HomeMy WebLinkAboutTUXEDNI PARK BLK 3 LT 7TuxednI'O
Park
Block 3
Lot 7
#041-022-36
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program. 4700 S. Bragaw St.
P.O. Box 196850 Anchorage. AK 99519-6650 Page of
www.d.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO40374 PID Number. 041-022-36
N« CMM General Contractors, Inc.
wastewater System: p New ❑ Upgrade
x�F P.O. Box 774042; Eagle River, AK 99577
ABSORPTION FIELD
1`1,a,41 (907)-688-8779 NMnW deedmm: 4
ODeepT«w DSt T«vn❑80 ❑Mp ❑Dewe
LEGAL DESCRIPTION
Soi RMN° 1.2
TpYDeM NR WWW
4
DI
GPFe
F,.
et« La s�
3 7 Tuxedni Park
DtpN bppe eoeom aarrlaprW Qe]e.
Cr O"M e. n. eta pw'
4.4 Ft.
6.0 n
To«arw. T12N Range:R2W '• 6, S.M.
Feeaaa.ewearq.r pear.
NIA
Growl Lenpa[
60
Ft.
Ft.
Well: phew ❑U rade
P9
cre,ai w.am:
3
tenn«a rwr.
awnutaiwwa was
FL
1
NIA Ft.
Clraanrcn(Pm«e• A B. c):
I"Dope,: ca a
r« eoe«pom erw
Fipe M««W'.
Private
181 Ft. 181 Ft.
720 Ftp
ASTM 3034,4- PVC
Drw«
DSM 0r Swc Wel« L"
Me W.
Dew emraa.
SullivanWaterWells
10/20/04 27 FL
CMM Generalewtracws.lne
7/20/05
Yob, 20
P iso
Ca" H gtt" p croubFL
TANK
DPM
Ft.
SEPARATION DISTANCES
Aseptic []Holding ❑S.T.E.P. ❑Other:
To
Septic
Absorption
LIR
Holding
lubiwPrivate
ea W.
tr-
From
Tank
Field
Station
Tank
Sewer Lia
Premier Plastics Ltd.
1 1300 Get.
r++
131
129
N/A
N/A
+100'
M« Polyethylene
MMro«a c«ry«a we.
sartac. wet«
+150'
+150'
NIA
N/A
LIFT STATION
Late»
73'
45'
N/A
N/A
V
N/A cM
xa.«.
F«aeom
1 28'
42'
N/A
N/A
'Poop Orl'MM et.
'Mpalr Mwl eL
Y.y, w««w«m «.
h
h
in
C~ Ore.t
N/A
N/A
N/A
N/A
Fw,a Meke a MaaM
EMdncel IrvpecOPw perbawt1 W
R«e«ee. Site not landscaped at the time of the as -built
BENCH MARK
survey. Test hole to 17.25' on 8/18/05. Monitor
Lpuaan ertl Dew.ppen.
NE corner of garage slab
tube intalled along the septic tank on 8/18/05.
sa .
100 FL
Erginw.irsuitnw ..,
QF.
4.95
P•�E,,.....
Inspections performed by: Russell Hepner, E.I.T.Dates: 1" 7/20/05
2 8/4/05
.�e".Allan W�P.lurfitt;=
Development Services Department Approval
vZ.
sX- NO 4977-E r ?�
Reviewed and approved by: Date:
SEPTIC SYSTEM AS -BUILT PLAN
Lot 7, Block 3 Tuxedni Park Subdivision
Anchorage, AK
Parcel ID: 041-022-38
SWING TIE RECORDS
Distance In Feet
Mark
A
B C
1 (CO)
21
9.5
2 (CO)
32.5
72
3 (CO)
33
75.5
4 (CO)
36
78.5
5 (CO)
39
82
6 (MT)
37.5
98
7 (CO)
37
96.5
8 (CO)
61.5
82
9 (MT)
65
84
10 (MT)
28.7
75.1
Test Hole
47.9
912
CO = Clean Out
MT = Monitor Tube
Scale: 1"= 60'
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SOILS LOG/PERCOLATION TEST
Performed For. CMM General Contractors Date Performed: August 18, 2005
Legal Description: Lot 7, Block 3, Tuxednl Park Subdivision Township, Range. Section: NW 1/4 Section 6, T12N, R2W. S. M.
DEPTH SLOPE SITE PUN
Sandy Silt (ML) with Gravel , brown, mofsL
Sand (SP -SIJ) with Silt and Gravel, pray brown, mast
Sample for Particle Size Distribution Report
Silly Sand (SM) With Gravel. gray. moist.
WAS GROUND WATER
ENCOUNTERED?
Sandy Sin (ML) with Gravel. gray.
moist.
F YES. AT WHAT
DEPTH?
Total Depth 1725'
V Pipe installed.
Depth b Water After
MmitorirpT
1NNO■110■
1NMENHEN
INENNEEN
I®E..■.■
1...■■■■
1■■■■■■■
I■.■■■.■
IN■■■■■■
ISI.■■■■■
E
MENNENNONE
■■■■■■■■.■
■■■■.■■.■■
■■.■■■■■■■
PERCOUTIONRATE PnruleshrAl FERC HOLE DIAMETER
TEST RUN BETWEEN FTAND FT
COMMENTS New Test Hole (8!1&05) located by original percolation test tole (7/09104). No Impermeable layer encountered Within 6 feet of the
bottom of the new system.
PERFORMED BY: Russell Hepner, EIT t Altan W. Murfitt. P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: August 19, 2005
72-008 (Rev. 4/85)
Certifieb 3Drilling -tog
by
ooc CO. am
SULLIVAN WATER WELLS
P.O. BOX WMffM cMXU K. nwsuA nosey
owamcwlmcc
r
•o ��•r-:• •.
UW Type
.4a, -x¢
Wal ltMm Opening Type &co' ► end a open hole
:.t Saea� , Start .feet Slapped seat
a Perforations Start feet Stopped feet
rw
GtTypEc9G: T—Q-41T>:• c.M oj-� /�scO
tapft from O I"L tD 'a e yet
•
eILnF-CAd Jf.QIC•J
�i4xf10 (�RAJIE"� �l'J BBa.�
r/ c�.•r
Driler's iJartre ��•-Li
Municipality of Anchorage
Development Services Department
+1 Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: A.W. Murfitt Company
Legal description: Tuxedni Park, Block 3. Lot 7
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. _
❑ Topographic information missing or inadequate. _
® Incomplete; missing as -built survey from professional land surveyor: monitoring tube for
HDPE septic tank
® Incomplete; missing invert elevations of tank inlet and outlet, beginning and end of
❑ 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. 1. Installation varied from Permitted design: trench ins
o?• /lib t��uesk:ot� vJa�ar Cosi\o.d \�1 ,
Name of reviewer: Julie Makela. P. E. Date: 8/16/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
MUNICIPALITY OF ANCHORAGE
Development Services Department
Onsite Water d Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SfTE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Permit Number: SW040374
Date Issued: Sep 03, 2004
Expiration Date: Sep 03, 2005
Parcel ID: 041-022-36
Legal Description: TUXEDNI PARK SUBDIVISION BLOCK 3 LOT 07
Design Engineer: 0009 A.W. Murfitt Company, Inc. Site Address: NHN COPPER DRIVE
Owner Name: CMM GENRAL CONTRACTORS, LLC Lot Size: 88242 SO. FT.
Owner Address: NHN COPPER DRIVE Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99507 -
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.
Received By.
Issued By.
Date: /( Lf Z-ot(
Date: O
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 SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. _. _ 1)(41-OPa-,31P Permit Number SW
Property owner(s) O dA (,AA_?j_o u . v, -k _� C ,_-4yn 4,.-, Lek—Day phone A I4-Z7f—:?
Mailing address (1)
MaWng..address (2)__4_1(/
Leg
Leg
Lot
Ve'��- Zip Code / !.:::: �7--- 7 � -
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accorga(nce with applicable Municipal Codes.
(Signature of
agent)
Permit Fees: Jr Waiver Fees:
Date of Payment: g �ulo4 Date of Payment:
Receipt Number: S_4A9q . Pffl Receipt Number:
(Rev. 12/00)
A.W. Murfitt Company_
CONSULTING ENGINEERS & TESTING
13810 Venus Way ■ Anchorage, Alaska 99515 • (907) 345-2737
August 31, 2004
Municipality of Anchorage
Department of Health & Human Services
On -Site Services Section
4700 South Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
ATTENTION: Mr. Jim Cross, P.E.
RE: Well & Septic System Design
Four Bedroom, Single Family Dwelling
Lot 7, Block 3 Tuxedni Park Subdivision
NE 1/4, T12N, R2W, Sec. 6, S.M., AK.
Anchorage, AK
Our Job 04-294.08
Dear Mr. Cross:
The referenced property represents an undeveloped 2 acre parcel. Mr. Robert Caywood of CMM
General Contractors, Inc. plans to construct a new four (4) bedroom, single family dwelling on the
lot as sketched on the attached site plan, Plate 2. Our design data is summarized in the following
dialog.
1. SOILS: Attached is a copy of the soil log/percolation test data, Site Plan, and soil
particle size distribution, Plate 1. The log documents the Silty Sand (SM) with Gravel
soil profile from a depth of 1.5 feet below the ground surface to a depth of 14 feet.
No water table was encountered. The receiving soil has a percolation rate of 2
minutes per inch.
Page 2.
DHHS
04-294.08
2. ABSORPTION DEEP TRENCH DESIGN:
a. Percolation Rate: 1 to 5 minute per inch
b. Allowable application Rate: 1.2 gallons/day/R.Z
c. Number of Bedrooms: 4.
d. Design Flow: 600 gallons per day (at 150gallons/bedroom).
e. Minimum Absorption Area: 500 s.f.
f. Max Total Depth (below original grade): 9.5 ft. (4.0 ft. cover, 5.0 ft. sewer rock).
g. Width: 3 ft.
h. Minimum Length: 50 ft.
i. Effective Absorption Area = 500 s.f. (10 s.f. per ft. of trench).
3. SURFACE WATERS:
There are no surface waters within 300 feet of the proposed septic system. There are
no streams or drainages on the property.
4. TOPOGRAPHY:
The septic site is slopes slightly to the east at 2 to 5, percent and to the north at 3 to 5,
percent.
5. IMPACTS:
On the basis of our site visits and the available site information, there are no well and
septic developments within 185 feet of this system and no septic systems within 200
feet of the proposed well location. Accordingly, there will be no adverse impacts on
adjacent wells or septic systems nor restrictions to future development of adjacent
lots.
6. WELL and SEPTIC INSTALLATION:
The well installation shall be installed in accordance with the most recent AMC
15.55 by an approved driller. The septic system designed herein shall be constructed
in accordance with the most recent AMC 15.65 by an approved septic system
installer (two construction inspections required). The installations shall be completed
in accordance with the requirements of the On Site Well and Septic Permits.
Page 3.
DHHS
04-294.08
Please call our office at 345-2737 if you have any questions or need additional information.
Sincerely,
A.W. Murfitt Company OF A�.4S al
' h
n i � _ i : •� *:'1�Tit �v e is
Allan W.
Allan W. Murfitt, P.E.
Registered Civil Engineer
COPY TO: CMM General Contractors, Inc. P.O. Box 77402, Eagle River, AK 996774042
ATTACHMENTS: Percolation Test Report and Soil Particle Size Distribution Report, Site Plan,
Deep Trench Design: Plate 1.
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Municipality of Anchoragei�CP�cFJ4�1NEER&$•�••.EA
Development Services Department
Building Safety DlAsion TN �
y� Onsite Water and Wastewater Program . •.' . y
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 9951MSO z a
www.muni.org/onsde rn ; Allan W. Morfh W
(907) 343.7904 4 ��'•• No. 4977-E
Soils Log - Percolation Test
Performed For. CMM General Contractors Date Performed: July 9, 260:(
Legal Description: Lot 7, Block 3, Tuxednl Park Subdivision Township, Range, Section: NW 1/4, See 6, T12N, R2W, S.M. Alaska
Depth
0-I,S � 0 •..,�
S1t• (pL\, Rod «m�.
nan
tsrwe\ tSM�, Sr•Y-�er5'rwr
1i"0`S�•
M' 40 4•� �n
it s1 1.l,sr {
x•14' S.
1a iM1,f,.,N�rb�t
r
12-
14-.... , W' -rtq\ %Lpt=+
15- 1 K.«• A$,, PC Ito
16-ck�ot
17-
1
1
WAS GROUND WATER
Date
ENCOUNTERED? No
Net Tlme
Depth to Water
s
IF YES, AT WHAT DEPTH?
L
Depth to Water After
O
P
Monitoring?
E
Date:
Reading
Date
Gross Time
Net Tlme
Depth to Water
Net Drop
6-1/16
7/9/04
2:34 pm
0
1-9/16
2:44
10min
4-8/16'
6-1116
7/9/04
2:50 pm
0
1-10/16
3:00
10 min
4-7/16•
6-1/16
7/9/04
3:05 pm
0
1-11/16
3:15
10 min
4-6/16•
PERCOLATION RATE 2.3 (mYwNrn) PERC HOLE DIAMETER r
TESTRUNBETWEEN 7.0 FT AND 7.5 FT
COMMENTS Recommended deep bench "en, weh application la16;12.9pd/er. For bur bedreorn hone, at 150 9pdMed. provide 500 M Inaeraeon surface.
PERFORMED BY: Russell Hepner, E.I.T., I Allan W. Murfitt CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: July 9, 2004
4S
.S
CF A1-4�4
Municipality of Anchorage .�Av' 4ENGINE'S .LT t
Development Services Department ,►
Building Safety Division
y� On -Site Water and Wastewater Program r
47DO South Bragaw St.
P.O. Box 196650 Anchorage, AK 9951 M50 �;.�� Allan W. Murf, t ,7 W
www.muni.orglonsite C •, Np. 4977•E
(907)3437901 Ot��F••'•,S. E���.•
� 9F0 r{�il ��...
Soils Log - Percolation Test +���e°F`s,o�-
Performed For. CMM General Contractors Date Performed: July 9, 2004
Legal Description: Lot 7, Block 3, Tuxedni Park Subdivision Township, Range, Section: NW 1/4, Sec 6. T12N. R2W. S.M. Alaska
0-I,S 0ggA. -'L
S1ti W,1(roL «tL,
1.s-4'
(t<wt\ (SMj, !r•7'�are'rn,
Pt'(.. 40 64 Cm;'
p`t4� )AwIIY
6.a„e�
(SH,I , {r•owr,
W' ItI4.\ Itpl\
lt,enesty Pe 110
�►r.�t1„et
WAS GROUND WATER
Date
ENCOUNTERED? NO
Net Time
Depth to Water
8
IF YES, AT WHAT DEPTH?
L
Depth to Watar Agar
D
P
Monxottrp?
E
Date:
Reading
Date
Gross Time
Net Time
Depth to Water
Net Dmp
6-1/16
7/9/04
2:34 pm
0
1-9/16
2:44
lomin
4-6/16'
6.1/16
7/9/04
2:50 pm
0
1-10/16
3:00
10 min
4-7/16'
6-1/16
7/9/04
3:05 pm
0
1.11/16
3:15
10 min
4-6/16'
PERCOLATION RATE 2.3 OWMAnkch) PERC HOLE DIAMETER r
TESTRUNBETW£EN T.0 FT AND 7.5 FT
COMMENTS Recommended deep Lrench system wnh oppllcatbn rete or 1.2 9pd/s1. Far bur bedroom name. &1150 9pdPosd, provide 500 of Inenreeon surface.
PERFORMED BY: Russell Hepner, E.I.T., I Allan W. Murfitt CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: July 9, 2004
S
Particle Size Distribution Report
GRAIN SIZE - mm
%COBBLES
%GRAVEL
%SAND
%SILT N. CLAY
0.0
4.3
71.5
24.2
SIEVE
SIZE
PERCENT
FINER
SPEC.'
PERCENT
PASS?
(X -NO)
1.5 in.
100.0
Atterbera Limits
I in.
100.0
LL= NV
P1=
.75 in.
100.0
D85= 0.552
.5 in.
98.9
D30= 0.0931
Dt5=
#4
95.7
Cc=
#10
91.0
USCS= SM
#20
88.0
Remarks
#40
81.2
#60
66.3
#100
45.3
#200
24.2
- (no spairtation provided)
Sample No.: 2 Source of Sample:
Location: Test Pit 2
A.W.nA �lyy Client: CMM Gencral Contractors
' Y' LL Project: Lot 7, Block 3 Tuxcdni Park Sub.
Com
No: 04-294.08
Date: 7/9/04
ElevJDepth: 7'
Material Description
Silty Sand (SM).
Atterbera Limits
PL= NP
LL= NV
P1=
Coefficients
D85= 0.552
D60= 0.214
D50= 0.169
D30= 0.0931
Dt5=
D10=
Cu=
Cc=
Classification
USCS= SM
AASHTO=
Remarks
Natural Moisturc 12.0%.
- (no spairtation provided)
Sample No.: 2 Source of Sample:
Location: Test Pit 2
A.W.nA �lyy Client: CMM Gencral Contractors
' Y' LL Project: Lot 7, Block 3 Tuxcdni Park Sub.
Com
No: 04-294.08
Date: 7/9/04
ElevJDepth: 7'
Municipality of Anchorage
Development Services Department
Building Safety Division
i 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: AW MURFITT COMPANY
Legal description: TUXEDNI PARK SID BLOCK 3 LOT 7
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.
❑ Topographic information missing or inadequate.
❑ Incomplete; missing _
❑ Incomplete; missing _
❑ 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. PLEASE SEE AMC 15.65.030 TITLED: "CONTENTS OF APPLICATION". NEED A SITE PLAN BEARING
THE ORIGINAL STAMP AND SIGNATURE OF OF AN ENGINEER, DRAWN TO STANDARD ENGINEERING SCALE BUT
NOT SMALLER THAN ONE TO 100. THE SITE PLAN SHALL Gtr O"rX-Q:T9r SHOW ALL MEASURED DISTANCES TO
ALL WASTEWATER DISPOSAL SYSTEMS, WELLS, SURFACE WATER OR DRAINAGE COURSES, ROADS, PROPERTY
LINES AND STRUCTURES WITHIN 200 FEET OF LOCATION OF ANY PROPOSED ON-SITE WASTEWATER DISOP_OSAL
SYSTEM.
Name of reviewer: JOE GOODALL
Date: 8/26/2004
Please supply the necessary information and re -submit your request.
'�Pa-U—ct, a� 0 oa--t
Municipality of Anchorage
Development Services Department '
y
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St. * "
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 041-02236 HAA # O E O L O
Expiration Date: i? I -� 2 - O S"
1. GENERAL INFORMATION
Complete legal description Lot 7, Block 3, Tuxedni Park Subdivision
Location (site address or directions) 9750 Copper Drive; Anchorage, AK 99507
Current Property owners) CMM General Contractors, LLC
Day phone 694-8758
Mailing address P.O. Box 774042; Eagle River, AK 99577'
Lending agency Alaska USA Federal Credit Union Day phone 694-7030
Mailing address P.O. Box 196717; Anchorage, AK 99519
Real Estate Agent N/A Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSO for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Q
Individual On-site 0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
on
lidfDSD also issues ssurequest private Certificates f Health Authority Approval
Ivaor 90 daysfrom the date of ie for properties served by or Class Cell and may breissued are
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 engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that �msnnows tg tion.
based on procedures outlined in the Health Authority Approval Guidelines for this app'
the
on -she 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 A.W. Murfitt company
Address 13810 Venus Way; Anchorage, AK 99515
Engineer's Printed Name Ailan Murfitt, P
5. DSD SIGNATURE
1-#� Approved for 14 bedrooms.
Disapproved.
Conditional approval for
A r46finnn1 CnmmAnts
Phone 345-2737
8/19105
49
F.Itan Il.
:_._ NO 50,77-E
bedrooms, with the following stipulations:
AND
Attachments:
HAA Checklist x
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: . Original Certificate Date:
(Rm. OL02)
Municipality of Anchorage V ,
Development Services Department
r Building Safety Division '
On -Site Water tl, Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.orglonsite
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 7, Block 3, Tuxedni Park Subdivision Parcel ID: 041-022-36
A. WELL DATA
Well type W-1. If A, B, or C provide PWSID #
Date completed°m° Sanitary seal (YM) Yes
Total depth 781 ft. Cased to 181 ft.
FROM WELL LOG
Date of test 10/20/04
Static water level 27 ft.
Well production 20 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 0 mg./I.
Arsenic: WA mgA. Date of sample:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Payethylene
Tank sae 13W gal. Number of Compartments 2
Foundation cleanout (Y/N) Yes
Date of pumping N/A
C. ABSORPTION FIELD DATA
Well Log (Y/N) Yes
Wires properly protected (Y/N) Yes
Casing height (above ground) 24 in.
AT INSPECTION
ft.
g.p.m.
Other bacteria N/A colonies/100 ml.
Collected by: Russ" Hww s Par CoYawa
Date installed 7/20/05
Cleanouts (Y/N) Yes
Depression over tank (Y/N) No High water alarm (Y/N) No
Pumper
Data installed 7/20/05 Soil rating (g.p.d.M2 or ft2/bdrn) 1_2 System type Deep Trench
Length 60 ft. Width 3 ft. Gravel below pipe 6.0 ft.
Total depth 10.4 ft. EfF. absorption area720 ft2 Monitoring tube Yes Depression over field No
Date of adequacy test WA Results (Pass/Fei) For _ bedrooms
Fluid depth in absorption field before test _ in. Water added_ gal.
Elapsed Time: _ min. Final fluid depth _ in.
Any rejuvenation treatment (past 12 mo.) (YM 6 type)
New depth_ in.
Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION
Data installed N/A Size in gallons
'Pump on' level at _ in. 'Pump cfr level at _ in.
Datum Cycles tested
Manhole/Access (Y/N) _
High water alar level at
Meals alarm a circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/Iift station on lot 131' On adjacent lots 150'+
Absorption field on lot 12W On adjacent kits 1W+
Public sewer main WA Public sewer manhole/cleanout WA
Sewer /septic service Ane 10.4 Holding tank NIA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 28' Property line 7Y Absorption field 8'
Water main N/A Water service line 44' Surface water 150'+
Wells on adjacent lots 150'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 45' Building foundation 42' Water main WA
Water Service line ro' Surface water 150'+ Driveway, parkirVahide abmW 80'
Curtain drain N/A Wells on adjacent kits 150'+
F. COMMENTS
in.
G. ENGINEER'S CERTIFICATION 49
I cart/ly that I have determined through field inspections and r.....
review of Municoal records that the above systems are in :A I I a n V. hl u rf i t t .
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Allan Mutt, P.E. Ufa`
Date 8/21/05 p OF st0
HAA Fee E Walver Fee 3
Date of Payment Date of Payment
Receipt Number Receipt Number
(Rev. 12/01)
ASBUILT
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPEF-Y:
AND THAT NO FNCROACHMENTS' EX ST EXCEPT AS
INDICATED. IT IS THE RESPONS191LITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RE:.ORDED SUBDI-
VISION PLAT. UNDER NO CIRCUM TANCES SHOULD
ANY DATA HEREON BE USED FOR CINSTRUCTION
OF FENCE LINES, OR FOR ESTA131 ISHING BOUND-
ARY LINES.
SUTARD h ASSOCIATES LAND SURVEYING 691
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08-15-05;16:16 : ;907 561 5301 # 1/ 1
_.
SW Ref. Ret. 111:
1055145
Client Name:
A.W. Murfitt
Project Name:
Tuxedni Park r lc4 �i dui
Caen Sample ID:
Tuxedni Park
Matrix:
Drinking Water
rlai$
Sampte
SGS Environmental Services Inc
200 W. Potter Drive
Anchorage. AK 99518
Tel: (907)582.2343
Fax: (907) 561-5301
All datesAhes are Alaska Standard Time
Printed Date rime: 08115/05 18:10
Corrected DateMme: 08/112/05 11:30
Received DateMme: 08/12/05 12:00
Technicat Director: Stephen Ede
Rateased �yt^I�//��e�
Anovratle Prep Analysis
Parameter Results PDL Units Method Llmtts Date Data Ink
Nitrate N.D. 0.10 ng/kg EPA 300.0 10.00 08/12/05 08112/05