HomeMy WebLinkAboutWOODHAVEN #1 TR B LT 4Woodhaven #1
Tract B
Lot 4
#015-281-59
Municipality of Anchorage
.. Development Services Department �;`_' :n='r,
Building Safety Division :'
On-Site Water & Wastewater Program, 4700 South Bragaw St. `s e , r r r T
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
Onsite Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW060221 PID Number. 015-281-59
Name:
LESLIE BRYANT
Wastewater System: ❑ New ■ Upgrade
Y
4120 LAUREL STREET //106 • ANCHORAGE. AK 99508
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 334-5000 4
0Deep Trench N'Shollow Trench 0Bed 0Mound 0Other
LEGAL DESCRIPTION
'°' "°"" 1 2
ran D.pth ton X11 0 MAX
GKN n
rt
Tract: Lot: Subdivision:
DWh to pow eatom frwn orq:al pad•:
Grem depth sanoah pip.:
B 4 WOODHAVEN #1
SEE DWG. n
3.71 n
Township: Range: Section:
rls edd.a ata.e ar4lna wadi
arae.l wroth:
— — —
SEE DWG. n
75 n
WELL: ❑ New [I Upgrade
Ge" .Wh:
3.0
NumMr aKnow:
1
Dstana. foow, free:
rL
n
Cwnolaann (Pmat-. ARM: Toa Do
Cooed io: (o�aat
Tobi obwvpu,,,, oroo:
Vqe "o":
I
.,\Cj rt
n.
511 so. n
D 3034/ F-810
Dnw �X�S��N Da. 0d 1:
scan Ma. te.a:
i t
KING OF DIAMONDS
Dae �*Vw,1: 006
Ft
vwa:
Puny sa M:
Ca." Height Above Ground:
TANK
gp„
n
n
SEPARATION
DISTANCES
■Septic 0Holding 05.T.E.P. t7 Other
TO
Septic
Absorption
lilt
Holding
4/Private
Naralaaluw:
ANCHORAGE TANK
CapwM o galarn:
1250
from
Tank
Field
station
Tank
sows tine
Well
too'+
—
—
25'+
Nada: STEEL
STEEL
NvmDi a oorrwerurwnb:
2
Surface water
100'+
100'+
—
—
—
LIFT STATION
Lot Une
5'+
10'+
—
_
—
N gabni
teanulwwnr.
5'+
10'+
uny on I.r.l a: Pump oll Nv.l ol: a •r nom a.
Foundation
—
—
—
PiHap Mat• t
than onpeotiora port«a,od el'
Curtain Drain
NONE
KNOWN
Remarks: OLD SEPTIC TANK WAS PUMPED, CRUSHED,
BENCH MARK
tocotan and D..ogaarn:
AND COMPLETELY ABANDONED PER UPC.
NORTH END TOP OF GARAGE SLAB
'R.F. = .44
~ted En.aam 99.50 n
GEG ���
Inspections performed by: Dates: 1st 8/30/2006
ENGINEERS
aoo� p0�
2nd 9/1/2006
o OF 0
��C.• �,9s��ll
3rd
vv
Development Services Department Approval
°'?. T
•• ...........
Reviewed and approved by: Date:
D • • ••••••••••••0
DO
•.J f y A. O� Gorness: 00
w CE— 95 :p �°� • • �
Reviewed and approved by: J / Datel
���°p
0OO�0p00
(R.v. 4/06)
IPERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER:
SW060221 015-281-59
I A R1
STI
23.9
55.5
ST2
32.4
62.0
DBL1
34.1
63.3
DBL2
35.4
64.4
FD
40.0
64.9
C01
51.4
35.6
MT1
51.7
35.6
CO2
56.3
87.4
111
521
87.9
E.3
41.2
64.5
1
1
I
I
1
NEW DRAINFlELD
TH/2� COi / /�� NEW 1250 CALLON `��♦
SEPTIC TANK ♦♦♦
III
I I THI!I, C<'?., ♦\\
DBL1&2 / \\
f'Oe7 FD \\
I I I EXISTING \
4 BEDROOM
HOUSE \\
III '•' ' • •, r \
Ll'�:: E..,
+': ;• .'7;: �: '. UNE UNDER DRIVEWAY ?� 1D0' WELLI
INSULATED WITH 4 INCHES OF RADIUS
1 INSULATION 4 FOOT WIDE
1
\ I
III/
EXISTING DRAINFlELD \\ /
TO BE USED AS A /
RESERVE SITE \\ /
III /
�4
GARNESS ENGINEERING GROUP, Ltd. p T*�0
CONSUL TANTS E GENERAL CONTRACTORS.�.•�..�� �•••••••• •• ••• ........... P,
3n1 C TDe111MD. MIR 101 • M4iM4VX. Mf IgD7 • R (Wr)337-ftn • IM[ (WI)a M" • MUM1L w.po.r.jwrF,Mn. D
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .... •• • ......• ••••••...
LESLIE BRYANT 334-5000 1 2 OF 3 Q A ';Je y . Go ess. �O
LECAL DESCRIPTION: DRAWN BY: OOc�'• E-79 3 , NAP
WOODHAVEN #1.LOT 4. TRACT B B.F.M./J.N.T.�Q�e a t!^I2 06' Fp°o
TYPE OF WORK: DATE: 40eO4Op��odc�
AS—BUILT OF NEW SEPTIC SYSTEM 9/7/2006
1RTI. V 1M)
PERUrTNUMBER: AS -BUILT DRAWING PARCEL 10 NUMBER:
SW0 -
SW060221 015-281-59
TOP OF TANK
AT INLET - 91.70
FINAL GRADE - 97.84-97.91
ST2
- TOP OF TANK
AT OUTLET - 91.66
f NEW 1250 GALLON
INVERT OF BUNGSEPTIC TANK `INVERT OF BUNG
AT INLET 91.05 AT OUTLET 90.82
6' BURIAL RATING
FINAL GRADE - 98.08-99.34
ORIGINAL GRADE 98.00
O HIGHEST POINT ftv
FILTER FABRIC
RELATIVE ELEVATION OF BOTTOME OF
TESTHOLE - 81.00 (NO H20).
RT OF PIPE
- 90.71
)M OF TRENCH
87.00
RELATIVE ELEVATION OF BOTTOM OF
TESTHOLE - 82.00 (NO H20). —
GARNESS ENGINEERING GROUP, Ltd. p°;'?' 4S
CONSULTANTS 6 GENERAL CONTRACTORS �...... • ...
ani c ANDOWL r Door • nw[ (wr}u»in • W (WrW a w • � w. p.rylnww,a.. a
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••••
LESLIE BRYANT 334-5000 3 OF 3:� «
LEGAL DESCRIPTION: DRAWN BY: oOOD•
WOODHAVEN #1: LOT 4. TRACT B B.F.M. �4'e
ey
TYPE OF WORK: DATE: QQO
PROFILE DRAWING OF SEPTIC SYSTEM UPGRADE 9/6/2006
Rw. OIMS)
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water d 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: Jul 25, 2006
Expiration Date: Jul 25, 2007
Permit Number: SWO60221 Parcel ID: 015-281-59
Legal Description: WOODHAVEN #1 TR B LT 4
Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 012141 JEROME ST
Owner Name: LESLIE BRYANT Lot Size: 47250 SO. FT.
Owner Address: 12141 JEROME RD Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE, AK 99516-2142
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.
Received By:
Issued By: lfl:\
Date: 7
Date: 7 Z: uG
Municipality of Anchorage
• Development Services Department
i Building Safety Division
- Onsite Water & Wastewater Program
4700 Bragaw St.
P.O. Box 196650
Anchorage, AK 99519-6650
www.d.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Property owner(s) LESLIE BRYANT Day phone 334-5000
Mailing address 4120 LAUREL STREET • ANCHORAGE. AK
Site address l ai q l-n-RD/Yli✓ Sr Zip Code 99508
Legal description (Sub'd, Block & Lot ) WOODHAVEN SUBDIVISION #11: LOT 4. TRACT B.
Legal description (Township, Section & Range) N/A
Lot Size Sq.FL
THIS APPLICATION IS FOR ( ®all that apply):
Absorption Field
19
Septic Tank
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms 4
THIS APPLICATION IS AN:
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.
GARNESS ENGINEERING GROUP, Ltd.
Permit/Rush FeesJ C -1L 0 C) (�
Date of Payment: _7k9 1.1 O C
Receipt Number.�-
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number.
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
July 18, 2006
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic Upgrade for Woodhaven Subdivision #1; Lot 4, Tract B,
To whom it may concern:
The existing 4 bedroom house is served by a private well and septic system. We are proposing to install a
new 1250 gallon septic tank and a deep trench type drainfield. Two test holes were excavated on the
property. The drainfield will be designed around the 30 foot radii of these test holes. Comments
regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAT\FIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography
below the drainfield is relatively flat. In short, there are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any gµestions, please contact us at 337-6179. Thank you for your assistance.
Cly,
ey P M.S.
NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design packagefor
this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamessengineering.com
I I
1 1
It
\ SIEFKER S/D /3;
\ LOT 8 \
I
I
I
1
SIEFKER S/D /3;
TRACT 8
(NO CONCERN)
�1
I
/
/
SIEFKER S/D j3; /
TRACT 7C.
SIEFKER S/D j3;
TRACT 7C.
_RAdIK �I
IIj / \
U / \
C;EPTc
II /%0' wEl�t ,EAE
I I
II LOT 2. TRACT B;
II WOODHAVEN S/D /1
\ 1
\ I
LLJI \
LLJ
F—
LOT
D3EN S/D
WOOOHAV%1
)SED SEPTIC UPGRADE
DESIGN PACE 2 OF 2)
EXISTING 4 \
/ BEDROOM \
HOUSE \
ti I
I
EXISTING
SEPTIC
SYSTEM
WOODHAVEN S/D /1;
TRACT A
r----------------
TRACT D-2: WOODHAVEN S/0 11
TRINITY PRESBYTERIAN CHURCH
\ \ WELL ON SOUTH SIDE OF PROPERTY
I \
I \
\ —1
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS i GENERAL CONTRACTORS Q•••••••• •• •••••••
trot c noon troto. nFtF tot • rtototwz. w t,lo? . htotC(907)U) tt1 • FM usa2" . trtttatF: �.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:... . .. ........ ......•••
LESLIE BRYANT 334-5000 1 OF 2 QQ a r y nese:
LEGAL DESCRIPTION: DRAWN 8Y: Q °,�. E-7953 :�
WOODHAVEN SUBDIVISION #11, LOT 4, TRACT B J.N.T./B.F.M. 00^ �!l I� t4v�
TYPE OF WORK: DATE:4��D00of 003sIll
SITE PLAN FOR SEPTIC SYSTEM UPGRADE 7/18/2006
(RFv.01105)
ULDIIJN l r%IlLRIM] \
NUMBER OF BEDROOMS:4 \
GALLONS PER DAY (CPD): 600
PERCOLATION RATES: 1.67 ! 1.62 MIN./INCH
PROPOSED APPLICATION RATE: 1.2 1
MINIMUM DRANFIELD SO.FT.: 500
DRAINFIELD DESIGN:
MAXIMUM DEPTH: 11 FEET
WIOTH: 2.5 FEET I
LENGTH:65 FEET I
M.OA APPROVED SAND FILTER: N/A
EFFECTIVE:4 FEET
REDUCTION FACTOR: N/A
ACTUAL SO.FT.: 520
/
SPECIFICATION/
LETTER THAT PERTAINS TO THIS DESIGN. /
TO OBTAIN A COPY OF THE LETTER
CONTACT GEG. BY PROCEEDING FORWARD I
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
ONOMONS OUTLINED.
i /PROPOSED DRANFIELD
TH#2
FA
' LEXI GUSEO ELD
AS
BE \\
RESERVE SITE \
EXISTING
4 BEDROOM
HOUSE
NOTE: THE CONTRACTOR
SHALL HAVE THE WEST LOT
UNE AND ALL WELL RADII
SHOWN FLAGGED BY A
REGISTERED LAND SURVEYOR
PRIOR TO CONSTRUCTION
FLOW DIVERTER
\
iPOSED 1250 GALLON \
SEPTIC TANK \ \
UNE UNDER DRIVEWAY TO BE
INSULATED WITH 4 INCHES OF
INSULATION 4 FEET WIDE
IG SEPTIC TANK TO
IPED, CRUSHED AND
ETELY ABANDONED.
Awl
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS& GENERAL CONTRACTORS
iINL AFM 6G0. }AI[ t01 • ,MOEIIME. Mf MSO) •FIC,[ tb"WI�I„ • Igut (10/}1L " • U - w�wwr *--1 .
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
LESLIE BRYANT 907-334-5000 2 OF 2
LEGAL DESCRIPTION: DRAWN BY:
WOODHAVEN SUBDIVISION #1, LOT 4, TRACT B 1 J.N.T.
OF WORK:
DESIGN FOR PROPOSED SEPTIC UPGRADE
(R".010M)
7/17
m`sig
od�0
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS 6 GENERAL CONTRACTORS it �' 4
]701 L 1W WI R . Wn 101 • N4HOR.CG M. 99901 • RIOiL (007)W-4176 • FA 90) -]3.6 • .[DNL 9....... • • • • .• • • D
SOIL LOG — PERCOLATION TEST ....... ....... ....:...
LEGAL DESCRIPTION: WOODHAVEN SUBDIVISION 1; LOT 4. TRACT B e'•.Je eE � Sa ess:
PERFORMED FOR: LESUE BRYANT DATE: 7/7/2006
(feet) as�� 44��00000��6�
ORGANICS TEST HOLE 1
1 =San_
:L:.•• SOIL CLASSIFICATIONS
•� •.*.
•'•••� GP ML
3 '0':'� GM CL
4 .; �•.. GC OL
�'::� �•• : SP CH
...
5 •: SM � OH
••�. Sc
6 •.•..•
• o•i.•
7 • :•: •:
•i i .•
8 •.•.•. Sp
9— •:.•.•
. 6*00.
10— .t;:;:
.; �.�.
11 "• •••
....�.
12 •' ••••
....�.
�•::�
13 .;� ;•
.� �.�.
• �.� .•
14 :• i•i•
.; •.�.
00 ..
•. • .•
•. • ••
•...••
16 •••
B.O.II.
17
18
PERCOLATION RATE 1.67 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19
TEST RUN BETWEEN 7 FT. AND 7.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: JORDAN TROISI
COMMENTS:
PERFORMED BY GEC. Ltd. 1. JEFFREY A. GARNESS. CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: !% 0(.
DEPTH TO
GROUNDWATER
DATE
DRY
7/7/2006
R
� 16 6
111
1
W
-
111
'•� Wfl l RAMUS .
CLOCK
TIME
i 1
WATER LEVEL
READING
NET DROP
(INCHES)
111
1
W
-
6"
-
III
2
��
111
�
6"
3
9:45
-
6"
-
111
111
�
�
9:55
X11
�
6"
���
5
X11
+
�`�
;I.
��
TH 1
,
ExlmNc 4
10:06
�
+
BEDROOM \
6"
%
HOUSE \
111
-
\
-
8
10:17
10
0"
6"
9
10:18
-
1.1
t
10
\
10
.II
\
.II
�
t' - 900•
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7/11/2006
1
9:34
-
6"
-
2
9:44
10
0"
6"
3
9:45
-
6"
-
4
9:55
10
0"
6"
5
9:56
-
6"
-
6
10:06
10
0"
6"
7
10:07
-
6"
-
8
10:17
10
0"
6"
9
10:18
-
6"
-
10
10:28
10
0"
6"
11
10:29
-
6"
-
12
10:39
10
0"
6"
iii
...n1 ttanlLK .
CLOCK
TIME
iii
a of
II.
!
9:32
III
6"
—
111
111
111
i
�
.II
i
•
3
9:43
GARNESS
6"
—
ENGINEERING GROUP,
Ltd.
,1
`E
U
TM 1 +
CONSULTANTS CONTRACTORS—It
101 • NKAIOM1Y.f. AIL 69!01 • P1tllG 901 7-6179 • FN 901 -O3N • 1YCB5(IL V.^••••N K.�^
.:
.........
D
BEDROOM \
]101 E 1100.
POM, 6U1E
HOUSE \
,11
6
SOIL LOG — PERCOLATION TEST
11
...., ......
....... .....�
LEGAL
DESCRIPTION:
10:05
WOODHAVEN SUBDMSION 1; LOT 4, TRACT B
6"
a fry G rness, 0
\
8
III
\
0.5"
'• E-7953
\
PERFORMED
FOR:
—
LESUE BRYANT DATE•
7/7/2006
ry
DEPTH
10:26
10
0.5"
5.5"
444dPr•.....10^o\�oto
11
(feet)
—
6"
—
OOOOo
0
o�
10
____
ORGANICS
ITEST HOLE 2
1
=aan
.::..•
SOIL CLASSIFICATIONS
2
•; .•.•
. 1,
•;.•.•
` ; 4-. GP ML
3
..•.•.
•; .•.•
GM CL
"••'•
GC OL
4
•; .•.•
L•::•
...
°. •°.. SW MH
5
...10
��•�:�
•: �•.: SP CH
TH#2
;•;•
SM J OH
' 0••'•
6
•...•
SC
7
�::•
• •'•'
SP
DEPTH TO DATE
•.••,•
.;
GROUNDWATER
�.•.
•0•�•�
0..
8
DRY 7/7/2006
•••
;.
DAY
•...•
10—
0
•• • ••
.; •.�.
.e.
.
11
�.•..
� S� �:
....�.
''
12
••••
.;00000-
•.�.
....,.13—
ego
14
•.•.••
�S0 ��
•. • ••
•0•�.�
15
;.
.; �••.
• �. •.•
.. �. .00
••.•
17
8.0.11.
18
PERCOLATION RATE 1.82 (MIN./INCH) PERC. HOLE DIA.
6 (INCHES)
19
TEST RUN BETWEEN 7 FT. AND 7.5
FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO
SOILS
LOGGED
BY:
SUSAN OSWALT PERCOLATION TEST PERFORMED BY:
JORDAN TROISI
COMMENTS:
GEG, Ltd. I, JEFFREY A. GARNESS. CERTIFY THAT THIS WAS ER ORMED IN ACCORDANCE
PERFORMED
BY
WITH
ALL STATE
AND MUNICIPAL GUIDELINES IN EFFECT ON THIS
DATE: 1
L
iii
...n1 ttanlLK .
CLOCK
TIME
iii
a of
II.
!
9:32
III
iii
...n1 ttanlLK .
CLOCK
TIME
iii
I
NET DROP
(INCHES)
II.
!
9:32
III
6"
—
111
111
111
i
�
.II
i
V v
3
9:43
—
6"
—
4
9:53
10
TM 1 +
/--EXISTING 4
;II
,+ �
BEDROOM \
n1
6"
HOUSE \
,11
6
10:04
11
KF��
1
7
10:05
—
6"
;Ei
\
8
III
\
0.5"
.II
\
,• • 100'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7/11/2006
1
9:32
—
6"
—
2
9:42
10
0.5"
5.5"
3
9:43
—
6"
—
4
9:53
10
0.5"
5.5"
5
9:54
—
6"
—
6
10:04
10
0.5"
5.5"
7
10:05
—
6"
—
8
10:15
10
0.5"
5.5"
9
10:16
—
6"
—
10
10:26
10
0.5"
5.5"
11
10:27
—
6"
—
12
10:37
10
0.5"
5.5"
(NO
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O
j3;
A
LLI
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CC
in
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POSED SEPTIC
DESIGN PAGE
D(ISnN�
BEDROOM
HOUSE
0-144
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J S/D /1
CHURCH
PROPERTY
GARNESS ENGINEERING
GROUP, Ltd.
> :`
CONSULTANTS & GENERAL CONTRACTORS
Igro, N.1[ w1 •
w i .
PREPARED FOR:
PHON
UMBER:
LESLIE
34— 00
1 OF 2
Q
LEGAL D nON:
DRAWN BY:
�0
DHAVEN UDI
SI N1. LO 4. TR T
B J.N.T./B.F.M.
TE:
4O
E OF WORK:
SITE PLAN R
EPI
SYSTEM UP RADE
71WV2006
(Rw.0L051
•7�
/2
J S/D /1
CHURCH
PROPERTY
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELl_ INSP[[CTION REPORT
I~¢'~ - ~'/3/ ~ UPGRADE
NAME
MAILING ADDRESS
LEGAL DESCRIPTION
ell Absorption area Dwelling
Liq. IF HOMEMADE: Insldelength ~ ~.~L~h ~*J Iq
DISTANCE TO: Dwelling
Manufacturer
DISTANCE TO: W,~ ~,~ I Foundation ,~_~
No. oflinesI Lengthofe~h ,~:~ J To,.,~ o,~
Top of tile to finish grade ~
Length
Matmial
Neares'C~ot line ~ ~
Trench wid~t~ ---
inches
NO, OF BI--DROOM~.~
PERMIT NO.
No, of compartments
PERMIT NO.
Liquid capacity in gallons
PERMIT NO. 'l ~O ~ ~ ~
Distance between lines ~J /~
Total effectiveabsorptio area
PERMIT NO.
Crib depth Total effective absorption area
Building foundation Nearest lot line
DISTANCE TO:
ass Depth Driller Distance to tot line I PERMIT NO.
DISTANCE TO: Building foundation Sewer line Septic tank I Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
DATE
72-013 (Rev. 3/78)
LEGAL
D'EPFIRTMENT C ...... FIt...TFI FIN"b EN',,,'IROi'..IMENTFIL. '
82:.'5 '" L.' S'FREET., /al)ICHORF~GE., F:IK.
254-4?20
PERHI'F I".iO. ,:: 78056Z )
FiF'PL I CFIN'F Pi I KE: GRFIE:OL,.ISK I
!..OC:I':tT I ON ..TEROHE ST
LED'iF:IL L4 TRFICT P,, I,.tO0[:,HFIVEN
[_Cl'[' SIZE 4, S)500 SQL.IF:IRE
]"'~"F'E OF SOIL FiDSORL:~I"ION SYSTEH IS: TRENCH
MFt)'::IMUM NUHFJER OF BED'ROOH.'S = 4
SOIL RI::FFING (SIt:! F"FZE:R)'-"~' '125
THE REQUIRED SIZE OF' 'T'HE SOIL, FISSORPTION S'~.'SI"EM IS:
THE LENGTH DIMENSION IS THE L.ENGI'FI (IN FEEl') OF THE TRENC':H OR [:,I:~'.t':iINFIEL. D.
THE DEPTH OF FI TRENCN Oiq: F'IT I:5 'rile DISTFtNC:E..' E:ET!.,J[:':E]'.,I THE SURFFICE OF 'T'HIE:
CiROUi'.,ID FIND, THE BOTTOM OF TNE EY:',CFi',/FIT.T.C~N (IN FEET).
FHEI-..[:. IS; NO ..,E.I !.,.!I[:,TH F i[. FIL. Ei'.IL. FIE_. .
TFIE CiRFI'v'EL D, EF'TH IS THE MIi",IIHLJM E:'EPTH OF .,Ft'I,EL E, E FI. ILEi',I THE OI..rF[q:~II..I. 'F'IPE
[qi'..iE:, TFIE E:OTTOH OF' THE E::-:',CFIVF:ITION <Ii'.,I FEiET).
PERMIT' FIF'PL. ICFINT Fit:iS 'rlqE RESF'ONSIE:ILIT"r' TO INFORM "[:HI':T, I}EF'FIF.'.TME]'~T' [:,IJRINCi THE
!NSTFiLI..FITIOi'.~ INSPECTIONS (.'iF F-li'.,l'~.' !.qEL.LS F~[:.',..'rlaO[Ei'.,II" TO THIS PROPERT'~.' FIND, THE
NIJME:ER OF' RE~:;I[)ENC:ES THFI'f' THE WE:L.L I.,.IIL. I_ SERVE,
. EIFIC:KFII...LING OF F:IN~Y 'E',9'STEH WII"HI.')U"F FIN61L ZNSPECI'ION F:IND FIPPI;.'.OVFIL [3"'r' THIS
DEF'FIRTHEi".IT !.'.1Z Lt.. BE SOEIJECT TO F'ROSECU'F I DIN.
['IlNtMLIM F.:,ISTFINCE E:ETNEEN Ft WELL. 8N[:, FIN's' ON-SITE SEWFtGE [:,ISF'O.SFIL. S'.r'S]-EM IS
:'L00 FEE'[' FOR FI F'RI',,,'FITE I.,.IELL..; OR
i50 TO 200 I':EE]" FROM FI F:'LIE:L..IC WELL E.',EF'ENDINC-i LIF'Oi'.,I 1'HE '[".?PE OF: F'IJF)L. IC I.,.IEL. L.
I.,.IE:LL LOGS FIRE RE[.]LIIRED FIND btLJST BE: RETLIRNE[:' TO THE DE:PFff~:TI"I[~},FI' WITHIN ]:0 D'FI"r'S
OF THE WELL. COHFi_.F.:I"ION.
OTHER I;.'.EQUZI~:ENENTS MFI"r' FIPF'L.'Y. SPEC:IFICI']TII]NS FINE) COIqSTRUCT!OI",I DIFICiRFIM':S FiRE
FI',,,'FIII...F~E,'L.E TO INSURE PF'.OF'EF~: IN'..E;TFII._I_FI]'ION.
CERTI F'~" THFIT
I FIt'l F'FU'ilLIFIR WITH THE REQI.JIREMEN'FS FOR ON--SITE '.:-:,EI.,.IERS FIND, WELLS FI'.S SET
I
FOF,'TI'.I BM THE MUNIC:IF'FILIT"r' CII::' FINCHORFIGE.
~:: I [,.lil_[.. INSTI::ILL THE S'Y'ZS,"FE]',I IN F~CC:ORD, F:fi",ICE I.,.IZTH THE COt)ES.
,..]:: I UND'ERSTFiN[:, THt":IT TFIE ON-SITE SEI.qER S'T'S';TI}]M i"lFl'.~.' REQLI[RE EI'.,IL.FiR[~EHENT IF' T'HliZ
F:!L":E~I [:,Ei",ICE I'.S REr'I(~.~[)ELEE:, _1.:0 I I'..IL';:[..IJE:,E.~ i',II:]RE THFIN 4 E:E[:,r~'.CIOHS.
=: .... , = ...... .............................. -,./- ..............................
FIPF'I_, I C:F~NT NIKE GR~]E~OWSK I
.................................. ................................... "'
PERFORMED FOR:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-950, Anchorage, Alaska 99902 276,222~J
SOILS LOG - PERCOLATION TEST
DATE PERFORMED;
J~ SOILS LOG
[] PERCOLATION
TEST
1
2
3
4
5
6
7
10-
11
13o
14-
15-
16
17
18
19
20
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
FT AND
(minutes/inch)
, FT
COMMENTS
72-008 (7/76)
Municipality of Anchorage
Development Services Department
Building Safety Division
• 4 On -Site Water & Wastewater Program
_ rog
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650 �� Ob o �s
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. d I- g COSA# d 6 O
1. GENERAL INFORMATION Expiration Date: / O - / EI- O 7
Complete legal description WOODHAVEN # 1 • LOT 4. TRACT 8
Location (site address) 12141 JEROME STREET * ANCHORAGE. AK 99516
Current Property owner(s) LESLIE BRYANT Day phone 334-5000
Mailing address 4120 LAUREL STREET #106 • ANCHORAGE. AK 99508
Lending agency Day phone
Mailing address
Real Estate Agent VICKY KAAS w/ HOMES UNLIMITED Day phone 727-5555
Mailing address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well 0
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
5.
As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
Information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 " ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, UD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines d Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily Idontifmable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benerit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
337-6179
Date 8 44
bedrooms, with the fllowing stipulations:
Attachments: /
COSA Checklist t/ Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Reort
Nitrate Advisory Other
. Q
ONSITE
WATER AND
WASTEWATER.:
By:
Original Certificate Date:
(Ray. 11N5)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: WOODHAVEN # 1: LOT 4, TRACT 8 Parcel to: D L.S' 2 YZ-S `j
A. WELL DATA _ • WELL TEST WAS PERFORMED BY KND ENGINEERING
Well type PRIVATE if A. B, or C provide PWSID# N/A
Date completed 9/1978 Sanitary seal (Y/N) YES
Total depth 67 ft. Cased to 67 ft.
FROM WELL LOG
Data of test 9/1978
Static water level 57 ft.
Well production 10 —
9 -p.m -
Well Log (Y/N) YES
Wires property protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
•6/14/2006
in
1.76 g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate O' q0 mg./L. Other bacteria �colonies/100 ml.
Arsenic: MD ug./L. Date of sample: 7/3/2007 Collected by: GEG Ltd.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Data installed 9/1/2006
Tank size 1250 gal. Number of Compartments E Cleanouts (YIN) YES
Foundation cleanout (Y/N) YES Depression war tank (Y/N) NO High water alarm (YIN) N/A
Date of pumping NEW Pumper
C. ABSORPTION FIELD DATA
Date installed 9/1/2006 Soil rating .p.d. or ft /bdrm) 1_2 System type SHALLOW TRENCH
Length 75 ft. Width 3 ft. Gravel below pipe 3.71 ft.
Total depth 12.34 ft. Eff. absorption area 511 ft' Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fall) PASS For 4 bedrooms
Fluid depth in absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: = min. Final fluid depth = in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at _in. "Pump off" le High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Public sewer manhole/cleanout N/A
Holding tank
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, perking/vehicle storage 5'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION Ay�
I certify that i have determined through field inspections and * . 4
review of Municipal records that the above systems are in """ .. '
conformance with MOA COSA guidelines in effect on this
date.
e ass.
Engineer's Printed Name JEFFREY A. GARNESS _CE 79 .`
Date �(6 /07
COSA Fee S Waiver Fee $
Date of Payment Date of Payment
Receipt Number Receipt Number
(Rev. 11105)
Parcell.D.
Municipality of Anchorage
WOODHAVEN
Development Services Department
4, TRACT B
Building Safety Division
12141 JEROME
Onsite Water & Wastewater Program
ANCHORAGE. AK 99516
4700 Bragaw Street
P.O. Box 196650 /
Anchorage, AK 99519.6650
www.muni.org/onsite
(907) 343-7904
���`�
CERTIFICATE OF ON-SITE SYSTEMS APPR
VAL
FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
COSA# d 6 D t'; D S
Expiration Date:,; — —2— R :!O Z
Complete legal description
WOODHAVEN
i 1: LOT
4, TRACT B
Location (site address)
12141 JEROME
STREET *
ANCHORAGE. AK 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
LESLIE BRYANT Day phone 334-5000
4120 LAUREL STREET #106 ' ANCHORAGE. AK 99508
Day phone
MCKY KAAS w/ HOMES UNLIMITED Day phone 727-5555
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
.0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
.0
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system Is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated heroin. I further verify that based on the
information obtained from the Municipality of Anchorage (les and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date x)15/0j•
Engineers Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines b Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of Me system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will N confer any legal right whatsoever.
5. DSD SIGNATURE
v Approved for —It— bedrooms.
Disapproved.
Conditional approval for bedrooms, with the filowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineers Reort
Other /
By. Q/, Original Certificate Date:
(Rev. 11105)
�
_: ON-SITE c?
x : • WATER AND
WASTEWATER
PROGRAM •'
Municipality of Anchorage
Development Services Department
�J Building Safety Division
On -Ste Water b Wastewater Program
4700 Bragaw Street
P.O. Box 198850
Anchorage, AK 995196650
www.muni.org/onsits
(907) 3437904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: WOODHAVEN /1; LOT 4, TRACT B Parcel
A. WELL DATA • WELL TEST WAS PERFORATED BY KND ENGINEERING
Well type PRIVATE If A. B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 9/1978 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 67 ft. Cased to 67 ft.
FROM WELL LOG
Date of test 9/1978
Static water level 57 ft.
Well production 10 —
g -p.m -
WATER SAMPLE RESULTS:
Casing height (above ground) 12+ In.
AT INSPECTION
•6/14/2006
29 ft.
1.76 g.p.m.
Coliform _Q colonies/1100 ml. Nitrate Q B mg./L. Other bacteria colonies/100 mi.
Arsenic: A+'—ug./L. Date of sample: 9/28/2006 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Date installed 9/1/2006
Tank size 1250 gal, Number of Compartments E Cleanouts (Y/N) YES
Foundation deanout (YIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping NEW Pumper –
C. ABSORPTION FIELD DATA
Date Installed 9/1/2006 Soil rating .p.d r Mbdrm) 1_2 System type SHALLOW TRENCH
Legh 75 ft. Width 3 ft. Gravel below pipe 3.71 ft.
Total depth 12.34 ft. Eff. absorption area 5111 fe Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass(Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: = min. Final fluid depth = in. Absorption rate >= 600+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (YIN 3 type) NONE KNOWN If yes, give date –
D. UFT STATION
Date installed
"Pump on" level at _in.
Datum
E. SEPARATION DISTANCES
Size in gallons Manhole/Access (Y/N
"Pump ofr Is High water alarm level at
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAM station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100,+ On adjacent lots
Public sewer main N/A
Sewer /septic service line 25'+
100'+
Public sewer manhole/deanout N/A
Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 105+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 5'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I car* that I have determined through Held inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date It 13dofa
COSA Fee I W . 0L
Date of Payment j J - (o
Receipt Number r a 1
(Rev. I vos)
Waiver Fee E
Date of Payment
Receipt Number
09/26/2008 13:28 FAX9073343001LESLIE BRYA.1'T'S OFFICE / 0002
Kd V D ENGINErRwG, r Tc.
20441 PTARMIGAN BLVD.
EAGLE RIVER AK 99577-8736
696-6111/FAX
June 16, 2006
Leslie Bryant
4120 Laurel Street
Anchorage, AK 99508
RE: WOODHAVEN lfi, TRACT B. LOT 4
Septic tem Adequacy & Well Elow Test
(Igne 14 2006
Test Procedure & Results:
The well was pumped at a constant rate while an acoustic sounder monitored the
draw down. At the beginning of the test, the static water level was measured at
29' below top of casing. At a pumping rate of 1.94 gallons per minute, the water
�evel dropped to a range of 48-54' and remained there for the duration of the test.
The well recovery was measured at 1.76 GPM. The Municipality of Anchorage
requirement for well flow is 150 gallons of water per bedroom per day. This well
exceeds this requirement.
On May 3, 2006 McDonald's pumping treated the above subject septic field in an
attempt to rejuvenate the system. On McDonald's pumping pumped the 1,250
gallonseptictank1ortogortoc
riitwasnotedthat water
wasleaking from e residence. Interior plumbing shoulbeinvestigated for thecausfssmleak At the beginning of the septic adequacy test, the
monitoring tube was dry. A total of 1100 gallons of water was added to the on-
site wastewater absorption trench and the fluid levels rose up to the lateral at a
depth of 6'.
These levels were monitored for the next day, which showed absorption of 483
gallons in 24 hours and another 100 gallons for another additional 24 hours for a
total of 583 gallons in a 48-hour period. The Municipality of Anchorage requires
fan absorption rate of 150 gallons of water per bedroom per day. This septic
system does not meet this requirement and needs to upgraded. Water samples
were not taken due to their time -sensitive nature and the failed septic system.
The assessment of the condition of the well and septic applies only to the
conditions as of the day tested. The flow and absorption rates may change due to
09/26/2006 15:29 FAX 9070045001 LESLIE BRYANT'S OFFICE
e003
Woodhaven f Tract B, Lot
June 76, 2006
Pate 2 of 2
subsurface conditions that may not be observed from the surface, changes in the
land use, water usage and other factors.
If you have any questions regarding the referenced property's on-site water and
wastewater system or testing procedures, please contact me at 696-6111/FAX
696-8111.
Respectfully,
lEJM Engineering, Inc.
Note: The operational life of all septic systems depends on the local soil
conditions, groundwaterlevels that may fluctuate during the year and the coater
usage of the family being served by the system. These conditions are outside the
control of the evaluator of this septic system. Therefore we can not give any
estimate of how long this system will function satisfactory for cturenI or future
occupants. All septic systems ultimately fail. Some systems last 15-20 years or
longer, while others fail after less thyears.
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES ,~U~,~y Or'' -
D~vm~on of Enwronmental Serwces ENVIR
..... ~'S~VIC~ DIVISION
On-Site Services Section
P.O. Box 196650 Anchorage. Alaska 99519-6650 ~-p '~ ,~ 7997
343-4744
CERTIFICAT, OF HEALTH AUTHOR,TY RECEIVED
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # _ L~/-~' - ~ / - ~-~
GENERAL INFORMATION
Complete legal description
Location (site address Or dirbCtion~)
Property owner
Mailing address
Lending agency
Mailing address
Agent ~r~
Day phone
Day phone~
Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: V"
TYPE OF WATER SUPPLY:
Individual well
communit?{Well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATE':R 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.
72-025 (Rev. 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/er 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 KND Engineerirlg Phone
20441 Ptarmigan Blvd.
Address ~le Rk,~ ~K 9~.77..~
EngineeCs signature 2~/7/~' ~
DHHS SIGNATURE
~ Approved for
bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
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 DH HS does this as a courtesy to purchasers of homes
and their lending institutions in orderto 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.
MUNICIPAI. ITY OF ANCHOI,1AGE
EN~II~OIG~4ENfAL ~ERVICE$,41~i~oN
Municipality of Anchorage
DFPARTMENT OF HEALTH & HUMAN SERVICES S£P
Environmental Services Division
825L
Street, Room 502. Anchorage, Alaska 99501. (907) 343 EIVED
Health Authority Approval Checklist
A. WELL DATA
Well type //')/
Log present (Y/N)
Total depth _ ~'
Sanitary seal (Y/N)
IfA. B, or C, attach ADEC letter. ADEC water system number
Date comeleted
Cased to _ ~ F /
Casing height (above g rou nd) ~ ,,,~,~'~,¢~/
Wires properly protected (Y/N) ~/
FROM WELL LOG
Date of test
/
Static water level ,,~'~
Well production
AT INSPECTION
g.p.m.
WATER SAMPLE RESULTS:
/
Coliforrn ¢ Nitrate.
/
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed 7/?/~ Tank size
I
Foundation cleanout (Y/NJ Y
Date of Pumping
/ /
C. ABSORPTION FIELD DATA
Date installed
Length Z//Z~ Width
Effective absorption area
Date of adequacy test.
~,~, .¢",~. Other bacteria
Depression (Y/I~"~ ,4//
Pumper
Number of Compartments ~, Cleanouts (Y/N) ¢
Soil rating (g.p.d./fF or fF/bdrm)
Gravel thickness below p~pe
Monitoring Tube present (Y/N) Y
Fluid depth in absorption field before test (in.);
Fluid depth /,,~, ~,'.~ (ins) Minutes later: /¢¢~)
Peroxide treatment (past 12 months) (Y/N}.
High water alarm (Y/N) --'-"'
/2 ::~ System type ~/~e,,¢¢¢~
Total depth /~
Depression over field (Y/N)
/
For_ ~ ~edrooms
Immediately after ~/¢ gal. water added (in.): ~7"
Absorption rate = ~ ~ g.p.d.
If yes, give dats '~
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed //' Size in gallons~ ~off
Manhole/Access (Y/N) ~"Pump on" level at* "level at*
High water alarm level at* ..~ *Datum ////'/
Cycles tested ./ J
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Sel~tic/holding tank on lot
Absorption field on lot
On adjacent lots /~)0
On adjacent lots
Public sewer main
Sewer/septic service line
Public sewer manhole/cleanout
Lift station ---
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation /0 ~ Property line /0 q~ Absorption field
Water main/service line ~D~ q~ Sudace water/drainage ~OD 4- Wells on adiacent lots
1OO%
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Properly line /O /~L Building foundation ~ ~F Water main/service line ,~' ~-t'
Surface water /OO 1- Driveway, parking/vehicle storage area
20o~. ¼ Cto~ss A/~
Curtain drain /OL~ ~ -I- Wells on adjacent lots /cC,'+ ~ 1¼~
F. ENGINEER'S CERTIFICATION
I certify that I ha ve determined thru field inspections and review of Municipal re.~. t~th~ ~.~ §J(btems are
in conformance w/th MOA HAA gu/defines/n effect on th~s date.
Signature ~¢~. ~
HAAFee $ ~, ~ Waiver Fees
Date of Payment ?Z~/~ Date of Payment
Receipt Number .... /. Receipt Number
72-026 (Rev, 3/96)*
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEO~i~k~CIPALITY OF ANCHORAGE
825 L Street - Anchorage, Alaska 99501 DEPT. OF [',EALTH &
ENVh~ONMENT/~L
ENVIRONMENTAL ENGINEERING DIVISION
Telepho.e 2E4-4720 FEB 2 1979
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND
IIFIECTIDNS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10] days for processing.
PROPER ~' WNE - ~ 4 PHONE
MAI LI NGr~d~D R ESS __ /W,~~,
PROPERTY RESIDENT ~f different from above)
PHONE
~ BUYER PHON~
MAI LING ADDR ESS
'~, LENDING INSTITUTION ' ~~'~''A~- ' PHONE
~ R~A~OR/AG~NT PHON~
MAILING ADDRESS
~.' lEGAL DESCRIPTION
NUMBER OF BEDROOMS
One ~J~ Four
[] Two [] Five
[] Three [] Six
[~] Other
iTi~EET
_ J/z'/x rL
6, TYPE OF RESIDENCE
SINGLE FAMILY
MULTIPLE FAMILY
[~ INDIVI DUAL* ATTAC./r-t WELL LOG, A-wel log is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date. g~ve well
[] PUBLIC UTI LITY depth (attach log if available,)
8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE'*
[] PUBLIC UTILITY
''If individual/on-site, give installation date ,,,/(~,~2~, ~
If svstem ia over two (2) years old an aoeduacv test ~s required
Dy this Department,
NOTE: THE INSPECTION FI=-E MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78t
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TiME
DATE DATE DATE
INSPECTOR INSPECTOR I NSP ECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [~ OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
E~]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY "~ ~
Connection Verified INSTALLER
[]Septic Tank or [] Holding Tank ~.,~
Size: I~.,b~'O If Tank is homemade SOILS RATING -
give dimensions: Iv ~ ~
TYPE OF TANK MANUFACTURE~ ~.~.._~
TOTAL ABSORPTION AREA M AT E R I A L ~..~_,~.~
4. DISTANCESwELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5, COMMENTS
[~APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accomp/~d~/,~ertif[cate)
[] DISAPPROVED
LEGAL DESCRIPTION
72-010 (Rev. 3/78)