HomeMy WebLinkAboutKARVIEW LT 1Karview
Lot 1
#015-163-48
"Not eligible for a COSA if the berm
has been removed"
Municipality of Anchorage
Development Services Department
40 -
Building Safety Division
On -Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Pagel of 3
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SWO90082 PID Number: 015.163.48
Name'lk Thomas
Wastewater System: ❑ New ® Upgrade
Address:
11401 Hideaway Trail, 9516
ABSORPTION FIELD
Phone: Number of Bedrooms:
❑ Deep Trench ❑ Shallow Trench ❑ Bed 0 Mound ❑ other:
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
1.0 GPD/Ft'
0 Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
7 Karview
+0.5 Ft.
0.5 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
2.5 Ft.
34 F.
Well: ❑ New ❑ Upgrade
Gravel width:
Numberot lines:
Distance between lines:
16 R.
3
1 5 Ft.
ClasaMcatien (Private, A, B, C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
Exist'g Private
Ft.
Ft.
474 Ft'
3034 PVC
Driller:
Date Drilled:
Static Water Level:
Installer:
Date installed:
Ft.
A+ Plus
6/24/2009
Yield :
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
❑ Septic ❑ Holding ❑ S.T.E.P. ❑ other:
To
Septic
Absorption
Lift
Holding
ublic/Private
Manufacturer:
Capacity:
From
Tank
Field
Station
Tank
Sewer Line
EXlst'g
Gal.
Well
102
138.4
110
30
Material:
Number of Compartments:
Surface Water
109
69.7
114
LIFT STATION
18
10.5
16
Si.:
Manufacturer: -
Lot Line
Gal.
76
95
83
"Pump on' level at:
'Pump off" level at:
High water alarm at:
Foundation
in.
in.
in.
Curtain
50+
50+
50+
Pump Make &Model
Electrical Inspections performed by:
Drain
Remarks:
Field covered w/ rigid insulation. reusing exist'g field. Exist'g tank
BENCH MARK
Location and Description:
inspected and no leaks found. Request modification of the
Garage door, top of slab
surface water waiver to 69 feet due to the creek actual location.
Assumed Elevation
100.0 Ft.
Engineer's Stamp
Inspections performed by: PANNONE ENG. SVC, LLC Dates: let 6/2212009
2nd 612412009
� OF •1144
��� P.\�
Development Services Department Approval
TH
Conditional Approval Date:
a
.n..••..
7�•.Steven • R. Pannone, i
`���/
Reviewed by:Date: 2
'• No. CE 8149 '• i
and approved
��Ie�1ESS,.i���
(Ray. 04/06)
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage. Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
htta:/1www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Program
�o
c
e�
Department
**** VARIANCE/WAIVER REVIEW ****
WR#: 090031 HA#:_ Permit#: 090082
PID#: 015-163.48
Legal Description: Karview, Lot 1
Engineer: PES
Applicant: jock Thomas
Your request for a waiver of the required 100 feet horizontal separation from the absorption field
to the surface water has been approved. The approved separation distance is 75.O�t. Also a
waiver of the required 10 feet to an existing bed has been approved. The approve separation
distance is 5 feet.�2jeel
[1
1 A .72
This waiver approval applies to the proposed absorption field to surface water and existing field l///
separations only. Any future upgrade to the on-site wastewater disposal system will require all 2 iD
separation distances be met or another approval from this department.
...............................................................................
Waiver Is Granted: X Waiver Is not
Date:/6 18/2009 Approved by:
..................................................................
Rec#: 042994 Amount: $800.00 Date Paid: 611/09
**** VARIANCE/WAIVER REVIEW ****
PROPOSED IFIELD UPGRADE
'BED, 15'V x3010.5'ED, 2'jD
EXIST'G BED IN FAILURE.
ISEPTIC TO BE REUSED
AREA EXIST'G LIFTSTATION,--
TO BE REUSED
m
101 tiL Es t
L
I F
/6
/'40
III �
I 'r 't
LS
F' 'RlOO-O
b EXIST'G WELL
EX
Ml
01
O� G 3BR H XIST' OQS�E,
m
138.4
69.7 �.
CONSTRUCT -,2' HIGH
\0EF�M7iGPS0M-3SEED
7:7
LOT UNDEVELOPED
NO WELLS! OR SEPTICS
W/IN 1001 FEET
EXIST'r, CREEK
SWING TIES
CO 'LS 6
MI 63.1 24.1
M2 95.9 53.9
NOTES: PANNONE ENG SVC, LLC
DRAWINGS P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
-'49 TH
KARVIEW S/D LT 1
;0
RICK THOMAS
11401 Hideaway Trail •CE 8149
PLAN
Anchora315ge-3201, AK 99516
.-I .........
kOFES�
�iIko 106/30/09
Scale c I e
P.I.D.P1
500'.
TNO
-ERMIT NO.
SWO90082
Sheet
1 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY
OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN
CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE MANUFACTURERS SPECIFICATIONS.
3. SCOPE OF WORK: UPGRADE ABSORPTION FIELD FOR EXISTING 3 -BEDROOM HOUSE. REUSE EXISTING LIFT
STATION. VERIFY INTEGRITY. REUSE EXISTING FIELD. INSTALL DUEL VALVE'S IN LIFT STATION TO SWITCH BETWEEN
FIELDS.
4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST
HOLE INFORMATION ABOVE 5 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS
LESS THAN 3 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY.
5. CONTOURS IN 4.0 FEET INCREMENTS.
97.01.5 96.
I--15.0
SP
92.0
WATER
—7.0BOH 90.0
DESIGN PARAMETERS
SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd)
TANK SIZE: 1250g S.T.E.P.
PERC. RATE: >1 MPI
SOIL RATING: 1.0 gpd/SF
AREA ROD: 450 SF
SYS. TYPE: 15 -WIDE BED
MIN LENGTH: 30 LF
SLS%
3OLFx 15' WIDE, 0.5'ED, 1' TO
TOTAL AREA: 450 SF
SECTION
TOPSOIL AND SEED
2.0• FILTER FABRIC & 2" RIGID INSUL.
ABOVE DRAIN ROCK
WO
mZ
FW
oa
ZW
�a
1 1/4" PVC F.M.
SLOPE VARIES
96.5
`
DRAIN ROCK 4" ABOVE PIPE INV.
DRAIN ROCK 0.5' BELOW PIPE INV.
1 1/4"0 PERFORATED PIPE
2.0' FILTER MATERIAL
PROFILE
wo
mZ
�W
1 1/4" PERFORATED LINE pc=i
W/ 1/4"0 HOLES ON 1.5' 7w
CENTERS 0 a
UPGRADE BED
ABBREVIATIONS
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#
MONITOR TUBE NO.
R.I.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
FLOW SPLITTER
96.5 INV
96.0
LEGEND
•-•-•-•- WATER LINE/
WELL RADIUS
EXIST'G SEPTIC
NEW SEPTIC
(FORCE MAIN)
CHAINLINK FENCE
NOTES: Ptil\1\ONE ENG SVC, LLA.. = "_���� Date
RECORD DRAWINGS P.O. BOX 102954 ANCHORAGE, AK 99510 4�QF A�gSI6/30/09
�
PHONE (907) 272-8218 FAX (907) 272-8211 Scale
* ,• TH z'k�l� NTS
KARVIEW S/D LT 1 j "' "' P.I.D. NO
RICK THOMAS/ teven R. onnome j PERMIT NO.
11401 Hideaway Trail ��'_P' CE 8149 .t?�� SWO90082
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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
Date Issued: Jun 09, 2009
Expiration Date: Jun 09, 2010
Permit Number: SW090082 Parcel ID: 015-16348
Legal Description: KARVIEW LT 1
Design Engineer: 0062 PANNONE ENGINEERING SERVI( Site Address: 011401 HIDEAWAY TR
Owner Name: RICK THOMAS Lot Size: 49358 SO. FT.
Owner Address: 11401HIDEAWAYTRL Total Bedrooms:3 Permit Bedrooms: 3
ANCHORAGE. AK 99516-1151
This permit is for the construction of:
❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
BERM TO BE BUILT AND HAVE TOPSOIL AND SEED BEFORE THE INSPECTION REPORT CAN BE
APPROVED.
Received By: J Date:
/,//
Issued By: kZ l'V% '4�1 Date: t%
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015.163-48
Property owner(s) Rick Thomas Day phone 315-3201
Mailing addressl1401 Hideaway Trail, Zip Code 99516
Site address 11401 Hideaway Trail Zip Code 99516
Legal description (Sub'd., Block & Lot) Karview SID, Lot 1
Legal description (township, Range & Section)
Lot Size 49.358 Sq. Ft.
THIS APPLICATION IS FOR (® all that apply):
Absorption Field
Septic Tank ❑
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms 3
THIS APPLICATION IS AN:
ZD
Initial
❑
Upgrade
Renewal
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
Pannone
LLC
(Signature of property owner or authorized agent)
Date of Payment:
Receipt Number:
(Rev. 11/05)
Date of Payment:
Receipt Number: aI/ e? y
Pannone Engineering Services «c
Steven R. Pannone, P.E., Principal
Licensed & Registered In Alaska and Florida
E-mail: stevetaoanenaak.com
June 6, 2009
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99519
Re: Karview S/D, Lot 1
Septic System Upgrade Permit Request
Ladies and Gentlemen:
I am writing to request an upgrade septic permit be Issued for the above referenced lot. The proposed
system will serve an existing three-bedroom house; the lot is currently developed. The lot is served by a
private water supply system located on the central portion of the lot. The surrounding developed lots
are served by private water systems; the private wells are located over 100 feet from the proposed soil
absorption system.
1. Soils. A single test hole was excavated in May of 2009. Ground water in the form of seeps was
encountered to a depth of 5 feet during the excavation. The water stabilized at a depth of five feet after
the monitoring period. Bedrock was not encountered in the test hole. Based on the percolation test
results and the overall soils appearance, the soils are suited for the use of a conventional wastewater
septic system with an application rate of 1.0 gpdpsf.
2. Proposed System
a. Percolation Rate:
b. Application Rate:
c. Design Flow:
d. Min. Absorption Area:
e. Total Depth:
f. Effective Depth:
g. Width:
h. Minimum Length:
i. Design Length:
j. Effective Absorption Area:
k. Septic Tank Size:
<S Min Per Inch
1.0 gpd/sf
450 gallons per day
450 sf
2 feet to bottom of sand filter
0 feet to bottom of bed
0.5 feet
15 feet
30 feet
30 feet
450 sf
1250 gallon S.T.E.P.
Mailing: P.O. Box 102954, Anchorage, AK 99510-2954
Physical: 11301 Olive lane, Anchorage, AK 99515
Telephone: (907) 272.8218 FAX: (907) 272-8211
Page 2 of 2
3. Surface Water: Surface water is located 64 feet from the test hole and 75 feet from the
proposed drain field upgrade. A two foot high berm will be constructed to prevent any overflowing
sewage from a direct connection to the surface water. There Is no other surface water within 100 feet of
the proposed tank or the drain field.
4. Topography: The average topography in the area of the proposed septic system is
approximately six percent based on contour information.
S. Waiver Request: I request a surface water waiver be granted to place the proposed upgrade
drain field within 7S feet of the surface water located south of the proposed location. Granting this
waiver will not affect the development of the neighboring lots.
6. Waiver Request: I also request the separation distance from the new bed be waived to five feet
to the 1978 abandoned deep trench. Granting this waive will allow the proposed bed to be five feet
farther away from the creek. The effluent from this system will not affect the existing trench. We will
maintain at least 10 feet away from the existing bed.
7. Drawing Markings: The Drawings are marked "For MoA Review Only". When written
notification that the review is complete, and that there are no further comments, is received from MoA
On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed Installation will not affect the future development of the surrounding or existing lots.
There are no wells or septic systems within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Attachments:
Sincerely,
Steven R. Perrone
CE 0149 j
Steven R. Pannone, P. E.
Principal
Mailing: P.O. Box 102954, Anchorage, AK 99510-2954
Physical: 11301 Olive Lane, Anchorage, AK 99515
6/6/09
PROPOSED IFIELD UPGRADE
'BED, 15'v x30'LO.5'ED, 2'TA)
EXIST'G BED IN FAILURE.
ISEPTIC TO BE REUSED
I AREA
EXIST'G LIFTSTATION 1978 DEEP TRE CH
TO BE REUSED ABANDONED Its 11991
L103 tit ES
N,
00' CRE K OFFSET
'R1OO.O
/Cto
EXIST'G WELL
.3
ol�b XIST'G 3BR HOQSIE,
-116.0
H1.
of
>
LI I 75:9
CONSTRUCT, 2' HIGH
BEffm7fGP5M-& -SEED
LOT UNDEVELOPED
NO WELLS OR SEPTICS
W/IN 100 FEET
EXIST'G CREEK
NOTES:
PANNONE ENG SVC, LLC
P.O. BOX 102954 ANCHORAGE. AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
'%Z' n:"Vkx�
. .... .....
.. . on.0 ........
nome
CE 8149
Dote
06/06/09
ISSUED FOR CONSTRUCTION
Scale
KARVIEW S/D LT 1
RICK THOMASteven
11401 Hideaway Trail
Anchorage, AK 99516
315-3201
P.I.D. NO
PERMIT NO.
swxxxxxxSheet
PLAN
1 OF 3
i;
NOTES:
PANNONE ENG SVC, LLC
P.O. BOX 102954 ANCHORAGE. AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
'%Z' n:"Vkx�
. .... .....
.. . on.0 ........
nome
CE 8149
Dote
06/06/09
ISSUED FOR CONSTRUCTION
Scale
KARVIEW S/D LT 1
RICK THOMASteven
11401 Hideaway Trail
Anchorage, AK 99516
315-3201
P.I.D. NO
PERMIT NO.
swxxxxxxSheet
PLAN
1 OF 3
r 1
/ I EXIST'G I --
\-EXIST'G �` r ' I WELL
WELL
SEPTIC 7 I I _ .'•
IaEA� oA1'Aj EXIST
'G SEPTICS
+ IN FAILURE_I
7
EXIST G I ; SEPTIC _ _ e�-� — l I
AREA —. �` ° irI
WELL. %', I i `1N
1 j EXIST'G I I
EXIST
PROPOSED I ^TELL %
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NOTES'����Dote
SSUED FOR CONSTRUCTION P�N� IN�P.O. BOX 102954 ANCHORAGE, AGE, AK 99510 L� .=qE OF;A�gs��l' 06/6/09
Scale
9
PHONE (907) 272-8218 FAX (907) 272-8211 i��P tl
i .. 49 TM ... 1-=100-
KARVIEW S/D LT 1 .4 P.I.D. NO
RICK THOMAS In
11401 Hideaway Trail 9 �+ CE�8149 na•� PERMIT NO.
Anchorage, AK 99516 �l� mss•. \?,! swxxxxxx
PLAN 315-3201 �lllj D�oiiss Sheet7 0F 3
\\ ��
SOILS LOG - PERCOLATION TEST
SLOPE
TEST
HOLE
WAS GROUND WATER
ENCOUNTERED? Y
IF YES. AT WHAT
DEPTH? -5.0'-
DEPTH TO WATER AFTER
MONITORING? -5'-
DATF- 5-30-2009
SLOPE
TH 1
Y
'FADING DATE CLOCK WATERTWE NET 71ME LEVEL NET DROP
READING
1 5-18-09 152
2
3
4 S E COMMEN S BELOW
5
6
PEROLATION RATE <1 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3.0 FT AND 4.0 FT
COMMENTS: Test hole excavated by A+ Home Services. Test Hole was presoaked before perc test. Five Qallons
of water was added to the test hole, but it seeped away faster than it could be measured. See Material Analysis
PERFORMED BY: 1. STEVEN R. PANNONE CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL ONTHEDATE OF THIS TEST.
TEST HOLE
1
OR
"' qs+���
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// �.. CE 8149�/
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ORGANICS
t
ISSUED FOR CONSTRUCTION
Scale
TS
2
Roots/Silts
ML
P.I.D. NO
3
PERMIT N0.
swxxxxxx
Poorly
4
Sp
Graded SAND
w/trace
Gravel
5
6
7
BOH
8
9
10
11
12
13
14
15
16
17
IB
19
20
SOILS LOG - PERCOLATION TEST
SLOPE
TEST
HOLE
WAS GROUND WATER
ENCOUNTERED? Y
IF YES. AT WHAT
DEPTH? -5.0'-
DEPTH TO WATER AFTER
MONITORING? -5'-
DATF- 5-30-2009
SLOPE
TH 1
Y
'FADING DATE CLOCK WATERTWE NET 71ME LEVEL NET DROP
READING
1 5-18-09 152
2
3
4 S E COMMEN S BELOW
5
6
PEROLATION RATE <1 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3.0 FT AND 4.0 FT
COMMENTS: Test hole excavated by A+ Home Services. Test Hole was presoaked before perc test. Five Qallons
of water was added to the test hole, but it seeped away faster than it could be measured. See Material Analysis
PERFORMED BY: 1. STEVEN R. PANNONE CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL ONTHEDATE OF THIS TEST.
NOTES:
�TTG��UID7�LTINNESSIINTEFFECT
PA 1�1�O L: ENG SVC, LLC_0FAxx�
P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211j
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"" "' "' "' /
.......
S; teven'. nnoee /
// �.. CE 8149�/
�04��' `� ``�
Date
6/6/09
ISSUED FOR CONSTRUCTION
Scale
TS
KARVIEW S/D LT 1
RICK THOMAS••
11401 Hideaway Trail
Anchorage,
P.I.D. NO
PERMIT N0.
swxxxxxx
SOILS 1
SheetOF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY
OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN
CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE MANUFACTURERS SPECIFICATIONS.
3. SCOPE OF WORK: UPGRADE ABSORPTION FIELD FOR EXISTING 3 -BEDROOM HOUSE. REUSE EXISTING LIFT
STATION. VERIFY INTEGRITY. REUSE EXISTING FIELD. INSTALL DUEL VALVE'S IN LIFT STATION TO SWITCH BETWEEN
FIELDS.
4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST
HOLE INFORMATION ABOVE 5 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS
LESS THAN 3 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY.
5. CONTOURS IN 4.0 FEET INCREMENTS.
SECTION
TOPSOIL AND SEED
FILTER FABRIC & 2" RIGID INSUL.
ABOVE DRAIN ROCK
2.0
I--15.0 DRAIN ROCK 4" ABOVE PIPE INV.
DRAIN ROCK 0.5' BELOW PIPE INV.
SP 1 1/4"0 PERFORATED PIPE
_ _. 2.0' FILTER MATERIAL
-7.0' Bon
1/4" PVC F.M.
UPGRADE BED
SLOPE VARIES
PROFILE
DESIGN PARAMETERS
ABBREVIATIONS
0
SEPTIC SYSTEM
w In
COPPER -----------------------
Dw
NO. BEDROOM: 3 (450 gpd)
mz
a:
WELL RADIUS
TANK SIZE: 1250g S.T.E.P.
�w
W
r
ou
1 1/4" PERFORATED LINE
ww uT
FOUNDATION CLEAN OUT
z w
W/ 1/4"0 HOLES ON 1.5'
z w
TANK CLEAN OUT NO.
o �
CENTERS
o
Ny
�¢
SYS. TYPE: 15 -WIDE BED
D
2¢
Z
NEW SEPTIC
MIN LENGTH: 30 LF
M#
W�
n
IaE< Ql fL) ate s4fimm i.
n
L 1
1/4" PVC F.M.
UPGRADE BED
SLOPE VARIES
DESIGN PARAMETERS
ABBREVIATIONS
LEGEND
SEPTIC SYSTEM
CU
COPPER -----------------------
WATER LINE/
NO. BEDROOM: 3 (450 gpd)
DIP
DUCTILE IRON PIPE
WELL RADIUS
TANK SIZE: 1250g S.T.E.P.
TH
TEST HOLE
PERC. RATE: <1 MPI
FC
FOUNDATION CLEAN OUT
EXIST'G SEPTIC
SOIL RATING: 1.0 gpd/SF
T#
TANK CLEAN OUT NO.
AREA ROD: 450 SF
SYS. TYPE: 15 -WIDE BED
D
C#
CLEAN OUT NO.
NEW SEPTIC
MIN LENGTH: 30 LF
M#
MONITOR TUBE NO.
(FORCE MAIN)
IaE< Ql fL) ate s4fimm i.
RIGID INSULATION
30LFx 15' WIDE, 0.5'ED, /X
W DCO
DOUBLE CLEAN OUT ------------
CHAINLINK FENCE
TOTAL AREA: 450 SF
AA DV
DIVERTER VALVE
FS
FLOW SPLITTER
NOTES: �t �������\\ Date
ISSUED FOR CONSTRUCTION PANNONE ENG SVC, LLC OF Al \� 6/6/09
P.O. BOX 102954 ANCHORAGE, AK 99510"" 4
PHONE (907) 272-8218 FAX (907) 272-8211 irj�Q sf9(� Scale
9Tf+ */� NTS
KARVIEW S/D LT 1 j "' """' P.I.D. NO
RICK THOMAS qzz t'teve R. annOr+e .
N0 %
11401 Hideaway Trail �� �� •, CE 8149 PERMxx IT �/ swx IT NO
Anchorage, AK 99516Sh
,•
DESIGN NOTES 315-3201 11l`�\\OFE` '� 3eOF 3
n Telephone: (907) 3445934
-RRA FIRMA TESTI N v Fax: (907) 344-5993
11301 Olive Lane
Anchorage, AK 99515 Laboratory Testing /Contraction Monitoring www.nge-tfLcom
PROJECT CLIENT:
Pannone Engineering Services
ASTM D1557 uncorrefied
Coarse
ASTM D4718 torrefied
Fine
PROJECT NAME:
Karview Lot 1
NATURAL M.C. %
8.1
PROJECT NO.:
2169-09
SAMPLE LOCATION:
SAMPLE NO/ DEPTH
09S-1
DESCRIPTION:
Poon rd. sand w/ ravel.
DATE TESTED:
9/19/2009
TESTED BY:
DP
REVIEWED BY:
Ron Caron C.E.T.
PARTICLE SIZE ANALYSIS
ASTM D4221 0136
: +s•
tao.o
+rr no M w eeo nw
sew
SIEVE ANALYSIS RESULTI
y--
1I
sIEVE
SIEVE TOTAL%
900 .
-
I- -
-
- _
�_
1
SIZE(mm)
SIZE(„.) PASSING SPEC
goo
l[
�I _.
152.4
76.2
6"
3" 100
Tao
38.7
1.5" 86
80A
-1-.
♦
Ii�.
F - I
19,05
3/4^ 74
�� 500 �'.`. _
-_ i -� j r _
r�i
_
_
12.7
9.5
1/2" 69
3/8^ 66
_
�- �'[ '
:
;
6.3
1/4^ 61
K 40.0 �'! -
rr r
'
1 1 I
I l:
`(
_
4.75
94 59
goo ii �..---
II
i _-�� �__i�.l
LL.
-* --�
2
#10 52
' I
m.o I[
rrr I -
i l -i
({
!
- -
- 1
0.85
120 45
I
f'
0.425
i40 37
too fT -
'
- 1.
�i�
_�
0.25
960 27
r
0A1i�_I t _ -
--
LL1 1.
,
- J
0.15
1100 14
+ao
to � I 6.+
o.m Door
0.075
szoo 4.2
GRAIN Sale N MILLIMETERS
HYDROMETER RESULT
ELAPSED WAETE TOTAL%
TIME mm PASSING
0
0.5
MOISTURE -DENSITY RELATIONSHIP
t
ASTM D1557
2
150.0
4
e
15
145.0
30
60
250
140.0
1440
Atterberg Unnits
135.0
AASHTO T90
Degradation
(ATM T-73
130.0
LA. Abrasion
0.0 2.0 4.0 6.0 8.0 10.0 12.0
AASHTO T 96
TM us" sernws repo"W!wan Nva Even pedomea b MwWwW �W erarE . bless atlrwies nobs. No mw war" is mage. Shoe p Maprela0al or *Pr.m be raqusd,
TFI W prvvl0e upon when npres[
%GRAVEL: 41.3
%SAND: 54.5
% SILT/CLAY: 4.2
USC: SP
FC:
.02 mm:
ASTM D1557 uncorrefied
Coarse
ASTM D4718 torrefied
Fine
OPTIMUM M.C.% (torrefied)
NATURAL M.C. %
8.1
COBBLES
GRAVEL SAND
SILT or CLAY
Coarse
Fine Cn. Medium
Fine
I
Municipality of Anchorage Page of AL
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: SW 47`703-31 PID Number: CIS -1(.3-18
Name: Michael Schallock
Wastewater System: ❑ New ❑ Upgrade
Address: 11401 Hideaway Trail Anch, AK
ABSORPTION FIELD
Phone: 346-3988
No. of Bedrooms:
D Deep Trench O Shallow Trench 14 Bed O Mound O Other
LEGAL DESCRIPTION
Rating:
S°"a
Total Depth It grade:
6
GPO/S Fl.
1
Lot: Block: Subdivision:
Depth to pipem from original grade:
Gravel depth beneath pipe
1 --- Karview
+0.5 1 FI
Ft.
Township:
Range:
Section:
Fill added a!]4ye original grade:
Gravel length:
_r1Z n/
R 3 W
.3 '2
L..% Ft.
3RI Ft.
WELL: ❑NewPJiggrade
Gravel width: 1
Number of lines:
Distancebetnenines:
1 Ft
3
FI.
Classification (Private. A.B.q: at Depth:
Cased To:
Total absorption area:
P' material:
FI.
FI.
SO Ft.
Driller: Oslo Drilled:
Slatic Water Level:
Installer. deeoVQL 5;� 7Y
/T
ate installed:
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
R1 Septic ❑Holding 0S.T.E.P.
To
Septic
Abawi,11irl
Lilt
HOWIng
UNWPri.ate
Manufacturer:
Capacity in gallons:
From
Tani
Field
slabon
Tank
Sewer Linn
Ani-barage frank-
1000
Well102
Material:
Number of Compartments:
115
110
30'
Steel
2
Surfac
Watere
109'
105'
114'
---
70'
LIFT STATION
Lot
18'
14'
16'
24'
Size In gallons:
Manufacturer:
Line
---
Foundation
76''
86'
83'
"Pump on" level
Pump off'146 : High water.5fu at:
__
___
((�LJJ
Curtain
Pump Make &Model
Electrical Inspections performed by:
Drain
N/A
I N/A
N/A
N/A
N/A
D"few-6-
EL.EcT7rtcs*e_ QpG poe_
Remarks::1. Depth from original qrd
T aoe BENCH MARK
Location and Description:
R . oacro r& y
2. LEVEL SGT ANC- 7AAJk.•
See plan for location
Assumed Elevation:
u 0 u 4771 C
r
ENMN
,..�� OF :4(q 1t
d A`�•e �!
Inspections performed by: nae mi gh Dates: is
'
2nd F -m -
rr • • .
r �•� oEL
CE-53�
���
Department of Health and Human Services approval
f�� ,.
Reviewed and approved by: a Dater�--
lir
«_ -23.99
(para IA. 9/91) MOA 25
Permit No. SW990331 Page 2 of 4
Municipality of Anchorage
Department of Health and Human Services Date 9/23/99
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196650 • Anchorage, AK 99519-6650• Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 1 KARVNW SUBDIVISION
RECORD DRAWING���
Lwsot4 SUED S 00'02'00 W 10' UnLm MEME ( � -
'�"� 164.95 �
�QC11VE WELL R
IEYI SUB(MSION
I KARN LOT 1
I
I �J
I N I WELL
I I o'
11 a
W •• +a —
I 1P •:
I
I FO
Z OC _ p5BU1L B ' (N01 UND) 1
L012�
�p SUBD •Tg A�DONED
ASN PIL pNK
GRID: 2
~ION FIELD
<X . /<. WDONED W ��E SXEM
I
W
• o T -• - -
■ o
YSi
—T/E— UG TELEPHONE
ELECTRIC
ZR-FLECTRIC
QTH TEST HOLE
SWING
TIES
A
B
1
DECRIPTION
1
77.0
79.4
TANK INLET
2
83.0
6.0
TANK OUTLET
3
99.3
23.5
N.E. C.O.
4
109.8
39.5
M.T.
5
120.0
54.5
S.W. C.O.
6
122.1
54.6
CENTER C.O.
VERTICA
BM CONTRO:
N HIGH POINT
OF WHITE ROCK ELEV■1C
KA MEWLNT DIVISION
- �F F N�q �
X491
i a_...I
\DENNIi D IGS}•
I— • ��� •
OVA
'00 E s •ti CE 5 •`Ar
• 164.95 1NAY TRAIL R.O.W. �����;• sN'\�
HIDA DATE 1�\...�• -2799
10 F.B. NO. 312 1.72 1 SCALE: 1" = 40' C. FILE 406STPID
Permit No. SW99031 Page 3 of 4
Municipality of Anchorage W.O. 994069/23/99
Department of Health and Human Services Date
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196850 • Anchorage, AK 99519-6650 • Tel: 343-4744
Well & On—Site Wastewater Disposal System
Legal Description: LOT 1 KAR VIER SUBDIVISION
NOTES
1 ALL CONSTRUCTION WAS IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS
OF THE MUNICIPAL CODE. AND THE MOA STANDARD SPECIFICATIONS (MASS) 1994, AS CURRENTLY AMENDED.
2 INSTALLED NEW 1000 GAL 2 COMPARTMENT STEEL SEPTIC TANK WITH 250 GAL LIFT STATION AS MANUFACTURED BY
BY ANCHORAGE TANK, MODEL ;AT1250L INSTALLED PUMP CONTROL PANEL WITH HIGH WATER ALARM LIGHT do
HORN IN HOUSE.
3 ALL PIPE WAS PVC CONFORMING TO ASTM D3034 OR ENGINEER—APPROVED EQUAL
SEPTIC
TANK PUMP
OUT
93.0
CONNECT TO INTERIOR
PLUMBING SYSTEM
P R O F I L E
SCALE: NTS
6' 38.0'
CLEAN
OUT 4' MON. TUBE
GROUNORIGINAL
D
1 _ _ INISH GRADE _
—1 r— FABRI�Xfilll`� N
1000 GAL
SEPTIC TANK
W/ 250 GAL
LIFT STATION
1 198 011ie) 1981M 11 nk?, 11
4' PERFORATED
PVC PIPE
BED SYSTEM
DRAIN FIELD
. 0
Permit No. SW990331 page 4 of 4
Municipality of Anchorage
Department of Health and Human Services Date 9/23/99
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196650 • Anchorage, AK 99519-6650• Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 1 KARVIEW SUBDIVISION
�-4" PVC PERFORATED PIPE
UNCLASSIFIED FILL
_ •..
S : } SLIGHTLY SILTY SANDY
6• TO 24 OF 4':� GRAVEL ROCK TO 6'
FILTER MATERIAL _� EL- = 90.1
PER 15.65.060D , '-
s
BOT. EL = 66.5 %r' SILTY GRAVEL WITH
SAND—SATURATED
2.5'
GEOTEXTILE FABRIC
FINISH GRADE
EXISTING GROUND -
SEWER
LIMIT OF EXCAVATION
(REMOVE ORGANICS do
ORGANIC SILTS)
• UNCLASSIFIED FILL AS DEFINED IN THE
1994 MOA STANDARD SPECIFICATIONS(MASS)
CROSS SECTION — BED SYSTEM
33-0'
`EDGE OF SEPTIC ROCK
4 PVC PERFORATED PIPE
PLAN VIEW — BED SYSTEM
PIPE FROM LIFT STATION
V 01 :4 11191 M l
•ti CE 56q7j
��• ~••,,,,N &
�� �Ofess�i
I W.O. 994061 GRID 2640 1 F.B. NO. 312. PG 72 1 SCALE: NTS IC. FILE 406SSC1 D I
C.O.
IC.0._ 09 vi
�-• M.T. c
Ls 0. =0X a
`EDGE OF SEPTIC ROCK
4 PVC PERFORATED PIPE
PLAN VIEW — BED SYSTEM
PIPE FROM LIFT STATION
V 01 :4 11191 M l
•ti CE 56q7j
��• ~••,,,,N &
�� �Ofess�i
I W.O. 994061 GRID 2640 1 F.B. NO. 312. PG 72 1 SCALE: NTS IC. FILE 406SSC1 D I
•
1st QPM
MUNICIPALITY OF ANCHORAGE
^S Pm
Department of Health and Human Services
p`,�v�
On -Site Services Program
p a
- 0.
"
825 L Street, Room 502
l 1 1
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343.4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Sep 13, 1999
Expiration Date: Sep 12, 2000
Permit Number. SW990331 Parcel ID: 015-163-48
Legal Description: KARVIEW LT 1
Design Engineer. 0060 DHI Engineering Site Address: 011401 HIDEAWAY TR
Owner Name: Michael Schallock Lot Size: 49358 SO. FT.
Owner Address: 11401HIDEAWAYTRL Total Bedrooms:3 Permit Bedrooms: 3
ANCHORAGE. AK 99516-1151
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 DHHS at least 2 hours prior to each Inspection. Provide notification by calling
(907) 3434744 (24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either. A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued By:
Date:
Date: 9. Is.,99
Project:
DHI CONSULTING ENGINEERS
Civil 0 Surveying Planning
SITE NARRATIVE
Lot 1, Karview Subdivision
Lot 1, Karview Subdivision is located east of Hideaway Trail road south off Upper
O'Malley. The lots to the north, south and west fall within 200 feet of the subject system.
The lot to the south has not been developed (See Sheet 1). The lots to the north and west
have wells and septic systems.
Domestic Water Wells:
There are wells on the lots to the north and west. The proposed upgrade does not impact
these wells nor does it impact the ability of adjacent undeveloped properties to install a
well.
Septic System:
The proposed bed system can be installed without requiring any waivers to seasonal high
water table or bedrock. The replacement system will not restrict or in anyway effect the
area available on adjacent lots to place a septic system.
Drainage:
The drainage, in general, is from the east to west at 6%. When the property is developed,
the drainage should remain the same. There is enough slope to the property so that the
lot can be landscaped to prevent ponding around the septic system.
There is a creek located on the lot and it appears to carry water throughout the year. The
subject septic system can be constructed 100' from the creek. There are no other streams
or other drainage channels on or within 100' of the lot. All disturbed areas will receive
topsoil and seeding to prevent erosion.
Summary:
The proposed upgrade to the septic system can be installed in conformance with existing
Municipality of Anchorage regulations and will not adversely impact adjacent lots relative
to their ability to construct system in accordance with Department of Health and Human
Services regulations.
406mr.rep
Dimond Center Tower, 5th Floor • 800 E. Dimond Blvd., Suite 3-545 • Anchorage, Alaska 99515
(907) 344.1385 • Fax 344-1383
l
Permit No. * Municipality of Anchorage Page 1 of 6
Department of Health and Human Services Date 8/31/99
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196850 • Anchorage. AK 99519-8850• Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT KARVIER SUBDIVISION
ti N
o —125TH AVE. — — W 125TH AVE.
rX
l o l 0°_ z'-^
WORLDITQP= I I I o
—
A RES SUBDIVISION yQ�' J� N °-Cn
42 rn
0 1 SNOWUNE
rvi I SUBDIVISION
` WELL
P
I 200' LIMIT OF
/ 1 INVESTIGATION I TERRACE
CHINOOK I ( SUBDIVISION
— ACRES IL THIS
i\ WELL HI \SYSEMEMEN� I PROJECT 1 ��
1 1 0=
I I r
STRUCK SUBDIVISIO OT �►
DEVELOPEDOFAt %44
I
•�.�aaa
600 j
0 • o
; 4 m 9'•,
.. N ,
NI DE HIG i
JG ��9ti CE 5867 i
C2 606,066*�M
KLAT RD. lks �ofess`••
DATE �aa�'S• !-
W.O. 99406 F.B. NO. •' SCALE: 1" = 200' C. FILE 406SSC2D
Permit No.
Page 2 of 6
Municipality of Anchorage W.O. 99406
Department of Health and Human Services Date 8/31/99
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196650 • Anchorage, AK 99519-6650• Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 1 KARVIEW SUBDIVISION PID No.
REPLACEMENT SYSTEM DESIGN CALCULATIONS
1. NO. BEDROOMS = 3
2. USE BED SYSTEM
3. ABSORPTION AREA = ( BEDROOMS)(150 GPD/BR)
BED APPLICATION RATE
_ (3)(150) = 562.5 SF
.8s
4. BED AREA = (LENGTH)(WIDTH)
IF WIDTH = 15'
THEN LENGTH OF BED = 37.5' : USE 38'
PERCOLATION RATE
MOUND do BED
PIT & TRENCH
APPLICATION RATE
APPLICATION RATE
MIN/INCH
GPD/SF
CPD/SF
0-1
NOT SUITABLE
NOT SUITABLE
* 1-5
0.8
1.2
6-15
0.5
0.8
16-30
0.4
0.6
31-60
0.3
0.45
GREATER THAN 60
NOT SUITABLE
NOT SUITABLE
FILTER LAYER
.7
1.0
Page 3 of6
Permit No. W.O. 99406
Legal Description: LOT 1 KARVIER SUBDIVISION Date 8/31/99
NOTES:
1 ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS
OF THE MUNICIPAL CODE, AND THE MOA STANDARD SPECIFICATIONS (MASS) 1994, AS CURRENTLY AMENDED.
2 INSTALL NEW 1000 GAL. 2 COMPARTMENT STEEL SEPTIC TANK NTH LIFT STATION AS MANUFACTURED BY
ANCHORAGE TANK. MODEL I'AT1250L. INSTALL PUMP CONTROL PANEL WITH HIGH WATER ALARM LIGHT & HORN
IN HOUSE. FINAL LOCATION TO BE COORDINATED WITH OWNER. ALL WIRING TO BE IN ACCORDANCE WITH ALL
LOCAL. STATE. & FEDERAL CODES & REGULATIONS. REMOVE & DISPOSE OF EXISTING TANK IN ACCORDANCE WITH
TITLE 15 REGULATIONS.
3 ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION
INTO THE SYSTEM.
4 MIN. COVER OVER DISCHARGE PIPE TO BE 4'—BED PIPE IN SAND. SLOPE THE PIPE TO DRAIN BACK TO
UFT STATION. INSTALL 2" OF INSULATION OVER PIPE.
5 CONTRACTOR TO LOCATE ALL UNDERGROUND UTILITIES PRIOR TO COMMENCING 147H CONSTRUCTION. CONTRACTOR
TO STAKE PROPOSED SYSTEM PRIOR TO CONSTRUCTION. SET STAKE AT THE 4 CORNERS OF THE FIELD WITH CUT
& FILL DEPTH MARKED ON STAKES. SET STAKES AT EACH END OF SEPTIC TANK & VERIFY SEPARATION DISTANCE
FROM WELL. NOTIFY THE ENGINEER OF ANY OBSERVED CONFLICTS PRIOR TO CONSTRUCTION.
6 CONTRACTOR TO NOTIFY THE ENGINEER AND DHHS 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION.
A MINIMUM OF THREE INSPECTIONS ARE REQUIRED. THE FIRST INSPECTION SHALL BE OF THE SUBGRADE
PRIOR TO PLACING THE SEWER ROCK. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF
GRAVEL, DISTRIBUTION PIPING, STANDPIPES, TANK, AND OT14ER COMPONENTS AS SPECIFIED. THE THIRD
INSPECTION SHALL BE AFTER THE LANDSCAPE WORK IS COMPLETED.
7 CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED—LINED. AS—BUILT DRAWINGS SHOWING ALL DATA
AS SPECIFIED IN SEC. 15.65.F.2. 3. 4. 5. 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE VNTHIN FIVE DAYS OF
THE FINAL INSPECTION. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT.
THESE AS—BUILTS SHALL BE USED BY THE ENGINEER TO PREPARE AND SUBMIT RECORD DRAWINGS TO DHHS.
8 ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE
ENGINEER IF ACTUAL SOIL CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN.
9 EXCAVATE THE ABSORPTION FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD
ELEVATIONS AT BEGINNING, MIDDLE. AND END OF BED BOTTOM. CONSTRUCTION EQUIPMENT SHALL
NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF
THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL.
10 PLACE 10' OF SEWER ROCK TO THE ELEVATION SPECIFIED. DO NOT CONTAMINATE SEWER ROCK NTH NATIVE
MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO t 1" PRIOR TO INSTALLING THE PERFORATED
PIPE.
11 ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER—APPROVED EQUAL ALL JOINTS SHALL BE
CLUED WITH AN APPROVED GLUE. CLEANOUTS SHALL BE INSTALLED AS SHOWN ON PLANS TO ACCESS ALL PIPE
RUNS. 4" MONITORING TUBES SHALL BE INSTALLED WHERE SHOWN ON PLANS.
12 COVER THE DISTRIBUTION PIPE WITH MIN 2" SEWER ROCK, AND COVER WITH CEOTEXTILE FABRIC BEFORE PLACING
INSULATION AND BACKFILL
13 MINIMUM SOIL COVER SHALL BE 2.5 FEET OVER THE PERFORATED PVC PIPE OF ABSORPTION FIELD AND 4 FEET
OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR I FOOT OF SOIL COVER BUT THERE
MUST BE A MINIMUM OF 2' OF COVER OVER THE INSULATION. ALL INSULATION BOARD SHALL BE 2" THICK BY 2'
WIDE (DOW HI -35 INSULBOARD OR ENGINEER APPROVED EQUAL).
14 AN APPROVED GEOTEXTILE FABRIC SHALL BE INSTALLED BETWEEN THE SEWER ROCK AND THE BACKFILL
15 MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS. TRASH AND CONSTRUCTION DEBRIS.
16 GRADE ALL FILL MATERIAL TO SLOPE AT 2% MIN. SLOPE WITH SIDE SLOPES 3:1 MAX SLOPE: AND GRADE IN SUCH
A MANNER THAT PONDING AT OR NEAR DIE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT 6' HIGHER
THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE WITH GRASS MIX AFTER COMPLETING INSTALLATION.
.em..
Permit No. Municipality of Anchorage Page 4 of 6
Department of Health and Human Services Date 8/31/99
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196650 • Anchorage. AK 99519-6650• Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 1 KARVIEW SUBDIVISION
LARSON SUED
S 00.02'00 W UTILIIY EASE=P�
�� 164.95 �
TIVE WELL RD/
I 00 \
I ,
Iccrun
`�i7 3 nesc616)i,
®[•P.1i�dii n
1 CAUTION !!! S1ON
SUBDM
I i wcsr"rno [inn ui�cs K LOT 1 VERTICAL CONTROL
\ L S'�T .2 OCK
/ ELEVm102.25
I o'T I
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164.95 T�i'�r�'•.....•••��:•
HIDEAWAYDATE
W.O. 99406 GRID: 2640 F.B. NO. 312 1.72 SCALE: 1" FILE 406STPID
Permit No. * Municipality of Anchorage Page 5 of 6
Department of Health and Human Services Date 8/31/99
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196650 Anchorage, AK 99519-6650• Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection
Legal Description: LOT 1 KARVIEW SUBDIVISION
Report
CO 9
dZ x
0
a Z
C4 /
• N / EXISTING SEWER PIPE W
• I ZF W
1000 GAI.. TANK Z U
~. • I \� REMONOTE 15TIN INSTAR CO
C,
SEE 2
OQYZN CPQ
• Z
p • Ld
w f QQO(iG�` F
•�: `\`
WRH SANG
BELOBELOWGROUND ANG FlLL
I i EXISTING C.O. C�.0. S.S AND MT'S
TYPICAL pLL
I•i / s� \
• � •• , I � \ �SORBTION FlELD
00 TTINGp4PULE
I` `\ T10N-SEE NOTE 5)
I. * q v ` 1 V51EM (STAKE LOCA
\ \ \ PROPOSED BED I 30' T.H. RAO1U5
J • TH !!// 104.8
ai
6 M1
I EXISTING)
II \ TOE OF UNCLASSIFIED FILL
MT/CO (EXISTIIIG)
SEE NOTELgILM 5
FJSEMEta
— .. 1 QG0 E� • ti•%,
• �. a •'4iE4 Q
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DATE , `• 1L1LV"& 44 r
W.O. 99406 GRID: 2640 F.B. NO. 312, PG. 72 SCALE: 1" = 20' 1C. FILE 406FRDID
s
Permit No. Municipality of Anchorage Page 6 of 6
Department of Health and Human Services Date 8/31/99
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196650 • Anchorage, AK 99519-8650• Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 1. KARVIEI/ SUBDIVISION
4" PVC PERFORATED PIPE — SEE NOTE 11
2" INSULATION—SEE NOTE 1r/—EXISTING
GEOTEXTILE FABRIC—SEE NOTES 12 &14
24" UNCLASSIFIED FILLFINISH GRADE
3:1 SLOPE 9 GROUND
(TYP.)�—
E 0 ES 10 do 12---�_
.1
.LIMIT OF EXCAVATION
SLIGHTLY SILTY SANDY (REMOVE ORGANICS d
GRAVEL. ROCK TO 6" ORGANIC SILTS
6" TO 24 " OF ' Q EL = 90.1 )
FILTER MATERIAL
PER 15.65.060D
s
•
BOT. EL = 66.5 + %r. SILTY GRAVEL WITH
SAND -SATURATED + UNCLASSIFIED FILL AS DEFINED IN THE
1994 MOA STANDARD SPECIFICATIONS(MASS)
2.5'
1. 1.
TYPICAL CROSS SECTION - BED SYSTEM
33.0'
2.5'
IfPIPE FROM UFT STATION
SEE NOTE 4
`EDGE OF SEPTIC ROCK (SEE NOTES 6 k 7)
4" PVC PERFORATED PIPE- SEE NOTE 11
PLAN VIEW — BED SYSTEM
�F. OF At e
VIS HI7_
CE 07 * V
I W.O. 994061 GRID 2640 1 F.B. NO. 312. PG 72 1 SCALE: NTS C. FILE 406SSC1 D
—09— ��
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c 0 _OX n
M.T. c
_
�}0_ _O% n
IfPIPE FROM UFT STATION
SEE NOTE 4
`EDGE OF SEPTIC ROCK (SEE NOTES 6 k 7)
4" PVC PERFORATED PIPE- SEE NOTE 11
PLAN VIEW — BED SYSTEM
�F. OF At e
VIS HI7_
CE 07 * V
I W.O. 994061 GRID 2640 1 F.B. NO. 312. PG 72 1 SCALE: NTS C. FILE 406SSC1 D
SEPTIC SOLU fgNS
04 BLACK Y
86 A
ANOMAOE. ALMA ME02 .
SOILS LOG—PERCOLATION TEST �
TEST HOLE #1
I PERFORMED FOR: MICHAEL SCHALLOCK DATE PERFORMED: 6/23/99 X1$_elw .CE 5F
LEGAL oESCRIPTION: LOT 1 KARVIEW SUBDIVISION W,O•# 99406 41es
14lklk.
ORGANICS -ROOT MAT
1
2 4' SLIGHTLY SILTY SANDY
GRAVEL. ROCK TO 6'
VERY THIN LAYER OF
3 • SAND k SILT THROUGHOUT
FORMATION
4 A OCC. ROOTS TO 12'
4
5 A
6
•.A e
7
8 1A SILTY GRAVEL WITH
Y SAND -WET
9
SITE PLAN
10 WAS GROUND WATER $
ENCOUNTERED 7 YES L
11
IF YES. AT WHAT O
DEPTH 4 8 0' E
12 DEPTH OF WATER
AFTER MONITORING 4 5.0' DATE: 9-2-99
13
14
15
16
17
18
19
20
00m®
mm
ormo�vvv
PERCOLATION RATE: 1.2_(MINUTES/INCH.) PERCHOLE DIAMETER: 6. I
TEST RUN BETWEEN: - 3' FT. AND 3.5'
PERFORMED BY: DEE MGH CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH
ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: SEPT. 2. 1999 402GCDll
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
0*'
825 L Street - Anchorage, Alaska 89501 Telephone 264.4720
ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION
REPORT
NAME
PHONE
NEW
//
WI),j
Z7 (,. � 2.VS
❑ UPGRADE
MAILING ADDRESS
Z.S 15 A' ST t N oo. c c% 01503
LEGAL DESCRIPTION
L 5s.a a
LOCATION
NO.OF BEDROOMS
DISTANCE TO:
Well / O / ,
Absorption are aG7
Dwelling 7Z •
PERMIT NO.
q%
U
;:Z
Manufacturer G.e Esr�
Material
of compartments
W h.
rn
Liq, ca acit gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
Cl
tj Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
JZ2
Oz F
Manufacturer
Material
Liquid capacity in gallons
O
W =
DISTANCE T0:
Well
Foundation
Nearest lot line
Z9 s
PERMIT NO.
J M Z
No. of lines
Length of each liner
Total length of lines
Trench width
Distance between lines
;:.3 W
6
SO
So
Inches
o t—
Top of the to finish grade 3 r
Material beneath tile //f?
'i3
Total effective absorption area
inches
Length
Width
Depth
PERMIT NO.
W
f7
i F
Type of Crib
Crib diameter
Crib depth
Total effective absorption area
W t\
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE T0:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
4-" C- F'
SOIL TEST RATIN G
6-S
µo
S
INSTALLER
!L -L5 1EFxcstvo}77jVj'. /At/L.
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,
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LC
IJ
t44
REMARKS
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It
APPROVED DATE LEGAL
GK _.3_-78
72-013 (Rev. 3/78) 1 7
1%111 rA I C I Iii-=iL I T•T OF= nr•aCF-1 F:-*nGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
625 'L' STREET, ANCHORAGE, AK. 99501
264-4720
fAE=LLL Fir4E> CAr4—= I TE _•E1JEF: Fs EF;rl I T
PERMIT NO. ( 780295 )
APPLICANT GQPDON UNWIN 2515 A ST 59503 276 4245
LOCATION
LEGAL L1 KARVIEW S/D LOT SIZE 49485 SQUARE FEET
TYPE OF SOIL ABSORETION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING CSG! FT/BR)= 85
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
C•EF•TH= r LEr4GTH= -1�? C3 FZ Fl %I EL_ C•EF>IFF4= _w4
THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
F:ECAL1 I F?E=E> S~ER'T I C= I-Fir4t< - I w"E= 12c6a C3Fi1LLC 04c
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- Tt4Ci < � ? FiF_•E F:EC!L1 I Fz ELS
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL; OF:
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MIST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F•EF!r'1 I T E:Xf=P I F E= 2=1, 1L_;1 ` c:
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMELED TO INC•LUDE MORE THAN 4 BEDROOMS.
SIGNED:--- v ✓�,�•�Li �---
APPLICANT GORfN !NWIN
ISSUED BY-('_�_ --- ---DATE __!_^� V3.2
--------------
A
ro� n
UNWIN • SCHEBEN'w K0RYNTA
Mr. Rolf Stricklin
Ai,chorace Municipality
Dept. of health & Environmental Quality
3500 Tudor Road
Anchorage, AK 99507
Re: Karview Subdivision
Gentlemen:%
August 5, 1976
Attached herewith is a log of a testhole on the above
referenced subdivision. The testhole was logged from a back-
hoe pit. In our opinion, a drainfield located within the
strata of sandy gravelly material should perform adequately.
Please call if you have any questions,
EDK/vi
Attachments
GORDON D. UNWIN, P.E.
LEO SCHEBEN,JR.,P.E.,L.S.
Very truly yours,
arl 'D. Ko, P.E.
Partner
EARL D. KORYNTA, P.E.
r
SHEET 1 OF 1
SOILS LOG
PROJECT Karview1Subdivision TEST HOLE N0. 3
CLIENT ELEV. TOP OF HOLE 989±
W.O. DATE June 30, 1976
0 Spruce & Birch to 12" 0 0
9" Forest Duff
1 1
2 '2
3 Damp, Firm Grey Silt ML 3
4 Damp Brown Sandy Gravel, GP 4
5 Grab Sample 5
6 85 SF/BDRM 6
7 7
8 8
9 Damp Brown Gravelly Silty Sand, SM 9
10 250 SF/BDRM 10
11 Grab Sample 11
12 Decreasing Moisture Content with depth 12
13 13
14 Bottom of Hole 14
No Free Water Encountered
15 15
16 16
17 17
18 ..���� 18
OF At
19
20
,,,r ♦ 497—H
-20 20
` 21 Ea D.Kory•a ��/ 21
22 , JJF •• NO. 1823E 22
23 44% '*90FESS00:-• 23
24 24
25 25
v
• `C
+I Oc ✓nil U
_1 yIJ m}m NO Ji i NO�yy Y • -wl—
'ra
c0•4100�
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r'1
M -W DRILLING, INC.
DRILLING LOG
Well Owner Use of Well
Location (address of: Township, Range, Section, if known; or distance main roar,
Size of casing Depth of Hole—LL—l'—feet Cased to feet
Static water level 7'1 tt. (above) (below) land surface. Finish of well (check one) open end ( );
Screen ( ); Perforated ( ).
Describe screen or perforation_ 1!t
Well pumping test at 3 gallons per (hour-) (minute) for—L--hours with = ft.
of drawdown from static level.
Date of completion ` ! i ! 7
WELL LOG
Depth in feet from
ground surface
Give details of formations penetrated, size of material, color and hardness
,
TO
i
r'1
M -W DRILLING, INC.
DRILLING LOG
Well Owner Use of Well
Location (address of: Township, Range, Section, if known; or distance main roar,
Size of casing Depth of Hole—LL—l'—feet Cased to feet
Static water level 7'1 tt. (above) (below) land surface. Finish of well (check one) open end ( );
Screen ( ); Perforated ( ).
Describe screen or perforation_ 1!t
Well pumping test at 3 gallons per (hour-) (minute) for—L--hours with = ft.
of drawdown from static level.
Date of completion ` ! i ! 7
WELL LOG
Depth in feet from
ground surface
Give details of formations penetrated, size of material, color and hardness
TO
L'as stic:v_
'
TO
'
3an•i `ill
'
TO
a
0r Z cr.ic,;
u
TO
is
Silt•t _•+v•i
5�
TO
av 1 `tn*,l n^:t,
To
�-
TO
73
To
75
Frncturc co^^ .;
7r-
Tp
2.^,
3r-.lroc'.c: crit^r secas +.n
.TO
.TO
® MUNICIPALITY ANCHORAGE
• DEPARTMENT OF HEALTH 3 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 l.D.0 OI5-163-YA HAA N �I�Notgn14nL_L_
1. GENERAL INFORMATION
Complete legal description r nr 1 yarn i pw SiihAii�4s41nn
Location (site address or directions) 11401 Hi deawaY Trail
Property owner %Michael Shallock Dayphone 14F;_1c) A
Mailing address a
11401 Hideaway Trail Anchoragp, Ax a41 c
Lending agency pacific Ala tia Mortage Day phone 758-752'
.Mailing address 2600 Denali Suite 702 Anchorage, Ax 995n1
Agent Tnfpm ppalt•�_(rinh Raerl Dayphone 272-0571
Address 724 r "1-h AVp Anh ge. AN 99501
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
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 r
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.
77 073 (R.v 11911 From "04 021
. S. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verity 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 D8I Coca u2ting_Engineers Phone 144-771AS.•
Address 800
Engineer's signature
6. DHHS SIGNATURE
_x Approved for R bedrooms.
Disapproved.
Conditional approval for
Additional Comments
M
Date P =J- f i
+�'Of At X
Y49'r^-l. �• :
CE -180
•,
Pic r •rnli4'•„
bedrooms, with the following stipulations:
Date 9 - a R -'/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
end 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.
T2,M(.A/911 0•cY MOAI21
�app ass
Municipality Anchorage 00
DEPARTMENT OF HEALTH &HUMAN SERVICES ����
Environmental Services Division
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4 44
Health Authority Approval Checklist
Legal Description; Lot 1 Karview Subdivision Parcel I.D.: 0 15 - U,3 - Ye
A. WELL DATA
Well type Res if A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) Yes Date Completed 9/1978
Total depth 200' Cased to 76.2' Casing height (above ground) 1 42'
Sanitary seal (YM)
Date of test
Statb water level
Yes
FROMWF4 LOG
9-11-0*
7.0'
Well production 3.0
WATER SAMPLE RESULTS:
Wires property protected (Y/N) Yes
AT INSPECTION
g.p.m. 6.0 g.pm.
Conform 4 Nitrate 1.53 Other bacteria
Date of eampne: 4'Z/ 9 4 Collected by: !%6E Alla fl
B. SEPTICIHOLDING TANK DATA
Date installed 9-22-99 Tank size 1000aal Number of Compartments _7 Cleanouts (Y/N) Yes
Foundation cleanout (Y" Yes Depression (YM) No High water alarm (Y/M Yes
Date of Pumping NPv Pumper N/A
C. ABSORPTION FIELD DATA
Date Installed 9-22-99 Son rating (g.p.dAForft'/bdnn) 0.8 System type Bed
Length 38' Width 15' Gravel thickness below pipe 12" Totai depth 4.0'
Effective absorption area 570 S.F Monlloring Tube present (Y/N) Yes Depression over field (YM) Nn
Date of adequacy test New System Results(Pass/Faiq N/A For 3 bedrooms
Fluid depth in absorption field before test (In.); m �8_ Immediately after4A gal. water added (in.): --
Fluid depth N A (Ins) Minutes later: Absorption rate - a.p.d.
Peroxide treatmant (past 12 months) (YIN) N/A f yes, give date
72-026 (Rev. 3196)0
D. UFT STATION
Date installed 9-22-99 Size in gallons 250 gallons
Manhole/Access (YIN) Yes "Pump on' level ar 41 "Pump off" level at' 3 7"
High water alarm level at' 45" 'DatumBottom of Vault (Basket)
Cycles tested One (New Syntem )
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
SeptiGholding tank on lot 102' On adjacent lots 1001+
Absorption field on lot 115' On adjacent lots 100+'
Public sewer main N/A Public sewer manhole/cteanout N /A
Sewer /septic service line 30' Lfft station lin,
SEPARATION DISTANCES FROM SEPTICA40LDINGTANK ON LOTTO:
Foundation 76' Property One 18' Absorptionfiekl 6'
Water mainlservice One 100' Surface water/dralnage 105Wells on adjacent lots 10n+'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property One 14' Building foundation
Water mainlservice One inn,.,.
Surface water 105' Driveway, parki"hicle storage area _ 3'
Curtain drain N/A Wells on adjacent lots 100+'
F. ENGINEER'S CERTIFICATION
I certify that / have determined thru field inspections and review of Munk! y • fl�aft 'abb;Wems are
In aontomDe70m th MQA HA yu Ines in elted on this date. ..V
Signature -
Engineers Name
Date 9- �j(fr;_•... .. 'ti"`'"
i ;',"r'".•fret;,; •,� ..�� LYi/
HAA Fee $ !��M 'Lo
Date of Payment -Ci -cR -19
Receipt Number - 5ag'18
72-026 (Rev. 3196)'
Waiver Fee*$
Date of Payment
Recelpt Number
SEP -29-01 10:10 FAO* -CM EAYIROMIEM1Al
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TttwJeet Namr/I La 1 Kat►kw CoUrnod tMwfllme 09/22/9 00.00
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R1trAwll 1.53 0.300 Pon RWt 700.0 l0 Me 091nlw 0912zf r SCL
09-23-1999 07:3" 5615301 P.01
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH 8 ENVIRONMENTAL PROTECTION '
\ 823 L Stmt - Anchorage, Alaska 99601
•
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 2644720 I
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES 1
DIRECTIONS: Complete all parts on pegs 1. Inaeeplaw ra plests will not be prooseaed- Please allow ten (10) days for processing.
1. PROPERT NE
PHONE
W I V1
�[ SINGLE FAMILY
MAILING ADDRESS
PROPERTY RESIDENT (If d0ferem from above)
PHONE
2. BUYER
PHONE
MAILING ADDRESS
LENDING INSTITUTION
PHONE
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
MAILING ADDRESS
p
S„e
4- REALTOR/AGENT
PHONE
MAILING ADDRESS
B. LEGAL DESCRIPTION
C d
4
�VIlv.J Ja+�P • —
STREET LOCATION
t `
N lh
B. TYPE OF RESIDENCE
NUMBER
�[ SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
INDIVIDUAL'
' ATTACH WELL LOG. A well log is required for all wells drilled
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
B. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE'
elf individual/on-site, give installation date ,
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72.01013/7811
THIS SIDE FOR OFFICIAL USE ONLY
-
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
ar SINGLE FAMILY
❑ MULTIPLE FAMILY
N MBER OF BEDROOMS
❑ ONE THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
lid INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER 7�0�
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
a SEWAGE DISPOSAL SYSTEM
O NDIVIDUAL/ON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER 7Fba `
6
DATEINSTALLED
IN ALLER
ptic Tank or ❑ Holding Tank
Sizer 00 If Tank is homemade
give dimensions:
SOILS RATING.
00
TYPE FTANK
MANUFACTU E
t
TOTAL ABSORPTION AREA
AV 41
MATERIAL
1
4. DISTANCES
WELLTO:
Septic Holding Tank
I /O/
Absorption Aree
Swiaer Line
l0//-
Nearest Lot Lim
1 /01,
Absorption Area to nearest Lot Line
5. COMMENTS
t1 -"APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE C '--I
BY (TiNe)
LEGAL DESCRIPTION
72-010 (Rev. 3178)