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Home My WebLink AboutTHOMAS L BOYLE BLK 1 LT 4BThomas L 0 Boyle Block 1 Lot 4B #015-282-28 93-E Municipality of Anchorage Page - I of 2. DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW94000/ PID Number: O/S2PZZP Name 6 Wastewater System: ❑ New gupgrade V/D L. PAT%�/.Q• G A PES Address ABSORPTION FIELD 9 a.ue_e- .5-T - itKNOR+9 c AK 757(0 No, ofBetlrcoms' 3 Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating Total Depth from original grade GP01S Ft S•S Lot BlockSubdivision' Depth to pipe bottom from original grade Gravel depth beneath pipe 48 1 3011 2 FI 3es- F, Township Range' Section: Fill added above original grade: Gravel length: -- -- -- T.2 -F, 77 Ft WELL❑New ❑Upgrade • Gravel width: -Ft Numberoflines: 2 Dislanobehavinlines 1 6 /7- Ft Classdicabon (Private. A.B.C): EXIST. Total Depth' Cased To: Total absorption area Pipe material 'FP/d rJCXF. fVRTE Ft I Ft 713 So F, /n 3 3ti .Vic. Driller Date Drilled' Static water Level: installer SvsTEN+S Date installed: -23-J1Y F,. Yield Pump Set at I Casing Height Awn Ground TANK GPM Ft FI SEPARATION DISTANCES XSeptic ❑Holding ❑S.T.E.P. To Septic Absorption Litt Holding 'ubLaPnvate Manufacturer: �s n 'T Capacity In gallons: From Tank Field Stal.on Tank Sewer Lines ,40124c,— ,--iAj/C.. /000 WellSurfac /O (01 /3/ 1 — ZSIt Material STCEL Number of Compartments: 2. /oa 4 100 LIFT STATION Water Lot 1/r It '1 26 1 r Size in gallons' Manufacturer Line — Foundation 76' RSI 'Pump on" level at: p oil" level at: High water alarm at. Curtain AJ OA) .�,1 f� w� mp Mak Do pudi Electrical Inspections performed by: Drain BENCH MARK Remarks: Location and Description: 7$/11- TOP OF FA6Ar aV&MJ� Assumed Elevation: /pU.UO Ft ENGINEER'S SEAL 0t 1 As ' 1' 4`4 17034 Eagle River Loop Road, No. 401 Inspections performed by: Dates: 1st P-23-29 •• •a•:, •• •••- • '•••"� 2nd P -z3 -qy.............' . �. Department of Health and Human Services approval j . • " T' ° ``= �~n��;;tJFEn,1 Reviewed and approved by: L1F1 Date: `.• 7201] IS" 9191) MOA 25 Permit No.SW940001 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage, Alaska 99519-6650 -Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal DescriptionPYLE SUBDIVISION; BLOCK 1, LOT 4B PID No.: 01528228 72-013 A (1N31- CO2 CO3 FINAL GRA�E� 86.7' C06& 86.7' 04 CO (C OZ C, MV(CO6& MT2) MT2) MTI) MTIN 0, T ............. . ......................... ..................... SUL&TION N ................... -72 ... ..................... ........ . ............................... NEW 000 GAL 87.4-'-' 87. SEPTIC 82.5 9 1 R TANK (CO�& (C06& 82.5 (CO4& C07)"IC.4 C'07) C C05) N.T.S. ........ .......................... . ............ ................................... .................. . ............. ....... ................... ............... .............. ........................................ ................................ JM9T20)' 0 (LOT; I A 8 FCO 01 67.0 104.0 COI A74.5' WATER FOUND 10/27/93 1 N 02 73.0 112.5 C CO2 CO3 78.0 1113.5 C04 107.0 150.5 -005O5 97.5-133.0 COO 125.5 167.5 C07 117.0 151.5 MTI MT1 108.0 151.5 MT2 MT2 124.5 167.0 jj Tj 100' WELL RADIUS WELL 03 .............. ............. co 0;� ..... ......................................... ............... ................. ..... . ................................... ......... . . . . . ..................... . . ...... . ................. . .............. 3: BDRM HOUSE NEW TRENCHES L % NEW 1000 GAL. T % SCALE 1" 40' 72-013 A (1N31- PAGE MUNICIPALITY OF ANCHORAGE °I @ DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650,'825 "L" STREET, ROOM 502 q VsJ CZ ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940001 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HARPER DAVID L & PATRICIA G OWNER ADDRESS:11741 CANGE ST ANCHORAGE AK 99516 PARCEL ID:01528228 LEGAL DESCRIPTION: BOYLE BLK 1 LT LOT SIZE: 49500 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 4B THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1 OF 1 %7-' 6-D ¢.r a.'" DATE ISSUED: 1/04/94 EXPIRATION DATE: 1/04/95 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 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: r Li DATE: ISSUED BY: �F�l sm m4 DATE: (b�h4- ng HEALTHAVTHORITY APPROVALS SEWER 6 WATER MAW EXTENSIONS SEWERS WATER INSPECTION ANDREPORTS WELL INSPECTION S FLOW TEST SITE PIANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL MECHANICAL INSPECTIONS ONSITE WASTE WATER DISPOSALSYSTEM DESIGN November 12, 1993 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99519-6650 REFERENCE: Boyle Subdivision, Block 1, Lot 4B ROBERT SHAFER. P.E. ROGER SHAFER. P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694.1211 RECEIVED NOV 12 193 Municipality uI . Dept. Health & Huma3 5.. c.,: We request you Issue a permit to upgrade the septic system serving the three bedroom house on the referenced property. An adequacy test performed on the existing system for Health Authority Approval purposes found the absorption capacity of the existing system to be inadequate. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavation water was seeping at 12 feet and after seven day water monitoring water was found at 10 feet. Attached it the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. A. Shafer, P.E. RAS/LSU/Jsu 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 seolweg uewnH g 411eaH 7daa ��...srt�1 eBeioyouy+o%!ll'=dlolunyy • %• • i AQP 4 ��lW • V [ N 04 J.87NJ.S NJINJVM se x' a.t8 nor yyv% ' Q ti Q0O a wwa s J Vf z 0 i H O O Z / _0 U= Z<0 4 N ow V) OVWia o Z WpN w M W W p 2 W W Z C T �w ~mZ W O m aJ LiOJ W} A N Oz0- D�-> a O V1�O i 0UU \ Y a ur, ZdVI W F- W d'O W a0 WHW Umt..O N} \ U NV)m�ZWd W -i V, Q 0Wp 0- M: as a W r N~ J� w W< o < I-- leo \ G U 0 Vj �O I La L. OMEO a �zV, �-LJZ� Uoa3 a LJ a wo Z �/) W v~iv=ia ��oc�� = 2 a o Y U O x U •�•' 4 W W O [-. F in V) OM in m w W d\N M CO�coZ h 7 z �' "pav''o oz �NN to tou W W O L)•r CO u'I .-1 H v z F-:::) II O II �Wr IL w wU OHO h Z um WWLZ C4 J U� O Z ppLio O.a P. a 3 i!J m=oo 'V! ink axe C7 a (_] MND A u7 �AMt0 6r OU 3 o Q leo .ss > �" `� � '•f 31y79 O Municipality of Anchorage • ... DEPARTMENT OF HEALTH &HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ?-> tO V1ILS(Nr,3 DATE LEGAL DESCRIPTION: /L SO, DT lU,a) Township, Range, Section: SLOPE StL-ly SAnO WITH FINa UNIRIRAA SANT ?CLt%75 TSEpU&1+0IR, WSW _ aT� cANCS WAS GROUND WATER YDS ENCOUNTERED? I CEEPIIQG I/J L IF VES. AT WHAT O DEPTH? I0� P 100 :� lo��l(93 E Depth to Witter Attert ./, 11101toring7 IO Dill z�r to =mmm PERCOLATION RATE Immutes anal PERC HOLE DIAMETER TEST RUN BETWEEN O OL FT PERFORMED d70341 Eagle River Lown Road Ne.204 I Eagle River Alaska 99577 ACCORDANCE aTH ALL STATE AND MUNICIPAL GUIDELIN � 72-008 IF". 4/851 ON THIS DATE. DATE THAT THIS TEST WAS PERFORMED IN PERCOLATION RATE Immutes anal PERC HOLE DIAMETER TEST RUN BETWEEN O OL FT PERFORMED d70341 Eagle River Lown Road Ne.204 I Eagle River Alaska 99577 ACCORDANCE aTH ALL STATE AND MUNICIPAL GUIDELIN � 72-008 IF". 4/851 ON THIS DATE. DATE THAT THIS TEST WAS PERFORMED IN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Boyle Subdivision, Block 1, Lot 4B GENERAL: RECEIVED NOV 12 1933 Municipality of Anchorage Dept. Health & Human Services 1. The scope of this project includes the installation of two five foot wide drainfields to serve the existing three bedroom residence on the referenced property. The existing septic tank is to be excavated to verify integrity. If of poor integrity, the tank is to be abandoned and a new 1000 gallon septic tank installed. The existing leachfield is to be abandoned in place. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4' cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Page Two Boyle Subdivision, Block 1, Lot 4B November 3, 1993 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION. 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Boyle Subdivision, Block 1, Lot 4B November 3, 1993 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Two of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F610 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2' thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Wall 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5'-2.5' screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, it's gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Boyle Subdivision, Block 1, Lot 4B November 3, 1993 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final Inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. \\ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE >4NEW 34 = ❑UPGRADE MAILING AQORES 1 b / LEGAL DESCRIPTION d LOCATION NO. OF BEDROOMS C-..) A-c�cv- S-- 43 DISTANCE T0: Wel� 7 AbsorDuZ�erZea�� Dwelt (p PERMIT �rll Z<, Manufacturer Materia No. of corD.partments kl�a Liqjca achy in gallons CD IF HOMEMADE: inside length Width Liquid depth DISTANCE TO: Well Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons 0 w= DISTANCE TO: WellA 4.. Foun a on Neare t l0 1 e !�— PEHMI N _�j Le LL Z No. of lines Lengt ach line Tota le hof lines Trenc wid;h Distance betwee lines f ? W Q inches HTop finish Material beneath the Total of tile to grad E f I� effective absorption area p inches Length Width Depth PERMIT NIJ. W H Type of crib Crib diameter Crib depth Total effective absorption area W 1 Well Building foundation Nearest lot line DISTANCE TO: Cla Depth `Ot o Driller Distance to lot line PERMIT NO. BHN W DISTANCE TO: Build' n los�pdation Sewer line f Septic tan/ Absorpt[on,pr a�) 11 OTHER PIPE MATERIALS 0-so4 Gh ST- SOIL TEST RATING A 1 Z A INSTALLER r REMARKS �p 'IL IL 11. d P; •• ••.S°e 9 rte: /�c�.• CE - 6793 .' .r •. ccs ... � n p�cfessi�c�� o`er � APPHO E DATE LEGAL 12K 15-1171A bZ3T 8L I 80 72-0131Rev. 31781 �' PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: MUP4 I C I P'A'L I TY OF= ANCHOFRAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 ON—S I _r SEWER ' F�EF2M I T 850569 09/06/85 JIM BROWN Off ha"'`IncAd°x, D �v 11600 CANOE ROAD oln•/a�w /c0 // -eo ANCHORAGE, AF: 99516 49 345-700II LEGAL DESCRIP: SUBDIVISION: BOYLE LOT: ,4A- �� BLOCK: 1 SECTION: 21 TOWNSHIP: 12N RANGE: 3W' LOT SIZE: 43560 (SQ.FT. OR ACRES) MAX BEDROOMS: 3 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site.' *+� TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. 1 am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back. distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 3 bedrooms and Zany enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK. MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED APPLICANT: JIM BROWN DATE: ISSUED BYV. DATE: - /� - �S� ------------------------- ----- SED W _ DF -1A I N DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 GRAVEL DEPTH (FT.) 0.5 3.0 TOTAL DEPTH (FT.) 4.5 7.0 GRAVEL WIDTH (FT.) 17.0 5.0 GRAVEL LENGTH (FT.) 34.0 44.0 GRAVEL VOLUME (CU.YDS.) 21.5. 28.6 TANK SIZE (GALS) 1,000.0 ** 1,000.0 *+: SOIL RATING (SQ.FT./BR) 125 125 *+� TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. 1 am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back. distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 3 bedrooms and Zany enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK. MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED APPLICANT: JIM BROWN DATE: ISSUED BYV. DATE: - /� - �S� ------------------------- ----- SOILS LOG iAl 11600 CANGE RD. ANCHORAGE, AK. 99516 ❑ PERCOLATION AMORE ' (907J 345-7008 TEST SOILS LOG - PERCOLATION TEST PERFORMED FOR: \ • I V.^ '1�T?r.w�% DATE PERFORMED: �S LEGAL 1 2 3 4 6- 7- 8- 10- 11 7810 11 12 13 14 15 16 17 18 19 O V-CTPIN K -S S 1LrT `t^Al, ) SITE PLAN Z:S flab IZ5�l6•� W) ' �- THOM A. FISCHER CE -6793 4e' • 67 IV 20 f4\•t✓p!�.(..�kn1?� ��4` PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS WASGROUND WATER L ENCOUNTERED? tib O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time THOM A. FISCHER CE -6793 4e' • 67 IV 20 f4\•t✓p!�.(..�kn1?� ��4` PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS WASGROUND WATER L ENCOUNTERED? tib O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth so Water Net Drop PERFORMED BY: CERTIFIED BY: DATE: GA•.HDI I GF~TER ANCHORAGE AREA BOROI"'�i DEPARTMENT OF ENVIRONMENTAL QUALII-v ,'. 3500 TUDOR ROAD ANCHORAGE, ALASKA 89507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM M SEPTIC TANK: DISTANCE FROM WELL110-1I0--'s6'dA'P0 MATERIAL MAILING �-�-�• nnoeee -�/ �— S7Q-r4 FigG - [<[ uoulD LIQUID CAPACITY 7s70 GALLONS. INSIDE LENGTH INSIDE WIDTH-DEPTH- SEEPAGE IDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: i NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH �Z , LENGTH 3 , DEPTHol �^ , �Ca LINING MATERIAL ` r1 olocz.?e- 4<./ay(' . DISTANCE FROM WELL %�' ��>, /C. BUILDING FOUNDATION, NEAREST LOT LINE 7o" ?' E . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SCO SO. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF ABSORPTION TOTAL LENGTH FOUNDATION , NEAREST LOT LINE , OF LINES , FT. LENGTH OF EACH TRENCH WIDTH TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE W Ell: TYPE/C f J;., DEPTH FROM _ WATER DEPTH ,BUILDING FOUNDATION. SAMPLE , NEAREST NEAREST SEPTIC Ct e SEEPAGE , OTHER LOT LINE . SEWER LINE-. TANKJ��, SYSTEM /m �� y�, CESSPOOL . SOURCES_ DISTANCES: S'e,,1h DIAGRAM OF SYSTEM DATE 9P/71 APPROVED�y��tT '� "� G2�/-G-C--C GREATER ANCHORAGE AREA BORvUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 5500 TUDOR ROAD POUCH 6.650 ANCHORAGE. ALASKA 99502 TELEPHONE 279.8686 PERMIT NO. SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT w PsV IVa + 1L�e MAILING ADDRESS Sr tar 3x /6-47 PHO,ry4- 7-7�2- NAME OF APPLICANT - - _ INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK SEEPAGE PIT D,RAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO ME SERV D. A D ieM un_ ^� FINANCED THROUGH ~I' T TO BE INSTALLED BY Sce F SOIL TEST RESULTS NOTE( THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED ' / / 7 / FINAL INSPECTIONe 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /D00 TYPE 61ne L).r El&.^EEPAGE AREA SIZE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT `' DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL —/ox ' SEPTIC TANK 5 SEEPAGE PIT ._.., Z DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT ^'oo�ed DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT �G DRAIN FIELD ••77S / ' ' SEPTIC TAN SEEPAGE PIT DRAIN FIELD TO RIVER. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL. E 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. MALT�t PL OR LICENSED DESIGNER 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER DESCRIBEDSYSTEMIS IN ACCORDANCE WITH SAID CODE. DATE '•'�O/// APPLICANT'S SIGNATURE TYPE DIAGRAM OF SYSTEM E AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE CREA.TER ARCHISA^E AEEA LC�� HEALTH r.. DE?AF.Tyr"T -t 32- EAGLE STREET ANCHORA^F, ALASKA 93501 CASE d Ferfcrmed For P� oLet al Dc -scrip Date performed QQK ul;;y :c% o of Fern Reportsa: S� tG ver ration Test Depth _reet Soil Characteristics Location Sketch 90 6w ,9. 7/ir S., di very /Ociely compac led wi i!r a /ow io-Y"Oder4e /7704 /4ee C O.p pfp71 //1l // COq/4C/S 6e/wer red;n,err/ Ore it/y eoiub /oe,yf, Was Ground Nater Encountered? If Yes, At What fepth Frcpo4ed Depth 0' com'4EFTS: C Installattlon: Seepage Fit_ Drain Meld Inlet_ =� 0 Deptn To -bot to Of Pit Cr Trenc. Test Ferformd By: -.a ,1 Data Certified By: j Dat � n MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 r Application Date J 1 G 4 �� 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) (,r -,T- 4- a. 1 R'o•rk_c Location (address or directions) 1 % -1 L'-2 ftCl � sq-- (b) Applicant Name t vr\ � )Z tt&ATelephone: Home 5— 44 Business Applicant Address 11-4-/ WAS - ST— (c) Applicant is (check one): Lending Institution ❑ ; Owner/builde)2r—buyer ❑ ;Other ❑ (explain); - (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual WePP Community ❑ Public ❑ Telephone Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsitel` Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11,84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval 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. 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm �vnT�'~''rYT ��f"rfK— GAI&ephone 7�� Addre Date ti Q9TIIT"r '_'0 '•••• •....^... �F1Q Engineer's Seal T n •, t+orr a ri^nre 7 CE • 6793 •,� y `� algfc�m.�o1o9�0 6. DHEP APPROVAL C� < Approved for bedrooms by yDate Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. Page 2 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design W%pe D9lA Date Installed C7 T� 67 Zs Length gth of Field 4z- / Width of Field �o Depth of Field 1 Gravel Bed Thickness Act rr Square Feet of Absorption Area 3. 7 `% Standpipes Present (Y/N) hl�- Depression over Field (Y/N) No Date of Last Adequacy Test N EW Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well __,�Z or To Property Line tt / To Building Foundation f 0O To Existing or Abandoned System on Lot Zorn ; On Adjoining Lots (Ces/ To Water Main rvice tine Zsr'►' To Cutbank (if present) N�I� To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ' ' CcfKH �Fi as f4%� D. LIFT STATION Date Installed Size in Gallons -Pump On" Level at — High Water Alarm Level at Tested for Electrical Codes N) _ Comments •' Check Permitted Bedroom Rating Against HAA Request .. access (Y/N) Off" Level at Vent(Y/N) during Adequacy Test. Meets MOA Icertify that Iha checked, verified, or conformed tttooa%MOA ndHAAguidelines ineffect onthe date ofthis inspection. Signed Date ( 6 Company t^ 1t%T0-%"¢- WnJd-C-v4tXMOA No. Receipt No. 3R L( l0 cvN Date of Payment �-- \ (D �y Amount: $ tPsco Page 2 of 2 72-026 (11,84) Engineers Seat MUNIDEPT. OF R'k5(frFl"�Y OF ANCHORAGE (MOA) EWlR0NMENT41&A1LW*k%THORITY APPROVAL (HAA) MAY 1610ECKLIST - FEBRUARY 1984 2644720 r ,, RECEIVED Legal Description: __ 4if ,tom A. WELL DATA Well Classification :"R1 V If A. B, C, D.E.C. Approved (Y/N) '-- N/ r Well Log Present (Y/N) Date Completed 19 7 a S Yield 3 5 CT -PM Total Depth I O (� Cased to ) 0 (' Depth of Grouting _ 7F1 Static Water Level Pump Set At 90 u Casing Height Above Ground ___t= °a Sanitary Seal on Casing (Y/N) YZ Electrical Wiring in Conduit (Y/N) YIES, Depression Around Wellhead (Y/N) IZ0 Separation Distances from Well: / f To Septic/Holding Tank on Lot 00 ; On Adjoining Lots of -t— To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots I C)Q/+- To Nearest Public Sewer Line _EyAt To Nearest Public Sewer Cleanout/Manhole h1(fk- To Nearest Sewer Service Line on/((ccot Z� Water Sample Collected byOate/ 1 Water Sample Test Results <—�TtSFA e rod Comments a -o e�IST1NA_ 4?J� B. SEPTIC/HOLDING TANK DATA Date Installed _74ize ( ZED No. of Compartments Z' Standpipes (Y/N) �_S Air -tight Caps (Y/N) Foundation Cleanout (Y/N) ` CS Depression over Tank (Y/N) WD //,^, Date Last Pumped Pumping/Maintenance Contract on File (Y/N) �1� Lt ;for Holding Tank High -Water Alarm (Y/N) N 1' Temporary Holding Tank Permit (Y/N) N Separation Distances from Septic/Holding Tank: To Water -Supply Well -C3Z)! To Building Foundation 66 To Property Line �S�'>`� To Disposal Field Z 8� To Water Main/ ,vice Lin _L5 '-1" To Stream, Pond, Lake, or Major Drainage Course Comments tea^' Page 1 of 2 72-026(11;84)