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HOMESTEAD HILLS #1 BLK 3 LT 11
Homestead Hills #1 Block 3 Lot I I #015-173-33 (?�\jISED tZ/lo/aLA Municipality of Anchorage ,._. , .� Development Services Department - , Building Safety Division i On -Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO30= 3 -2t PID Number. ()Re 1511 12, Ops- M. NOTetBRYCE dJULIE ERICKSON Wastewater System: 0 New ■ Upgrade 4510 TRAPLINE CIRCLE a ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 346-2258 55 ■ Deep Trench O Shallow Trench O Bed 0 Hound 0Other LEGAL DESCRIPTION Sag Re": 0.8 Tota Depth han "" pale 8.5/7.5 (MAX) GPD/:, R R Black: Lot: Subdivision: 3 11 HOMESTEAD HILLS Depth to pipe bottom ham orVwl gneee: 1.7/0.7 Grata depth beneoth pipe: 6.8/6.7 R R Township: Range: Section: — — — rte added above "Iral pee.: Ge.el length: SEE DWG. R 33.5/40 rL WELL: O New p Upgrade c,a.el width: 2.5/2.5 Numb.. of rme 2 Getawe bete. eme: 14'+ R R aeu:licetion(Private. AILQ. Caeee Ta Total obeorptfan Oreo: m Pipe lt.rel: 990+ . R SCH 40 PVC G Drover. Dole pro"; Static water L«N: kytaNr. i arc J y i 0 M1vl l We kato 5%2 0-25/2004 R vied: Papp Set rd: toeing Height Amve Gard: TANK CPe R R SEPARATION DISTANCES aseptic DHolding aS.T.E.P. 0Other To Septic Tank Absorption Fmid Lift Station Holding Tank Public/Private ew Ser time � a`ANCHORAGE TANK cavoaty k, 90 1500 From Well too'+ 100'+ — — 25'+ Yo1*rot STEEL Number of eomPeMwnte 2 Surface Water 100'+ loo'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — Site N goeone pan lee at: EX15-t'\NG Foundation 5'+ 10'+ — — — Curtain Drain►aro NONE KNOWN Ysse • trlrnl Hnsp. s pafonnw or. Remarks: OLD SEPTIC TANK COMPLETELY ABANDONED BENCH MARK Location and Deecrlpte PER UPC. BOTTOM OF TANK Ae.unwd rl..atiw.: 96.36 R ENGINEER'S SEAL 0040 Inspections performed by: GEG. Ltd. Dates: 1st _5/20/2004:....g .-..... °.�� 2nd 5/24/2004 3rd 5/25/2004DO •.:� "r Go ess:' Development ervices Department Approval 011C Reviewed and approved by: ate: OtJ O'Professloeoa, o (Z/a) �DO0000� o Ey PERMIT NUMBER: SWO3O313 I II I I I I I I I I I I .I I I I I ITMr2 + I I I I I I I I I I I I I I I I I I I I I I I I I I AS -BUILT DRAWING PoCEL 1D, N48E 73-33• BY DEC, BUT NO STANDPIPE f A T' B STI 55.76 9.37 ST2 60.81 18.71 DBL1 52.27 21.27 DBL2 52.73 21.98 iD 63.01 22.26 MTl 93.12 51.24 COI 93.62 50.87 CO2 85.58 65.01 MT2 108.23 55.92 CO3 1109.08166.73 C04 1102.92182.05 / E%ISTINC 5 I/.• j BEDROOM HOUSE A \ I \ I 8/31/2004 DRAWN BY: A.J.G.o ff. ..... • • _ `Y444 ''•. GARNESS ENGINEERING GROUP, Ltd. a* 4 Q y SCALE, CONSULTANTS 6 GENERAL CONTRACTORS 1" = 4D, ..... „ •.•••... ssa-se oo •vex ton»x • F wnsn-en von a ninon aoen. sN10oTP � • e•�cNoanca. ea 99507vwd+ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BRYCE do JULIE ERICKSON 346-2258 2 OF 3QO p •, •• Came 3 •'• �O� F LEGAL DESCRIPTION:OQ'Pu HOMESTEAD HILLS: LOT 11, BLOCK 3 0� Os •...•••.• d�to 0 Opo Tssslol, TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC UPGRADE 4000 PERMITNUMBER: A S —BUILT DRAWING PARCEL IDNUMBER: SWO SW030313 015-173-33 I—FINAL GRADE - 105.23+ STI / ST2 TOP OF TANK AT INLET - 101.23 - INVERT OF BUNG AT INLET - 100.7 WEST TRENCH FINAL GRADE - 97.3-97.8 :UTNE ELEVATION OF BOTTOM OF :STHOLE - 79.70 n L� NEW 1500 GALLON SEPTIC TANK FINAL GRADE 99.27+ 5ON i=NAL GRAD 95.20 ,FILTER FABRIC -INVERT OF PIPE 94.43 14'+ BOTTOM OF :NCH - 87.70 TANK AT - 101.21 INVERT OF BUNG AT OUTLET - 100.43 EAST TRENCH INSULATION F-ORICINAL GRAL I 97.42 FILTER FABRIC :RT OF PIPE - 95.73 - BOTTOM OF TRENCH - 88.92 RELATIVE ELEVATION BOTTOM OF TESTHOLE - J 8/31/2004 DRAWN BY: GARNESS ENGINEERING GROUP, Ltd. A.J.G. CONSULTANTS& GENERAL CONTRACTORS SCALE' 5701 F TUDOR ROAD S411TF 101 • ANCHMAGF., M 00507 • PNONF (007)3374170 • FA%!007)336-0766 1 - - 40' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BRYCE do JULIE ERICKSON 346-2258 3 OF 3 LEGAL DESCRIPTION: HOMESTEAD HILLS: LOT 11, BLOCK 3 TYPE OF WORK: PROFILE AS—BUILT DRAWING OF NEW SEPTIC SYSTEM A, ` ....... .... e4 A. G mess: O E 9 �FO� 00°roressl9^O Lf- Municipality of Anchorage Development Services Department +� Building Safety Division Onsite 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: harness Engineering Group Legal description: Homestead Hills #1. Block 3. Lot 11 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. 1.) Please verify soil ooelication rate; _2.) Please verify grovel annual fee). Name of reviewer. Julie Makela. P.E. a.., JAM 4911volq o5 Date: 12/9/2004 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW030313 Legal Description: }HOMESTEAD HILLS #1 BLK -3 LT :11 ' S/ Z0)Oy _�-n qP 01 Date Issued: Aug 15, 2003 Expiration Date: Aug 14, 2004 Parcel ID: 015-173-33 Design Engineer: 0041 AK Water & Wastewater Consultan+ Site Address: 004510 TRAPLINE CIR Owner Name: Bryce Erickson Lot Size: 53726 SO. FT. Owner Address: 4510 TRAPLINE CIRCLE Total Bedrooms: 5 Permit Bedrooms: 5 ANCHORAGE. AK 99516-1540 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 specked 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: • WA FERMI Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water& Wastewater Program 4700 South Bragaw SL 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. 015-173-33 Permit Number 5W 0303 /3 Property owner(s) BRYCE ERICKSON Day phone 346-2258 Mailing address (1) 4510 TRAPLINE CR. Mailing address (2) Zip Code 99516 111 Legal description (Lot, Block & Sub'd.) HOMESTEAD HILLS: LOT 11. BLOCK 3 Legal description (Section, Township & Range) N/A Lot Size Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 5 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 0 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. ALASKA WATER do WASTEWATER CONSULTANTS, INC. PennitFees:-}�V• _. Date of Payment: d Receipt Number: Waiver Fees* Date of Payment: Receipt Number. ALASKA WATER & WASTEWATER CONSULTANTS, INC. July 14, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Well and Septic System for Lot 11, Block 3, Homestead Hills Subdivision To whom it may concern: The existing 5 bedroom house is served by a private well and septic system. The septic system is in a state of failure and must be upgraded. Two testholes were dug on the property. The septic system will be designed around the 30 foot radius of these test holes. We are proposing that a 1500 gallon septic tank and a deep trench type drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 0.8 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 15 & 3 minutes/inch b. Proposed Application Rate: 0.8 gallons/day/f2 c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 934.5 ft2 f. Total Depth: 8.5 feet (max.) g. Effective Depth: 6 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 80 feet total length k. Effective absorption area = 960 fie 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached site plan, the average topography in the area of the proposed drainfield is a 15-20. percent slope running approximately northeast to 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: akwwc.com southwest. In short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you kave any questions, please contact us at 337-6179. Thank you for your assistance. II Jeffref Afqlamess P.E., M.S. NOTE. Attached is a site plan drawing, a design drawing, two soils log, and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246' website: akwwc.com rS�nC HOMESTED HILLS /1 LOT 9.� LOT D, BLOCK 3 r � \ 1 1 / 1 ,.G I 'Y I HOMESTED HILLS /1 LOT 10, BLACK 3 Il ALTERAHTE SITE 1 1 n ♦♦--_HOMESTED HILLS /1 i LOT 8. BLOCK 3 / � 1 I I n i c;;PnC 1 i AaL I 1 � / 1 / / PROPOSED I SEPTIC 1 UPGRADE 1 AD Y1wil I — -- --- — --- — — — J ♦-------------- -- \ HOMESTED HILLS /1 C;EPTIC i \ LOT 18, BLOCK 3 ARaD 1 � 1 / ------ PEE I ACE 2 OIFN2) 1 1 1 `-SEPTIC I I AREA I 1 HOM 1 1 I I I 1 1 I 1 1 LOTT7, HILLSBLOCK 3 I HOMESTED HILLS /1 HOMESTED HILLS /1 1 1 LOT 12, BLOCK 3 LAT 13, BLACK 3 -------------------------- -------------- ------------------- ------ ------------------ ------- TALUS WEST TALUS WEST LOT 10, BLOCK 4, LOT 9. BLOCK 4, ALASKA NATER & WASTENVATCR CONSULTANTS, INC. PARED FOR PHONE NUMBER: BRYCE EL JULIE ERICKSON 346-2258 1L DESCRIPTION: HOMESTEAD HILLS LOT 11, BLOCK 3, OF WORK: SITE PLAN FOR PROPOSED SEPTIC SYSTEM TALUS WEST TALUS WEST T B. BLOCK 4. LOT 7.RLOCK 4. 7/11/2003 AWN BY: '`G •'•' N.C.H. 1" = 100' E NUMBER: 1 OF 2 % '•J fr v _ .nm ss: 910 io\�OQ. `'' I PROPOSED 1500 CALLLON SEPTIC TAI I 'a•A., EXISTING S / •A / BNOUWM / EXISTING DRNNFIELD TO BE USED AS A RESERVE SITE— IXISTIIC SEPTIL� TANK TO BE COMPLETELY ABANDONED \ PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 8.5 FEET DEEP MAXIMUM BY 2.5 FEEF WIDE BY 80 FEET LONG. ADD 6 FEET OF CLEAN, WASHED SEWER DRAINROCK. INSTALL / TRENCH PARALLEL TO SLOPE CONTOURS. F5:2VIII LINE FIAGGE REGISTERED ALASKA RATER & WASTE NVATER CONSULTANTS. INC. 3701 F. T000R ROAD. SUITE 101 • ANCHMAGF. AA 99507 • PNMF (907M374179 • FAX (90])338-3740 PREPARED FOR: PHONE NUMBER: BRYCE do JULIE ERICKSON 346-2258 HOMESTEAD HILLS; LOT 11, BLOCK 3 OF WORK: DESIGN FOR PROPOSED SEPTIC SYSTEM UP—GRADE 7/10/2003 N.C.H. 1" 40' NUMBER: 101� 2OF 2 17 e AA(&�mn w. - 7—tATM11 SM 8 9 10 11 12 13 14 15 16 17 18 DEPTH TO ERI DATE DRY C;ipnc ARS THII .TN/2 DATE READING CLOCK TIME NET TIME (MINUTES) SOIL CLASSIFICATIONS 6/24/2003 '0 ALASKA WATER & WASTEWATER — 6' — CONSULTANTS, INC. � 9 ;,* 30 SOIL LOG — PERCOLATION TEST 0 . , ....., LEGAL DESCRIPTION: HOMESTEAD HILLS SUBDIVISION; LOT 11, BLOCK 3 �A a•.J fr a �� °6 9 Ss- PERFORMED FOR: BRYCE & JULIE ERICKSON PATE; 6/23/2003 �� '' •......• '' �44o�D00000�d� �F�G G (f et ==== ORG TEST HOLE 1 2- o i — — 3:12 HIII!il GM 7—tATM11 SM 8 9 10 11 12 13 14 15 16 17 18 DEPTH TO ERI DATE DRY C;ipnc ARS THII .TN/2 DATE READING CLOCK TIME NET TIME (MINUTES) SOIL CLASSIFICATIONS 6/24/2003 1 2:12 — 6' — IGW 2 •- 30 3 3/4- 2 1/4- II:G P111111111ML — 6' — 4 3:12 30 4- 2- 5 3:12 HIII!il GM CL 6 3:42 30 OM ilk 2- •MH !+ - %//%CH i!tlilllSMq'.�� • Sc 7—tATM11 SM 8 9 10 11 12 13 14 15 16 17 18 DEPTH TO ERI DATE DRY C;ipnc ARS THII .TN/2 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 6/24/2003 1 2:12 — 6' — 2 2:42 30 3 3/4- 2 1/4- 3 2:42 — 6' — 4 3:12 30 4- 2- 5 3:12 — 6. — 6 3:42 30 4- 2- 19 I I PERCOLATION RATE 15 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 7.5 FT. AND 7.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: JOE MARCHEITI COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WX P FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: rF o.0 04 o pF... ALASKA WATKR R WASTEWATER 0 CONSULTANTS, INC. * SOIL LOG - PERCOLATION TEST ... •„ .. •, .......... LEGAL DESCRIPTION: HOMESTEAD HILLS SUBDMSION; LOT 11, BLOCK 3 OD a .'_Je fr Or ess: Op'Pi E 9 PERFORMED FOR: BRYCE & JULIE ERICKSON DATE: 6/23/2003 •' \FO (feet) 4" — ORC�4���4000'��0000 TEST HOLE 2 1 — 6" 2 SOIL CLASS11 CATIONS -:o`.5:e". GW _c—c ORGPc 3 10 GP ML 2 1 4" GM CL — 4 — GC OL — SW MH , 1 j 1:16 10 ': •'• SP CH i 5 SM : OH t { 6 — Sc l 11 — { ♦TH/z 11\ ��TOBBEN 7 10 \ DEPTH TO DATE SM SPURKIAND \ 3" GROUNDWATER �� TEST HOLE \ 1:26 — 6" 8 DRY 6/23 2003 1:36 10 DRY 6/30/2003 I \ 9 SITE PLAN i 10 DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 TIME (MINUTES) READING (INCHES) 6/30/2003 1 12:32 — 6" — 12 2 12:42 10 2 1 4" 2 3 4" 13 3 12:46 — 6" — 4 12:56 10 2 1 4" 2 3/4- 14 14— 15 8.0.11. 16 17 18 PERCOLATION RATE 3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 3,0 FT. AND 3.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN COMMENTS: AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W RFORMED IN ACCORDANCE PERFORMED BY WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: -7 1 4" 5 12:56 — 6" — 6 1:06 10 2 3 4" 2 1 4" 7 1:06 — 6" — 8 1:16 10 3" 3" 9 1:16 — 6" — 10 1:26 10 3" 3" 11 1:26 — 6" — 12 1:36 10 3" 3" OMESVHILLS LAT y. BLOCK 3 HILLS f HILLS 11 BLACK 3 , LLUS WEST 10, BLOCK TALUS WEST LOT 9, BUOCw4. ITIE. IHILLS /1 10 10, OCK 3 3101 F TWK4R0A4 SlITF 101 - CNCW AGF, 1K 00501 - MONO (OO )W3 170 - PREPAR FOR PHONE NUMBER 8 ' CE & JULIE ERICKSON 346-2258 LE OLSCRIPTION: HOMESTEAD HILLS LOT 11 LO 3, TYPE OF WORK: SITE PLAN A-1 rjw7m4/ S' iTED HILLS 01 12, BLACK 5 100' NUMBER: ' 1 OF 1 11 rs nC 4, \1 1• Ca0TB9•.••••D0 953 .• 4d G �n 0 - Municipality of Anchorage Page of 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: C? 1 _ 00 2 R' PID Number: Namebelk.ra LtoLrij1e.Lif [IWastewater System: New ❑ Upgrade Address: 6 t Flet ABSORPTION FIELD 1 ro, vii cc Phone: No. of Bedrooms: Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth frog originalgrade: 06 GPD/Sq Ft. Lot: Block: SuOdivla n: Depth to pipe bottom from original grade: Gravel depth beneath pipe 1 t 3 7 i++ fIrln . 1 Is 3, 0 Ft Ft, Township: Range: Section: Fill added above original gra de: Gravel length: 04 OZ err Ft. Ft. WELL: KNew ❑ Upgrade Gravel depth: Number dl linea: D'su=between lines: Ft. t Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area Pipe material: I V 7 FL -71 FL ^ 1008 SO FL F -C,10 Driller. Date Drilled: Stagg 7j S Insleller: Vc Date lnste ed: Q 6' --21—q I Ft. P iryQAA LLiigdq Yield, Pump Set at: Casing Height Above Ground: TANK GPM Ft �TC Ft. Ft. SEPARATION DISTANCES XSeptic 0Hold ing ❑S.T.E.P. To Septic Abaorplion uh Holding ubllUPdvale Manufacturer: Capacity In gallons: From Tank Field action Tank Server Limen, b O Well 1.5 5 -AhlL Material: ST`I— I— L Number of CoFnments: Surface Ne A ly//�- I I LIFT STATION Lot Lig N f Size In gallons: Manufacturer: Line Foundation 1 9 A /Z P/,/� "Pump on' level at: 'Pump off" level at: High water alarm at: curtain �T Pump Make a Model Electrical impactions performed by: Drain Remarks: BENCH MARK Location and Description: J4,T Z. Lo,- N E L L'c r W4, -- F;rd Sidra- L• F toy Assumed Elevation: fs 1 i JO — Ft ,_• ENGINEER'S SEAL 19 > ccd Inspections performed by: S Dates:1s 9 q 2nd113/4) Department of HeaM and Human Services approval Reviewed and approved by: a Date: /D�7- 9/_ 72-013 (1A1) MOA 25 Clean Out 1 0 Monitor Clean Out 1 Standard Trench, 84' LONG 9' DEEP 6' OF SEWER ROCK 3' min. Cover 1250 gal Septic tank Foundation Clean out lv...... i- Mira Fi 140 . 6 Feet of' Septic TESTNOL£ 82. IUBBLN SF'UKKLANll r.L. LpT 11, BLOCK 2, HOMESTEAD HILLS SEPTIC SYSTEM ASBUILT ANC w.. 9950 BLVD. SECTION PZ T12AI Raw DATE, ANCH. AK, 99502-3904 SEPT.27, 1991 ,.,,,....,,, �,.... DEAN LUR(1V/C14 11 SHEET. ?/? GRIID 2636 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910098 DATE ISSUED: 5/14/91 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. EXPIRATION DATE: 5/14/92 OWNER NAME:LUBOVICH DEAN C & OWNER ADDRESS:9021 GRANIT PL.IR ANCHORAGE, AK 99507 PARCEL ID:01517333 LEGAL DESCRIPTION: HOMESTEAD HILLS #1 BLK 3 LT 11 SEC. 22, T12N, R3W, SM LOT SIZE: 53725 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: DATE • S f i DATE:�� T _ BFJUFtF�LANLD F= _ F 6151 M. DIMOND BLVD. ANCHORAGE, ALASKA 99502-3904 19011 248-5095 SPECIFICATIONS FOR SEPTIC SYSTEM INSTALLATION LOT 11 BLOCK. 3 SEC 22 T12N R314 1.0 GENERAL 1.1 Owner is Dean Lubovich, 9021 Granit Place, 349-6026. General Contractor is bell Homes, Steve Bell, 345-2355. The General Contractor will act as an agent for the Owner. All inquiries and communications shall be directed to the Gener- al Contractor. 1.2 Engineer is the person or entity hired by the Owner to inspect this project. The Engineer must be recognized by the Municipality of Anchorage, Department of Health and Human Services. 1.3 Contractor is the person or entity hired by the Owner to install this project. The Contractor must be recognized by the Municipality of Anchorage, Department of Health and Human Services. 1.4 The Drawings, sheets 1 through 3, shall be part of this specification. 1.5 All materials and workmanship shall meet the require- ments of the Municipality of Anchorage, Department of Health and Human Services, the conditions of the permit, and all applicable rules and regulations currently in effect. 1.6 All excavation depths are advisory, and are to be verified and may be modified in the field by the Engineer. 1.7 It is the responsibility of the Owner or the Contractor to adhere to the approved design, to verify that the speci- fied separation distances are met, and that the required inspections are performed. 1.8 The Contractor or the Owner shall report to the Engi- neer any observed condition which would put the septic system in violation of State or Municipal regulations. 2.0 SEPTIC TANK 2.1 If there is an existing septic tank, it may be used if it meets the capacity requirement for the residence. The tank shall be inspected by the Engineer, and its water tightness and structural integrity shall be verified. 2.2 A new septic tank shall be one fabricated by either Anchorage Tank and Welding or by Greer Tank Specifications for septic system installation Lot 11 Block 3 Homestead Hills S/D pg.l The septic tank shall be a UPC -approved two-compartment tank, constructed of 12 gauge, or better, steel with bitu mastic coating. The tank shall be set level an undisturbed soil.The tank shall be covered with the equivalent of four feet of soil. 2.3 The septic tank shall be installed a minimum of five feet from the house foundation and a minimum of five feet from the absorption area. 2.4 The septic tank shall be a minimum of 100 feet from any well serving a single residence; 100 feet from any body of water, creeks or drainage ditches with flowing water; 150 feet from Class "C" wells, and 200 feet from Class A or Class B wells. 2.5 All pipe connections to the tank shall be mechanical watertight calder couplings. Cleanouts shall be installed as designated and capped with air -tight rain caps. Clean - outs shall extend a minimum of 12 inches above final ground elevation. Provisions shall be made for landscaping and importation if topsoil. 2.6 Lift station shall be as manufactured by Anchorage Tank and Welding 3.0 ABSORPTION FIELD 3.1 Gravel used in the absorption field shall be 0.5 to 2.5 inch screened and washed rock, with less than 3% passing the No. 200 sieve. 3.2 Sand, used for leveling or for filtering, shall have an effective grain size between No. 40 sieve and No. 18 sieve. Uniformity coefficient shall be less than 4. Not more than 5% by weight shall pass the No. 200 sieve. 3.3 4 -inch perforated pipe shall be ASTM F810. For pres- sure distribution, pipe shall be Schedule 40 PVC or ABS. 3.4 Solid 4 -inch pipe shall be Cast Iron or ASTM D3034. 3.5 Monitor standpipes shall be installed as shown. That section of the pipe penetrating the gravel shall be perfo- rated, either by drilling 0.5" holes on 6 -inch centers or by joining a section of F010 perforated pile to a solid section of pipe. 3.6 Geotextile shall be Mirafi 140. 3.7 Insulation shall be extruded direct burial polystyrene. Dow Chemical Styrofoam HI 40. 3.8 Topsoil shall be a mixture of 40-60% organic matter, 20-30% sand and more that 20% silt. All quantities are measured by volume. Specifications for septic system installation Lot 11 Block 3 Homestead Hills S/D pg•2 3.9 Grass seed shall be Kentucky bluegrass. 4.0 INSTALLATION 4.1 Locate all underground utilities, property lines, future driveways, existing or proposed water wells, water ways, surface and sub surface drainage facilities, lakes, ponds, and all other facilities requiring separation dis- tances from the proposed septic system. Notify Owner or Engineer of any observed possible conflict. 4.2 Stake alignment of system with markers showing the protective distances from wells and water bodies. 4.3 Establish an elevation benchmark. This BM shall be easily identifiable, stable and permanent. An arbitrary elevation of 100 can be assigned. 4.4 Install the tank as shown on the drawings. Record the inlet and outlet elevations of the tank. Tank shall be placed on undisturbed native soil. 4.5 Excavate the absorption field. Bottom of excavation shall be level and scarified. If sidewalls smears, they shall also be scarified. Record elevation of beginning, middle and end of trench. Record elevation of each corner and center point of bed. Construction equipment shall not operate on the floor of the excavation. Any material com- pacted by the operation of the construction equipment shall removed and replaced with uncompacted materials. 4.6 Place the rock to the depth specified. Do not contami- nate rock with native materials or spoils from the excava- tion. Level the rock surface (+- 1") before installing the perforated pipe. 4.7 Install the distribution pipe. Record the elevation of each joint. For pressure system solvent weld the joints. 4.8 Cover the distribution pipe with rock, and cover the excavation with geotextile before backfilling and placing insulation, if required. 4.9 Record the finished ground elevation at the beginning, middle and end of trench. Record the finish ground eleva- tion at each corner and at the midpoint of the bed. 4.10 Furnish a copy of all survey notes to the Engineer. 5.0 INSPECTIONS 5.1 A minimum of three inspections are required. The first inspection will be of the open excavation. At this time the soil conditions will be observed and compared to the design assumptions. Ground water conditions or presence of bedrock will be verified. Specifications for septic system installation Lot 11 Block i Homestead Hills S/D pg•v The second inspection will be after placement of gravel, standpipes, distribution piping, tank(s) and other compo- nents as specified. The third inspection will be after completion of the work. Any deficiencies will be noted and the Contractor notified. Such deficiencies shall be corrected within ten days. 5.2 All electrical work requires either an MOA electrical inspection or certification by an licensed electrician. Submit proof of inspection or certification to the Engineer. 5.3 Submit catalog data of all mechanical equipment. 5.4 Notify Engineer at least 24 hours in advance of begin- ning any work. Specifications for septic system installation Lot 11 Plock 3 Homestead Hills S/D r pg.4 �o i I— �� a I �� 9 I 10 _Qr t DT W Q I O � welr� o L w I ¢ Well O 11 \ J� Y Tes le LUTy T thole d2 well J 4 O 1 \ �1 l Y I � o LQr 12 / f� • ..+Y.if •......a . w..' • i`1'1}(\1111`11j1\ CE -2225 a S1PTli �`Ti:a srarra�t� a esa ear 2S] r 953 SCAL£, 1' = 1II7 Fr. 1OBBEN SPURKLAND P.E. LOT 11BLOCK 2 HfJM£STEAD HILLS SEPTIC SYSTEM ICSICN 6731 V. DIMUND ELVD. S£C 2P T12N P361 11ATe3 MY 1E� 1991 K. A ANCH, 99502-3904 DLA.N UIR WIaA SHEET. 1/3 ma, c-636 ANC AK. 9 o � o Lar 10 190.8-- 59.6 101.3 1031 \ a- r. • �' LDT 12 ° - +'r• t�.zl cacrc F�a�s ufrarx� Welf u 0 Sl TS !d'9 4i 159 t75 Ski 1' = 50 FT. TOBBEN SPURKLAND P.E. LOT 11 BLOCK P HOM£STEAB HILLS SEPTIC SYSTEM EESla4 6751 W. DIMOND ELVD. S£C 2z I'M R3W BATE:j PAY 10, 1991 ANCH9 AK. 99502-3904 B£A1l LOWMA SHEET 147 M[B- E6X, RAW Clean Ltut O Kwtcr LYeart Out Standard Trenchr 84' LLW 9' LEEP 6' Ot" SEVER RXK 3' rave. Co ver Y1257 gat Sept- tarda ro-A�tbn Clear: OGt r �.fL.•U'•t°'�•'� ;�s t ........... • 'hcn Spudland � � l"4i l P CE-2225 Z'.o l0'01, Clea�ocrts ssic htonrtor 4' Tonsa 3' Coveerr Exist Gror+d 4K� Cover over Tank MOM ktrafi 140 6 feet of Septa- Rock AAl TOBBEN SPURKLAND P.E. LDT 11, KDCK 2, HDM.EEFEAD HILLS SEPTIC SYSiEN DESIGtJ 6751 W.. 9950 BLVD.ANC RK. 99502-3904 SECTION 2Z VEN R3V DATE, MY 12 1991 n , � n (qqT) 3£rkN LU30VILH SHEET, 313 GRID 2636 AVE "C" SUITE 203 20A CHORIAGE, ALASKA 99501 CONSULTING ENGINEER TELEPHONE. (907) 279-3916 Sr-PTIC sysTt14 Dl=st6tJ LOT \LI V3K R1 40I-kF.s'TEgD t+ILLS 'bEpcN t. VSOViLE.► SOIL V-AYINE7 }rr..,t les y�3I9L ^� I6V _ p Z O. G - °2 r4 6 tdremw1 Fs V.- 4 I;L50 at Sep�;� 4 rocl . Lnoo �z = s Tobben Spurkland P.E. SCDTIc SySTF-M DESt(,ry I.oT 111 'axal F%0"F-Si�AD !i►LLS -1Z A, Tl LO SoVi rl 4 I1 %1 .6 i ft t.&, U' .e,, .4v.,,,a Q�l.` -&* l".., -•-I VYA/J L,ot N.4.trt t.I. 0 o e, L 4C�tt� le S ; t.,40.*4� o4 A '8_�Q - ""v. 1 - A _ r L N p r G 0 ^X^ Vlr K p •�Gt� L40#-5 % w • }� 1 .-`{ENGINEER'S SEAL) � ' Municipality o1 Anchorage DEPARTMENT OF HEALTH 8 HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502 0650 js ••• +• SOILS '�c°i� .aLbv .'rl O SLOG —PERCOLATION TEST r` ,• C_ PERFORMED FOR: 1JeLtelotU- DATE PER FORM ED:,�. I3 LEGAL DESCRIPTION: 1 fTr Its SK!' 410"ESrt6Lpwnship, Range, Section: 5 C—.C✓ZZ 712N 2 10 Irl ILLS SLOPE SITE PLAN 18- 19- 20- COMMENTS 81920COMMENTS IF YES. AT WHAT DEPTH? Depth to water Alte-r I Monitoring? �LL2_ Dale: ENNEMENREM 4PIi 0vZQ 4N%Ls 1 2 ;+ $Art10y SILT zz a" 3- 42 I'll. I 4- 4 Zo 5 ■i■.EI"52"E, roro •/.. rt 7 7 e2or/ SILT O -o - ZZ VIA 8 '�..• DtrL. R•pGK 1 20 -1 r�•= 9 DeKse- - 10- 10 11 11 r a ' —a t 12- 2 13 13 `r - u. 14 r. 15 .' 1• ` 16 oT"TD O P "OLC 17 18- 19- 20- COMMENTS 81920COMMENTS IF YES. AT WHAT DEPTH? Depth to water Alte-r I Monitoring? �LL2_ Dale: ENNEMENREM Net Time Depth to Water Net Drop 4 —•— —•— zz a" ...■■■.HE■ 42 I'll. I so Zo 5 ■i■.EI"52"E, roro •/.. rt 1a— e2or/ � O -o - ZZ VIA 1 127 1 20 -1 ENOMMENNEN NNENNOMMEN .■.■■.■■■■, eltl� Reading Date Gross Time Net Time Depth to Water Net Drop 4 —•— —•— zz a" 42 I'll. I so Zo 5 o e/ roro •/.. rt 1a— e2or/ � O -o - ZZ VIA 1 127 1 20 -1 PERCOLATION RATE q (minutes/inch) PERC HOLE DIAMETER to II PERFORMED BY: 1 •'s • I CERTIFY THAT THIS TEST WAS PERFORMED ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-M (Rev. /,85) jl W z Municipality of Anchorage DEPARTMENT OF HEALTH S HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST �:,-.'• "a `(ENGINEER'S SEAL), / O0- -�ANICS 3- 3 ' � Sot -Na C.1 e r T C_ 6 6- ..t PERFORMED FOR: le-" LLA-Lo^LrzcJ, / DATE PERFORMED�`_�Z LEGAL DESCRIPTION: -�� III 6y a 4a. a,aGSLw�V'OWRShIp, Range, Section: t I2hl (Z3Ul/ Sa..,..2.2- 1 2 2- / O0- -�ANICS 3- 3 ' � Sot -Na 4- 6 6- ..t rte✓ 7 �•i 8- 12 12- t t �. to t1 C(., r 13 't't �L c 14 ri r —. oW1 15 16 17- 18- 19- 20- COMMENTS 7181920 COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? I YD S IF YES, AT WHAT L DEPTH? p E t Depth to Water Atter Monitoring? Dry Date y S ., PERCOLATION RATE o (minutes/inch) PERC HOLE DIAMETER e TEST RUN BETWEEN Z FT AND LFT PERFORMED BY: I CERTIFY THA IS TEST WAS&RFD IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-M (Rev. 4/115) • - -- - S • _.-.. . LOCATION OF WELL (Pleas, com,al, either la, la ar IC.) Z 8114 a9^ a D4'Lor 013 11 la. V, 41 y --� r:e - -3 ItTC1-3TANCL AND DIRECTION FROM ROAD INTERSECTION, 91111' A4410.1 ane Asea 41 Well LOtallon 2 'EL:. .VO _. t �J_ �i -v* M 41.114_ •r act -._--. -- I WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological 8 Geophysical Survey, 0.1111,9 pe•mll No A.D I. No. _ S.c lien No. Ta.nlnlpNQ Range Eq Moridlan 3 C]WO .__.._.• 3. OWNER OF WELL; _.feet8s. e. Sar fat. iap eenem m a- _RECEI_VED- t -----SEP 2-7-1991--__ __--Municipality of Anchora ---' --.— DepL Health & Human Sery Cos --- ' I I :a .u'rM wit: rOV IPA[ TCA S CEPTISICATIJN: _d WELL DEPTH. fllnal) 3. DATE OF COMVLETIQ_N. e, ❑Caeca 1061 WRolory (3Drive, [Ou9 Augo1 C' Jolted QSOrtd ❑ Other s 7. V7G•� Domeellc Psallt Supply ❑ Indullry Irrl9atlon (] Rea04f9, 0comme01441 l� Test Well 0 01Mr. S. CASINO' U TnnaaeJ p(`�W'e rd od dlenl. lIn IQ—,71-11 Depin Wel21 t _i�L la..1 fl. diem._ -1, to—_ it Dore SHcWp-I ft. S. F.NISHOOeFF*�'EL'''""L"". TIP.' r/�.r.2.N.r/lt�! DIAme1,r•�/ Slot/Ell also: 361 p.l.,en - ft. end Bete hN:nd Ororel Door 10. STAT,C WATER LEVEL•__345-_10. ]LL�YLLC U Ata„ ar XB,ia• land sv,fdte Oat• Ea4�pmenl V)od: _,a II , PUMPING LEVEL e.lo. Ia,d eurlote old MELD 7_/1. ofq, I Its, pumpinl ql ^--- 11- aIle, —_ nn pumD:n9 `-0 p M, iZ.OPnuTINU Well Or 411.4: O Va. U No "61:41 C7 Neal co wart Q O,n,`,: -- _ 13. PUMP. tit prallae V) NP_ Lengln of 01ep Pape _-^ _----- „l,. capoeltf _9 El Q I. t., u JH O QentrUrtol U Other Id Pga1ARNS 1 11. Wa•er !e wD. •otos• a O F f-1 C _. 1 •,1, J1.1 N O m� l,dlsuano ,nport., Il a 11114 1• of m -ey�y)e onJ 0alleli r% ^ ` z_ R - yf •J .,.,•J •.n;,, yam./ [441111.1 one. Ail 9� 041,' l el ,41141 actor Lnrn4 a• Ia,- 02•WWR IPf011 4001 Oi,•rlb-Olen: WHITE_ $,,,, 04iS, PINW•061141, CANARY-Cuuomot • y MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services ` On -Site Services Section CELIZ' P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 52 Li— E3 –33N HAA It �g $ �, A y a 1. GENERAL INFORMATION Complete legal description Location (site address or directions) `a pro Property owner M'L 10012 PA r,,—!n_G Day phone HF -; c Mailing address u.cro Lending agency Mailing address Day phone Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Y= Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank _ Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-M(Rw.1/91) Front MOA#21 5. 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 of 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. 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'�NA20Na e -('JS• SVc Phone Z?Z a2r9 Address "74D.0 -%0y- iyzoas .t4&JcA Ate gc)sicr Engineer's signature{ Date A?IZ3 Noir-_; SriAT-rACAcbt2C'riN2T# SGLA1mE4. 6. DHHS SIGNATURE Approved fore �/R bedrooms. Disapproved. Conditional approval for Additional Comments 30 G Y� y Steven R. Pennene "C� ,CE -8149 '*Rous"%0" �Cata�:a't3' bedrooms, with the following stipulations: Date g'ZG- e)9 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and theirlending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissicrs in the professional engineer's work. 72 WS IR". 191) e9Ck MOA N21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICU C E I V E D Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska e95o1 • (907) 34A1$ 42 41998 Municipality of Anchorage Dept. Health & Human Services Health Authority Approval Checklist Legal Description: L N&m&,ar&Ab JJ) CL C I Parcel I.D.: O/S- 1?3 -.a-K A. WELL DATA Well type P4 kQA-r FA If A. B. or C. attach ADEC letter. ADEC water system number Log present (YM) Y Date completed 6121 i ?I Total depth ( Cased to I Casing height (above ground) Sanitary seal (YIN) v Wires properly protected (YIN) Y FROM WELL LOO AT INSPECTION Date of test 6 h I l 41 8116 i Static water level -3s ZS I Well production WATER SAMPLE RESULTS: g.p.m. 3 • U &p.m. Coliform —0— Nitrate I. }A Other bacteria —c> Date of sample: 8 //(* 1414 Collected by: S • R 3 AALUO N rr B. SEPTIC/HOLDING TANK DATA Date installed91 Tank r 2 Number of Compartments Z. Cleanouts (Y/N) Y Foundation cleanout VY/N) _� Depression (Y" wU High water alarm (Y" -- Date of Pumping 2Y/, Q 6 Pumper A' Awe SV C C. • ABSORPTION FIELD DATA Date installed Cr I? If Sod rating (&pAAF or f 2fodrm) P• 6 System type'D Length a 4 Wi*b vairAAa..n./ Gravel thidtness below pipe 6 Total depth 197.3 F.Qbctive absorption area f cob Monitoring Tube presem(Y" Y Depression over field (Y!N) �y_ Date of adequacy test P -06,19M Results (PasslFailf-3AsS For A( bedrooms Fluid depth in absorption field before lest (in.): `/C Immediately afterjg2 gal. water added (in.): yQ 4N Fluid depth f'� (ins.) Minmes later: //GYJ Absorption rate = Goo r g.p.d. Peroxide treatment (past 12 months) (YIN) UNIrAV"^- If yes. give date D. LIFT STATION Date installed Manhole/Acceis (YIN) High water alarm E. SEPARATION DISTANCES •r.t1 Size in SEPARATION DISTANCES FROM WELL ON LOT TO: at' "Pump off' level at' Septic/holding tank on lot /SS ` : On adjacent lots gyp© + Absorption field on lot /320 : On adjacent lots / o o f Public sewer main A11A Public sewer mauhole/cleanout ,vJA Sewer /septic service line / SSr Lift station /o c, f SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation /O' Property line Wart Absorption field N /O ` Waren main/service line -Ve Surface water/drainage / ctf'- Wells on adjacent lots / C t SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation a21 Water main/service line -5-6 t Surface water /ceD� Driveway. padung/vehicle storage area S©'4 - Curtain drain /C)O t- Wells on adjacent lots / 20 10 Property line F. ENGINEER'S CERTIFICATION I certifv that / have determined thra field inspections and mlew of,Nunicipal rer,* are in conJarmance with ,WOA IMA guidelines in effect on this date. Signaturec \7Q Engineer's Name V -To- je-,a UT-w.wveved �j!' It Date 81z -319R NAA Fee S 01-,C )n . CX_ j Waiver Fee S Date of Paymem 4 -Q,-1- 1 1z -70) Date of Payment 1 l Receipt Number ()\ �4J Receipt Number Rev. 8/95 OSS: haa.wk.doc 3104" L 0000" CE -9149 Steven R. Pannone, P.E. P.O. Box 142025 Consulting Engineer Anchorage, Alaska 99514 (907)272-8218 Legal: Lot 11 Block 3 homestead Bills S/D Owner: Mr. John McIntyre Residence: 4510 Trap]ine Drive, Anchorage, AK 99516 Septic System: Tank Size: 1250 gallons. Absorption System Type: Deep Trench (from Municipal records) Absorption System Size: 3x6x84 Absorption Area: 1008 $.f. Installation Date: 9-7-91 Soil Rating: 250 sf/br Date of Pumping: 814/98 By: A+ Home Service Date of Test: 8/16/98 Test Procedure: The System was inspected and measured. Tank was found with 3 feet of cover. Liquid depth was measured to be 12 Inches. The drain field was found to have 3.5 to 7.3 Feet of cover and a total depth of 10.3 feet. There was 45 inches of liquid measured in the field's monitor tube. Water was added from the well at a contanst rate of 3.0 gallons per minute (GPM). The water levels in the tank and drain -field monitor tube were monitored. A total of 600 Gallons of water was added. During the test the level rose 4 Inches in the field. No rise was noted in the tank. The infiltration rate was monitored for 1100 Minutes. At the end of this period the water level in the field returned to the original level. During this period, a total of 600 Gallons were absorbed. By extending the observed infiltration rate, a total absorption rate 600 + Gallons per day was arrived at. An adequacy test to determine the wells production was conducted at the same time as the septic system adequacy test. The initial static level of the water was found to be 28 feet below the top of the casing, with a total depth reported to be 71 feet from MOA records. Water was pumped from the well at a constant rate of 3.0 gallons per minute (GPM) for 3.3 hours. A total of 600 gallons were pumped from the well with the static water level drawing down to 47 feet below the top of the well casing. The water quality was also tested for bacteria and nitrates. The test results indicated that there was no bacteria present, and nitrates were discovered in the amount of 1.78 mg/l. This is acceptable per MOA DHIIS Regulations. TESTS RESULTS: This system meets the code and operational requirements of the Municipality of Anchorage. In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. ;moi v .............•S2** .� 49 LH ;. :Steven P. Pannone:�P it W ��f% gCt�ESt49 �i ♦�+.lfkr ;&�44 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH d HUMAN SERVICES wl� Division of Environmental Services On-Sito Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# OIS— 171— _33`r 1. GENERAL INFORMATION HAA # ti1fl��1o3t1`i Complete legal description LoT l \ P, V, I 4-ic�w�es ;o_� NiilhS'�1 _ Location (site address or directions) ySl d J 1`r Property owner ►1Lo LZ+L1 N D -a" Day phone Mailing address 4. 10 ro ( CG V� Lending agency N FI Day phone Mailing Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: -1 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: i Individual on-site V Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-02S(RW.1/01) Font MOAR21 5. 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 of 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. I furtherverify 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 \I - q1, r�/ c Y 7- L . Phone 277!- 3 9! h Address .) n � L-4, / `o k-'(1 F/ A_ 3 Engineer's signature D C A r I A -/-`-`"l' Date 6. DHHS SIGNATURE X Approved for �`� bedrooms. Disapproved. Conditional approval for Additional Comments An • bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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 engineer's work. 72425 MW.1191) ext MOA K1 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: el tl, B to 2 4esLt oQ Parcel I.D. O 15 — 113 — 33 Wlls A. Well Data Well type R, If A. B, or C, attach ADEC letter. ADEC water system number N/4 Log present (Y/N) _�� Date completed A •R/• 4 I Driller A 1p "e Total depth 71 Cased to -7 1 Casing height r�2 112, Sanitary seal (YM) x Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test - Z 1 • all 7. 6. 9y o Static water level Well flow y g.p.m. —g -P.M. IT —' Pump levelt f, Qo 40 w 4 r, C <o o M .a. SEPARATION DISTANCES FROM WELL TO: 0 Septictholding tank on tot 14) ; On adjacent lots 14 5 z m Absorption field on lot t 3 j ; On adjacent lots 170 Public sewer main N lA Public sewer manhole/cleanout "//-V Sewer service line > >o Petroleum tank Noxa WATER SAMPLE RESULTS: Coliform 0 Nitrate �1• a Other bacteria Date of sample: 7�i /9Y Collected by: TS S B. SEPTIC/HOLDING TANK DATA Date installed 4/7/g, Tank size /9 re -D Compartments al Cleanouts (YM) Y Foundation cleanout (Y/N) 4 Depression (Y/N) N High water alarm (Y/N) K11A Alarm tested (YM) N Date of pumping 114 Pumper 1 Aa a C '5 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 114 I On adjacent lots I L/0 -t Foundation ' 1 In To property line VA Absorption field to Water main/service line > Surface water/drainage 72.026(3193)• Font CONTINUED ON BACK PAGE C. UFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) 'Pump on' level 'Pump off' Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date Installed 9l'? I 'l t Soil rating (GPD/Ftz) .. (I System type I _, r_ 6 Length R %4 Width a Gravel thickness % Total depth 4 —1 I Total absorption area I oats Cleanout present (Y/N) Depression over field (Y/N) Date of adequacy test '7/, / 9 V Results (passifail) t� for Bedrooms Water level in absorption field before test L/7 After test 5 J; Peroxide treatment (past 12 months) (YM) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 13 5 On adjacent lots 13 'z- Property line To building foundation 9(-/ To existing or abandoned system on lot IV/i-\ On adjacent lots Hot Cutbank No �1 -e Water main/service line i .2 t— Surface water we 0'e Driveway, parking/vehicle storage area > >o Curtain drain l`I o K.e E. ENGINEER'S CERTIFICATION I cerVfy that I have checked, verified, or conformed to all MOA and HAA guidelines in eHecton the date o) irils inspection. 4 % 4,...... Signature t W . Engineer's Name loLL U1V_-aCA f7 L= ,,` e` •s ei �p CS:2;5 y Date HAA Fee $ Sdt�'•o� Date of Payment '/3 9� Receipt Number 96 x.55 q6 e 72-026 (197)• Back Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE !S/ DEPARTMENT OF HEALTH i£ HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # n% -S- �' 7) HAA # y\ iz)`� � C) Lk GENERAL INFORMATION Complete legal description Location (site address or directions) '�✓�/0 -to 64 ✓ hp C�'� .4 (Stula4.anS c.t� Property owner Dza4 L L' �� ✓' �1 / Day phone Mailing address 9'02/ 4"A"4" f lac Lending agency er� florl4aslt_ Day phone e 6F Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: �- 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank — Community on-site — Public sewer — NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72.43 (A". t/91( Front MOA 621 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 of 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. 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 o b ht w S p c ret ",1� L= Phone X79-3�t/b 6. 0 Address Engineer's signature DHHS SIGNATURE Approved for bedrooms. 10 Date Disapproved. - Conditional approval for bedrooms, with the following stipulations: Additional Comments A�_ Date /o - a s- 9./ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an Independent professional engineer registered In the State of Alaska. The DHHS sloes this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. M= (P.. W) B. Maim or Approved for bedrooms. 10 Date Disapproved. - Conditional approval for bedrooms, with the following stipulations: Additional Comments A�_ Date /o - a s- 9./ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an Independent professional engineer registered In the State of Alaska. The DHHS sloes this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. M= (P.. W) B. Maim .r Municipality of Anchorage Department of Health & Human Services AEM HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Le)4 d&MA'IbwP Parcel I.D. A. WELL DATA Well type P-J—S If A• B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) __ Date completed b -21-2 Driller A D7H e— Total depth 7/ Cased to .! Casing height 30 )1 Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test • t"tIGPALRY OF ANCHORAGE Static water level 7j' S I ENVIRONMENTAL SERVICES DIVISION Well flow / g,p,m. q$.Tn 2 1 1991 Pump level 3e#0 -"f RECEIVED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot � ; On adjacent lots /70 Absorption field on lot // ; On adjacent lots 2u o Public sewer main Public sewer manhole/cleanout Sewer service line N/A Petroleum tank NZA WATER SAMPLE RESULTS: 1 Coliform Nitrate ,�- �� Other bacteria Date of sample: lc /I s�`f Collected by: B. SEPTIC/HOLDING TANK DATA Date installed g171q/ Tank size 1AS,0 Compartments Cieanouts (Y/N) 2 Foundation cleanout (Y/N) Y Depressionn/(Y/N) High water alarm (Y/N) Nle Alarm tested (Y/N) tNlli\-- Date of pumping Pumper tl% SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Z Well on lot 15s— On adjacent lots %60 Foundation / y To property line11A - Absorption field O Watermain/service line Surface water/drainage NIA 72.026 (Rev. 7/91) From CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Size in gallons Vent(Y/N) High water alarm levet "Pump on" levet at Meets MOA electrical codes (Y/N) _ —Manufacturer_ Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water Date installed q/7l i (' Soil rating ° System type 7;x4fG4 -Length !�Y Width 3 Gravel thickness �' Total depth Total absorption area /n 0 �i Cleanouts present (Y/N) i / Depression over field (Y/N) Date of adequacy test'' Nfi� t,.. _.. K' Results (pass/fail) ��M —for— bedrooms Peroxide treatment (Past 12 months) (Y/N) - N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot l On adjacent lots %7J Propertyline y� To building foundation %LZ To existing or abandoned system on lot ►��/� On adjacent lots Cutbank —NA Water main/service line NZA Surface water Y�A Driveway, parking/vehicle storage area Curtain drain N/A E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name , •��(�, ,; ,4 Date /d / �� % `, : • y,,+ 0� HAA Fee $ Of Waiver Fee: $ Date of Payment 10-2r- 4/ Date of Payment Receipt Number cL3/ /+s— $B /,Q__ Receipt Number 72-026)Rw. 1.91) Back MOA 21 i ,CHEMICAL-& GEOLOGICAL,LABORATORY ti p �A DIVISION OF COMMERCIAL TESTING do ENGINEERING CO. TELEPHONE (907) 562-2343 - �� ''5633 B Street - - . ! Anchorage. Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria M r TO BE COMPLETED BY WATER SUPPLIER O PUBUC WATER SYSTEM LD.'Y kl"- O PRIVATE WATER SYSTEM ❑ Check Sample (for routine sample - With lab ref. no. 1 ❑ Treated Water - 13 Special Purpose ❑ Untreated Water SAMPLE Time Collected No. LOCATION Collected By 2 I I rt 3 1 I 4 I s ` TORE COMPLETED BY LABORATORY ! 1 -Analys s shows this Water SAMPLE to be a�'factory i O Unsatisfactory - 0 Sample too long to transit; sample should not be over 30 hours old at examination to ndicate retiable resufts. Please send new sample via special delivery mail. . Date Pecelved Time Recelved ' lL tb Analytical Method: Mambrano Filter I I No. of colonies/100 ml. 1.60-1 —Result• Analyst 00 91.55211 FT -1 u I m I m I I m A.D.e.c. BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter: Direct count 5% O G eotf(mndtooml Verification: LSD BGB BEFORE - Fecal Coliform Confirmation k^\, QQ £++\ VP COLLECTING SAMPLE Final Membrane Finer Resufts Coliformeloo ml TNTC c q Reported By I 1 Data Held For Confirm tier, Time: S6 S.M. Too Numerous To Count p.m. OB = Other Bacteria .. ,r CRY .I l Sur .. ZO CoA , � � rn E77-1 FETE I SAMPLE DATE: sto. Day Year SAMPLE TYPE: ❑ Check Sample (for routine sample - With lab ref. no. 1 ❑ Treated Water - 13 Special Purpose ❑ Untreated Water SAMPLE Time Collected No. LOCATION Collected By 2 I I rt 3 1 I 4 I s ` TORE COMPLETED BY LABORATORY ! 1 -Analys s shows this Water SAMPLE to be a�'factory i O Unsatisfactory - 0 Sample too long to transit; sample should not be over 30 hours old at examination to ndicate retiable resufts. Please send new sample via special delivery mail. . Date Pecelved Time Recelved ' lL tb Analytical Method: Mambrano Filter I I No. of colonies/100 ml. 1.60-1 —Result• Analyst 00 91.55211 FT -1 u I m I m I I m A.D.e.c. BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter: Direct count 5% O G eotf(mndtooml Verification: LSD BGB BEFORE - Fecal Coliform Confirmation k^\, QQ £++\ VP COLLECTING SAMPLE Final Membrane Finer Resufts Coliformeloo ml TNTC c q Reported By I 1 Data Held For Confirm tier, Time: S6 S.M. Too Numerous To Count p.m. OB = Other Bacteria CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 8 STREET ANCHORAGE. ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561.5301 INALISIS REPORI 1I SAMPLE for MOREordart 39327 Data Report Printed: OCT 16 91 1 16:12 Client Sample ID:Lil 113 BONESTEID BILLS Client Nam :20611111 SPURELIND. P.L. PVSID :UA Client lett :T066EN3 Collected OCT 15 91 4 13:45 hrs. SPO I PO I MOVE RECEIVED Received OCT 15 91 4 16:10 hrs. Rag I Preserved vith .13 REQUIRED Ordered By :TOI1E11 SPURILAND lnalysis Completed :OCT 16 91 Send Reports to: Laboratory Super s r EPREN C. LDL 1)TO611EM SPURILIND. P.E. Released Ey V14-- 2) .................................................................................................................................... Chamlab Ref 1: 915523 Lab Smpl ID: 1 Matrix: NATER Parameter Tested MIIRITE-M Sample IOUIIME SAMPLE COLLECTED IT: SIUIRT. Remarks: lllovable Result Units Method Limits --------------------------------------------------- 2.8 mg/1 EPI 353.2 10 .............................................................................................................. 1 Tests Performed See Special Instructions lbove Dl -Unavailable MD. Bono Detected " Sae Sample Remarks lbon MA- Not Inalyzed Lldess Than. CT -Greater Than r"SE3S Member of the SGS Group (SociBtd Gdndrale de Surveillance) �`G �CIIEMICAL &GEOLOGICAL LABORATORY ,,r �i A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. TELEPHONE (907) 562.2343 5633 B Street Anchorage. Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM LD. S I/--P1RIVATE WATER SYSTEM n M4..V Adow c,r s:.,:. z.vcx SAMPLE DATE: FLVJ LSC. Day SAMPLE TYPE: l loutine /7 Check Sample (;or routine sample with lab ref. no. I O Special Purpose SAMPLE No. LOCATION 2 3 4 5 Y] ❑ Treatea Water t<Untreated Water Time Collected Collected Bey TO BE COMPLETED BY LABORATORY i Analysis shows this Water SAMPLE to be: P -Satisfactory O Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Dale Flecaived 7 Time Received 7f�O Analytical Method: Membrane Filter No. of colonies/100 ml. Lab Ref. Nn Result, Analyst 110240 _� m U m u m BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter: Direct Count C Coliforml100ml Verification: LSO BGB BEFORE Fecal Coliform Confirmation COLLECTING SAMPLE Final Membrane Filter Results A Coliform/100 ml Reported By j2 ��• 1 Ce-, Date rC• =s_Cj f TNTC = Too Numerous To Count Time: f l� E I} a.m. OB = Other Bacteria