hC Jb JOIM
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56Z
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 /WATER SUPPLY PERMIT
Initial
Date Issued: Jul 21, 2004
Expiration Date: Jul 21, 2005
Permit Number: SWO40273 Parcel ID: 050-511-15
Legal Description: !North Slope #1 Block 3, Lot 4
Design Engineer: 0070 KND Engineering Site Address: 31000 Kuparuk Ave
Owner Name: Jim Bickman Lot Size: 43260 SQ. FT.
Owner Address: 31000 Kuparuk Ave Total Bedrooms: 3 Permit Bedrooms: 3
Eagle River. AK 99577 -
This permit Is for the construction of.
nv' Disposal Field E Septic Tank Ej 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 ddy.
B. Covered, sealed, and heated to prevent freezing.
Received By -
Date: , Z&Zo�/
lssuedBy-.- Date: 7
Municipality of Anchorage %*�. lob,,
Development Services Department eor
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-511-15 Permit Number SW OY"O 2
Property owner(s) Jim Bickman Day phone 694-9694
Mailing address (1) 4316 Upper Kogru Dr, Eagle River, AK. 99577
Mailing address (2) —Zip Code
Legal description (Lot, Block & Sub'd.) North Slope Subd. Addn. #11, Block 3. Lot 4
Legal description (Section, Township & Range) '3k0O0 ku P3 rLLK Ne,
Lot Size 43,260 Sg. Ft. Acres/Sq.Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only
Well Only
El
Sewer and Well
Water Storage
E]
Sewer Upgrade
THIS PROPERTY CONTAINS:
HotTub
Jacuzzi
Swimming Pool
El
Water Softening Unit
El
Therapy Pool
n
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.
of property owner or authorized agent)
Permit Fees: Y%(/0 'I" kel7U— Waiver Fees:
Date of Payment: W-2 V'0 Y, Date of Payment:
Receipt Number: Receipt Number:
(Rev. 12100)
KNDENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER. AK 99577-8736
(907)696-6111 / FAX (907)696-8111
July 19,2004
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99319-6650
Subject: New sewer permit — North Slope S/D Addn :1, Block 3, Lot 4
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit to construct a
wastewater system on the subject lot. On June 14, 2004 two test holes, TH04-1 and
TH04-2, were performed for the proposed system. Then on June 30, 2004 two more
test holes were performed, TH04-3 and TH04-4. The middle of the property appears to
be the most suitable area for septic system construction.
The test hole on the west side of the property (TH04-1) has approximately 1.5-2' of
organics with ground water at 4' so with the 1' penalty (for June water monitoring)
ground water is approximated to be at 3' in high ground water season, there is only Y
of unsaturated accepting soil, so this test hole will not be used. The test hole on the cast
side of the property (TH04-3) has approximately I' of organics and ground water
measured at 4.89'on 7/7/2004. With the 2'penalty (for July water monitoring) ground
water is anticipated to raise as high as 2.89'making this test hole also unusable.
The test holes located in the middle of the property (TH04-2 and TH04-4) appear to be
the most suitable for septic system construction. As a side note they are also very
similar to the two test holes used for the lot to the east (N. Slope Addn. #1, Block 3, Lot
3) in regards to ground water depth. TH04-2 has about 1-5-2' of organics with ground
water measured at 5.5' on 6/21/2004 and at 6.89 on 7/7/2004, and at 7.53' on
7/19/2004. Even with all of the penalties for June and July water monitoring this test
hole appears to be in an area well suited for a septic system. TH044 was performed
above TH04-2 to determine if the ground water conditions were consistent in the area.
TH044 has approximately l' of organics with ground water measured at 7.19' on
7/7/2004, ground water was measured again on 7/19/2004 and found to be at 8.00'. It
appears that this test hole has even deeper ground water than that of TH04-2. It is our
conclusion therefore that this area is adequate for a wastewater system.
Since there is no seasonal high ground water level information for this property we
looked at the surrounding area for information. The properties in the immediate area
have all been successfully developed to date and some have had test holes with water
monitoring conducted in the high ground water season. The property to the west (N.
Slope Addn. #1, Block 3, Lot 5) had ground water at 5', 4', and 2.5' during high ground
water season, the test hole with ground water at 2.5' was not used. The wastewater
system that was constructed to serve this property was an IDSF (see attached site plan
Subject: North Slope Addn. $1 Block 3, Lot 4
7/19/2004
Page 2 of 2
& test hole documentation). The property to the east (N. Slope Addn. #1, Block 3, Lot 3)
had ground water at 7.5', 4.5', and 5.5' during high ground water season. The
wastewater system constructed to serve this lot was two shallow at grade trenches (see
attached site plan & test hole documentation). The ground water depths found on these
two properties is a good indication that the ground water tables in TH04-2 and TH04-4
are not inconsistent with the ground water tables in the immediate area. Typically in
North Slope Subdivision there are portions of the lots that are not well suited for
wastewater system construction. We have identified the area that will best serve this
property in wastewater disposal and intend to keep as far as possible away from TH04-
1 and TH04-3. We believe that two shallow at grade trenches utilizing TH04-2 and
TH04-4 will best serve this property for years to come (see design for details).
During the construction of the system soil consistency will be monitored to ensure
there are no drastic changes. The general slope of this lot is from north to south at a
grade of approximately 15-20%. The lot and surrounding lots are served by private
water systems.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100'of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111 /FAX 696-8111.
Respectfully submitted,
END Engineering, Inc.
Kenneth M. Duffus, P.E.
Attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/ Percolation Test
Adjacent property documentation
Owner/ Excavator Specs
WELL & WASTEWATER
I North Slope
DISPOSAL SYSTEM
Addri. #1, Block 3, Lot
DETAILS/SITE PLA
4
NO PUBLIC WELLS WITHIN &W Or
P�SED SYSTEM.
NO PRIVA TE WEUS WITHIN 2W OF
P�Ell SYSTEM EXCEPT AS NOTED.
M SEPTIC SYSTEMS WITHIN EW OF
PROPOSED WELL EXCfPT AS NOTED.
OF A
Z4
Ar ............. . .. is
Aq
A111111'
DESIGN DETAILS
3 BDRM X 150 GPD 450 GPD
450 GPD/0.8 GPD PER SO. FT. (13.3 MIN/IN.)z 563 SO. FT
(563/5'(W)) X I.O(RF) (0.5' GRAVEL) = 112.6 FT. TRENCH
USE 2 TRENCHES - 57 (L) X 5' (W) X 0.5'(D)
Totat depth of system Is 2.0' from originat grade.
Excavate top 2', remove organics & Instatt _Z�_ OF MOA approved sand.
Totat depth of gravet below distribution pipe Is 0.5'
NOTES:
1. USE 1000 GALLON SEPTIC TANK, INSULATE IF (4' OF COVER.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.
3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS, SEPTICS, LOT LINES, FOUNDATIONS AND ALL OTHER SETBACKS.
PREPARED FOR,
Jim BIckman
4316 UPPER KOGRU DR.
EAGLE RIVER, AK. 99577
(907) 694-9694
FIELD BOOKS COMPUTM.
BOUNOmr.
DRAWN:
STAKINCZ
CMECI(CO.
ASDULt;
DAM.
DWI FILL
CF"D'. I
4C^D"1-'0403I.DWG1 ""' 04031
Scale: 1'= 100'
PAGE I OF 3
ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER. AK 99577-8736
11
WASTEWATER DISPOSAL SYSTEM DETAILS
North Slope AcIdn. #I, Block 3, Lot 4
PROPOSED 1000
GAL SEPTIC TAN 16'
D Co 00
Corl�
4 F
46'
-ft'7"%�NX
-d. - -
-1dw qT..A-Z4 '
AV
AL
9TE *T
0
.... ... ... ......
KENNETH M.
CE -71
................ .
EN
mill
PREPARED FOR:
J1m Bickman
4316 UPPER KOGRU DR.
EAGLE RIVER, AK. 99577
(907) 694-9694
nEU) BOOKS COMPUTM
D�Aft. — 0" V13G
KMD
DAM 7/20
om FLE GFAD. SE07C
AcAD "L'04031.DWG J'a mm: 04031
TH
10,
M-1.
Scale, 1'= 20'
PAGE 2 OF 3
K,
L"11 LU) ENGINEERING
20441 PTARMIGAN BLVD.
ZALiLt; RIVER, AK 99577-8736
fit
WASTEWATER DISPOSAL SYSTEM DETAILS
North Slope Addn. #1, Block 3, Lot 4
4' MONITORING TUBE
FROM SPLITTER
PLAN VIEW
LEACHFIELD DETAILS
A)aTe' rnu Jkept4 0fr s-euje'r
OrItWAJ- d3rU.Ae,
4' MONITORING TUBE --I
BRACING AS NEEDED—
PLYWOOD BARRIER
AROUND TRENCH �7
13RIGINAL GRADE
1.5' TO 2' DEEP —J
REMOVE ALL ORGANICS
& LOAM
.Aw, OF A
TE*t9 '1'" "'
..... ........ ..... ...... 0
.. . ....... ............ ......
KEN
CE-71il(I
. ............ ..
-%onSS10� -AV
Nk
4'
4' MONITORING
'I-Oc-�F- kc- 6,LoLj
F4' CLEANOUT
2' MIN C13VER
FINAL GRADE
GRADE
-�.5' SEVER ROCK
------ t5Z� MIN M.O.A.
5' WIDE I SAND FILTER
FRUF ILE VIEW
LEACHFIELD DETAILS
NOTE, BOTTOM OF SEWER DRAINROCK MUST BE 4+ FEET ABOVE GROUND
WATER DURING HIGH GROUND WATER SEASON AND 6+ FEET ABOVE BEDF
PREPARED FOR:
Jim Bickman
4316 UPPER KOGRU DR.
EAGLE RIVER, AK. 99577
(907) 694-9694
FIELD BOOKS COWUTM.
9�w ORAW
MM
3TAM112:
A�f: DATE 7/20j
owr� ML CFaD-. SE07
4M'LL 04031.[)WG I joa �: 04031
SCALE, NTS
PAGE 3 OF 3
L"11 LW ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
KVIDENGINEERING, INC.
Date
G!oss
Time
Net
I Time
Depth to
Water
20441 PTARMIGAN BLVD.
1
6/21/04
EAGLE RIVER, AK 99577-8736
101,
—Drop
-
nneia
1:10
CE 71
V.
SOILS PERCOLATION TEST
3
Performed for: Royce Martin Date Performed: 6/14/04
Project: North Slope 91, Lot 4, Block 3 TEST HOLE # 04-1
Depth
(Feet) SEE ATTACHED SITE PLANJ
JM ORG/OL FOR HOLE LOCATION
GM/SM density increasing w/
depth, clay & silt - grey
NMW B.O.H.
10-
11-
12 -
Water Monitoring
13 -
Date Depth
14-
717/2004 5.85,
is- 7/1912004 6.05'
16-
17-
18-
19 -
HOLE PRESOAKED
20- PRIOR TO TEST
Was Groundwater encountered? YES What depth? 6'
Depth to water after monitoring? 4' Date? 6/21/04
Reading
Date
G!oss
Time
Net
I Time
Depth to
Water
Net
1
6/21/04
1:00
101,
—Drop
-
2
1:10
10 min
V.
2"
3
1:20
10 min
61/4"
13/4-
4
1:30
10 min
51/4"
1�
5
1:31
101,
-
6
1:41
10 min
811.
2"
7
1:51
10min
61/4"
13/4"
8
2:01
10 min
51/4-
1.
9
2:02
101,
-
10
2:12
10 min
8"
21,
11
2:22
10 min
61/4"
13/4"
12
2:32
10 min
51/4"
Water
Added
Percolation Rate 10 (min/ in) Pere Hole Diameter 6"
Test Run Between 2 feet and 3 feet
1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
INKINIDENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
SOILS PERCOLATION TEST
Performed for: Royce Martin - Date Performed: 6/14/04
Project: North Slope :1, Lot 4, Block 3 TEST HOLE 9 04-2
Depth
(Feet)
ORG/OL SEE ATTACHED SITE PLAi4--J
I FOR HOLE LOCATION
GMISM density increasing w/
depth, clay & silt - grey
12 -
Water Monitoring
13 -
Date Depth
14-
7/7/2004 6.98'
15- V19/2004 7.53'
16-
17-
18-
19-
11OLEPRESOAKED
20- PRIOR TO TEST
Was Groundwater encountered? YES Whatdcpth? 7
Depth to water after monitoring? 5.5' Date? 6/21/04
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
6/21/04
1:00
101,
-
2
1:10
10 min
71/2"
21/2"
3
1:20
10 min
6-
11/2"
4
1:30
10 min
51/4"
3/4"
5
1:31
10-
6
1:41
10 min
71/2-
21/2"
7
1:51
10min
6-
11/2"
8
2:01
10 min
51/4-
3/4-
9
2:02
101,
-
10
2:12
10 min
71/2-
21/2"
11
2:22
10 min
6"
11/2"
12
2:32 -F,
0 —m i n
51/4"
3/4"
* ,
Water
Added I
Percolation Rate 13.3 (min/in) Perc Hole Diameter 6"
Test Run Between 2 feet and 3 feet
1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
OF A
'"'*'NDENGINEERING, INC. It
2044117ARMIGAN BLVD. CO
EAGLE RIVER, AK 99577-8736 14–
SOILS PERCOLATION TEST Kennel M. Du
CE 7116
Performed for: Royce Martin Date Performed: 6130/2004 14V ."v—
OFESSO*'.
Project: North Slope :1, Lot 4, Block 3 TEST HOLE # 04-3
Depth
(Feet) SEE ATTACHED SITE PLA
JIM ORG/01. FOR HOLE LOCATION
1
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
GM/SM density increasing w/
depth, clay & silt & sandy – grey
B.O.H.
Water Monitoring
Date Depth
7/7/2004 4.89'
7/1912004 6.46'
Was Groundwater encountered? YES Whatdepth? 8'
Depth to water after monitoring? 4.89' Date? 7/7/2OD4
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
2
3
4
5
6
7
8
9
10
11
12
Percolation Rate _ (min/in) Perc Hole Diameter 6"
Test Run Between — – feet and feet
L Kenneth N1. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
OF AL "It
"'KNIDENGINEERING, INC.
i6i to
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
SOILS PERCOLATION TEST CE7116
Performed for: Royce Martin Date Performed: 6/30/2004 44-VPROFE - SSII��
Project: North Slope 91, Lot 4, Block 3 ---TEST HOLE # 04-4
Depth --I
(Feet) ORG/01. SEE ATTACHED SITE PLM4
in I FOR HOLE LOCATION
11-
12-
GMISM density increasing w/
depth, clay & silt & sandy -grey
B.O.H.
Water Monitoring
13 -
Date Depth
14-
7/7/2004 7.19'
15- 7/19/2004 BAY
16-
17-
18-
19-
20 -
Was Groundwater encountered? YES Whatdepth? 7.5'
Depth to water after monitoring? 7.1cY Date? 7/7/2004
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
3/4/03
1:00
9 1/4"
-
2
1:10
10 min
41/2-
5 3/4"
3
1:11
9 1/4"
4
1:21
10 min
4 1/2"
1 53/4"
5
1:22
9 1/4"
-
6
1:32
10 min
43/4-
5 1/2"
7
1:33
91/4"
-
8
1:43
10 min
43/4-
5 1/2"
9
1:44
91/4-
-
10
1:54
10 min
43/4"
5 1/2"
11
1:55
91/4"
-
12
2:0-51
10 min
4 3/4"
Water
Added I
PercolationRate 1.82 (min/ in) Perc Hole Diameter 6"
Test Run Between 2.5 feet and 3.5 feet
1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South
Bragaw St.
P.O. 13OX 196650 Anchorage, AK 99519-6650
www-cl-anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. HAA -" f) an
1. GENERAL INFORMATION Expiration Date: 9 — / 0 — C),6 -
Complete legal
Location (site address or directionsj__3j0DD_Kjupanjk,_Ayp _Fagle gLyp
r AK qq
1;77
Current Property owner(s) Day phone _fi9jj=2_j_qB.
Mailing address 4-'4 1
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
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
CommunityClass_ Well
Public Water System
_R
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
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 4 by an Independent professional
civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for he
transfer of title (except between spouses) for properties served by a single-family on-site wastewater dispo t sal
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. (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 Fir Phone .(907) (;qF;-Gl
Address _qn441 ptarM1gan_BJVd,_FaglP River, AK qq-977
Engineer's Printed Nam Kenneth jg.,DUffus_� Date GIELU—
Engineer's Comments:
This Investigation was completed In compliance with
ADEC and MOA regulations. The assessment of the
condition of the well and septic applies only to the
conditions as of the day tested. The now and absorption
rates may change due to subsurface conditions that
may not be observed from the surface, changes In
land use ' local soil characteristics, groundwater levels
that may fluctuate during the year and the water usage
of the family being served by the system. The operational
life of all well and septic systems are subject to these
various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system.
Therefore, KND can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can KND guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
5. DSD SIGNATURE
_-JeL'00' Approved for bedrooms.
Disapproved.
Conditional approval for _ bedrooms, With the following stipulations:
A
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineers Report
Other
Original Certificate Date: C, _/0 -05,
By: 1c),
MunicipaUty of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 9951"650
www.cl.anchorage.ak.us
(907) 343-79"
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: North Slope #1 B3, I A - ParcelID: 050-Sil-IS
A. WELL DATA
Weil type-orlylu
Date completed 8/5/04
If A, B, or C provide PWSID #
Sanitary seal (Y/NLY_
Total depth -JjQl_ft. Cased to -IQI_ft.
FROM WELL LOG
Date of test 8/5/04
Static water level 68 ft.
Well production 6 9 -p -m
WATER SAMPLE RESULTS:
Well Log (Y/N)y
Wires property protected (Y/N) Y
Casing height (above ground) 2 4 1
AT INSPECTION
ft.
g-p-m-
Collform -Q�--_colonles/100 ml.Nitrate 0.1 mg./I.Other bacteria 0 colonies/100 ml.
Arsenic: M mgA. Date of sample: 5/26/05 Collected by: KND Engineering
B. SEPTIC/HOLOING TANK DATA
Tank Type/Material SEPTIC/SnEL _Date installed 9 / 16 / 0 4 Jank size 1000 gal.
Number of Compartments 2 Cleanouts (Y/N) -Y
Foundation deanout (Y/N) I-J:)epression over tank (Y/N) N High water alarm (YM) N
Date of pumping NA - New Tank - Pumper
C. ABSORPTION FIELD DATA
Date installed 9/16/04 oil rating (g.p.d./fe or fe/bdrm) AU System type Mound
Length 114 (2 X 571 ft. Width S ft. Gravel below pipe 0. 5
Total depth 2,94113,19* ft. Eff. absorption area 5M-te Monitoring tube Y Depression over field
Date of adequacy test NA - New SMern Results (Pass/Fall) PASS For J_ bedrooms
Fluid depth In absorption field before tesL_in. Water addeO-_ gal. New depth In.
Elapsed Time:----jnin. Final fluid depth n. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) — If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Aecess (YIN)
'Pump on' level at— in. *Pump off" level at— in.High water alarm level at in.
Datum — Cycles tested Meets alarrn & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main 7S'+
Sewer /septic service line 2 5'+
Onadjacentlots 100'+
Onadjacentlots 100'+
Public sewer manhole/cleanout 10 0'+
Holding tank 10 0'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5 ' + Absorption field 5 ' +
Water main 10'+ Water service line 10'+ Surfacewater 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surfacewater 100'+ Driveway, parkingivehicle storage 10 ' +
Curtain drain 50'+ Wells on adjacent lots 100'+
F. COMMENTS
01�_A4
G. ENGINEER'S CERTIFICATION
I certffy that I have determined through field inspections and
review of Municipal records that the above systems are k,
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Kenneth M, Duffus 194A,
HAA Fee S430-00 Waiver Fee $ —
Date of Payment Ulob5 Date of Payment
Receipt Number Receipt Number
(Rev. 12101)
6- 6-05; 2:24PM; ;007 581530, 2/
SGS Ref.9 1052936001 All Dates/Times.are Alas" Standard Time
Cli=tN&me KND Engineering Printed Datefriene 061OU2005 10:14
Project Name/# N. Slope B3. 1A Collected DateMme 'OV2612005 16:10
Client Sample ID N. Slope B3, LA Received DatelTime OR2612005 16:58
Matrix Drinking Water Technical Director Stephen C. Ede
Sample Remarks:
Allowable Prep Analysis
Pwamcw Results PQL Units medw ContainerlD Limits Date Date wt
Private Zrictividual A�alysls
Ahnninum 1156 20.0 Ug/L EP200.8 D 05/31,105 OUO2/05 TK
Antimony 1.00 U 1.00 Willi, EP200.8 D (<--6) 05/31/05 061=5 TK
Ar=ic 5.00 U 5.00 og/l. EP2DO.8 D (<-50) 05131105 06/02105 TK
Barium 34,11 3.00
Ug/L EP200.8 D (<-2DOO) 05/31105 06102105 TK
Cadmium 0.500 U 6.500 ug/L EP200.8 D (<-5) 05/31/Oi 06=05 TK
Chromiturt 4.70 1.00 ug/L EP200.8 D (<-IDO) 05131105 061=5 TK
Copper 19.0 1.00 ug/L EP200.9 D (<-1300) 05/31/05 06/02to5 TK
Iron 2730 250 UgIL EP200.8 D (<-300) 05/31105 06WOS TK
L,ead 2.55 0.2DO us/L EP200.9 D (<-'I 5) 05/31105 061=5 TK
Manganese 92.3 i.00 ug/L EP200.8 D (<-56) 05/31/05 06102/o5 TK
Chloride 5.51 0.100 mg/L EPA 300.0 B (<-ZO) 05127105 JJB
Phosphorus 200 U 200 uA EP200.9 D 05/31/05 06102105 TK
Fluoride 0.100 U O.IDO mg/l. EPA 300.0 B (<-2) 05/27105 JJB
Potmium 1080 560 uA EP200.8 D 05131/05 OGWM5 TK
Nitrate -N 0.100 U. 0.100 mg/l. EPA 300.0 B (<-10) OV27/05 JJB
Selenium 5.00 U 5.00 uvL EP200.9 D (<-50) 05/31105 061=5 TK
Nitritc-N 0.100 U 6.IDO mg/l. EPA300.0 B (�O 05127/05 JJR
Sodium 4580 5()0 ug/L EP200.8 D (<-250000) 05/31105 06=5 TK
Silicon 5720 200 ug/L EP200.9 D 05/31/05 06W05 TK
Silver 1.00 U 1.00 ug/l. EP200.9 D ("100) 05/31105 O&WA5 TK
Thallium 1.00 U 1.00 tigil- EP200.8 D (<-2) 05/31/05 06/020 TK
Sulfate 14.0 0.100 ing/l, EPA 300.0 B (<-00) 05/27/05 JIB
Zinc 684 5.00 ug/L EP200.9 D (<-SDOO) 05/31/05 06/OMS TK
Total Diswived Solids 186 10.0 mg/l. SM20 2540C C (<-5DO) 05/27/05 KP
Nickel 2.67 .2.00 ug/L EP200.9 D (<-100) 05/31105 06102/05 TK
HCO3 Alkalinity 129 10.0 mg/L SM20 2320B C 05/27/05 kP
CO3 Alkalinity 10.0 U 10.0 mg/l. SM20 2320D C 05/27/05 KP
OH Alkalinity 10.01.1 10.0 mg/L SM20 2320B C 05/27/05 KP
6- 6-05; 2:24PM;
SGS Rcf.#
1052936001
Clicut Name
KND Engineering
ProjectNamef#
N. Slone B3. LA
Client Sample ID
N. Slope B3, LA
Matrix
Drinking Water
;907 5815301
a 3/ 4
All D21csiTimeso re Ataki Standard T' ime
PrinterlDste/Time
0610612005 10:14
Collected Datdrimit
'OR26J2005 16:10
I
RectivedDateMme
OV2612005 16:58
TeebuicalDirector
Stephen Q Edt
Parameter
Reswts
PQL
Units mcum
Cwtainef ID
AJ10wable Prep
Ufnits Date
Analysis
Dre
Init
Privato Individual Analysis
Conductivity
260
3.00
umhos/cm SNUO2510a
C
0512M5
Kp
P11
7.80
O.IDO
pflunits EPA150.1
C
(6.54.5)
051205
KP
Alkalinity
129.
10.0
mg/L - SM202320D
C
05/27/05
KP
Total Coliform
0
col/lODmL SM2092220
A
(<-I)
0&26105
TLF
$U
11500 Daryl Avenue, Anchorage. Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
Registered Land Surveyors (907) 522-4625 Fox
.WWW.Iangsurvoyars.com / tnfoOlangeurveyors.com
I hereby certify that I have surveyed the following described property.
LOT 4. BLOCK 3. NORTH SLOPE SUBDIVISION, No. I (PLAT No. 70-110)
Anchorage Recording District. Alaska. and that the Improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto. that
no Improvements on the property lying adjacent thereto encroach on the survoyod
promises and that there are no roadways, transmission lines or other visible oasoments
an said property except as Indicated hereon.
Dated this the 4-'�' Day of M1 . S,.*,QS at Anchorage, Alaska
It Is the responsibility of the owner to determine the existence of any easements.
covenants. or restrictions which do not appear on the recorded subdivision plat.
kup
Zoe
00
8.91 X
COVERED ENTRY
LOT 5
Z.
GRAVEL
DRIVE WAY:
0
W,
67
2.0' CANT
LOT 4
844CON), 2.0' CANT
43,260 s.f.
SEPTIC CLEANOUTS
;0
LOT 3
-C Z06
00.
10'
UTILITY EASEMENT
LOT 7
PLOT PLAN
AS BUILT X
SCALEI" —=40' GRID -LE 703
Project No.
04-092
11500 Daryl Avenue, Anchorage. Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
Registered Land Surveyors (907) 522-4625 Fox
.WWW.Iangsurvoyars.com / tnfoOlangeurveyors.com
I hereby certify that I have surveyed the following described property.
LOT 4. BLOCK 3. NORTH SLOPE SUBDIVISION, No. I (PLAT No. 70-110)
Anchorage Recording District. Alaska. and that the Improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto. that
no Improvements on the property lying adjacent thereto encroach on the survoyod
promises and that there are no roadways, transmission lines or other visible oasoments
an said property except as Indicated hereon.
Dated this the 4-'�' Day of M1 . S,.*,QS at Anchorage, Alaska
It Is the responsibility of the owner to determine the existence of any easements.
covenants. or restrictions which do not appear on the recorded subdivision plat.