HomeMy WebLinkAboutTURNAGAIN PARK #2 BLK 1 LT 1Turnagain Park
#i
Block 1
Lot 1
#018-241-30
Municipality of Anchorage Page 1 of 3
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO60195 PID Number. 018-241-30
I
John & Sharon Andrews
Wastewater System: Upgrade
14401 Old Seward Hwy. Anchorage, AK 99515
ABSORPTION FIELD
Four
Deep Trench
227-3102
sd RA.V
TOW Depet fr napti 9:
LEGAL DESCRIPTION
.8 GPDNe
12 Ft.
etax La slee4aat
Depth to Ppe eomtt harp aavW w.
Geer depth t>eesrtt p"
1 1 Tuma ain Park No. 2
3 Ft.
9 FL
Ta4r4rp. Rrtpa Bggrc
Fi.EMa •GOs•a,pnr Vtle
Grvr Lrpar.
0-1 Ft.
42 Ft.
Grata •iWt
fMnt•r Pl lns..
DnWOOatwen lns•.
Well: Existing
3 Ft.
1
- Ft
CW VM1usm (Rrvr•, A B. Q.
Tar D.W: Cassa b:
ar awap�On W.
Pp• MrerW.
FL FL
756 Fe
I ASTM 3034 PVC
Dater
00•ONW: SWw Wrs L••r
Acreage Systems
7111.1212006
Ft
rra.
P4 set`
t; " "eP"G'°"'a:
TANK-EXISTING
GPM
Ft.
Ft
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
SepticAbsorption
Lift
Holding
lublidVnvate
v
From
Tank
Field
Station
Tank
Sew Line
was
:04W
>100'
N/A
NIA
>25'
r
Suf.wrer
>100'
>100'
NIA
N/A
LIFT STATION — EXISTING
Laths
>5'
1'
NIA
WA
C-21
FPurrntt
>5'
>10,
WA
WA
h
�
h
W r
h
None
Noted
P Lw. tAvoa�
v4v.a�r via
cwt. Dian
R"""'
BENCH MARK
bee Lot One waiver.
Garage Slab
100.0 Ft
Engineer's Stamp
CY a
4t P\� �µ�`rq♦i
'
Inspections performed by: MEA Dates: 1" 7111106
to
_ 49t^
-
2nd 7112/06
i �1
to .........._....._ _....... ........ _..r
♦10
Department of Health and Human Services approval
ni4C AE E. AVOE i50V y
'.D.
Reviewed and approved b : //.✓f/ ,./ %�� Pim l Date: %-2 �-0 6
PPeV
# --,% C-4-A38'�
''.
�
♦� ^PEpZ :�:'
tae. too•) If
♦♦a,i
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit No.: SW050257
= N
S
Page 3 of 3
PID No. 017-361-03
Drain Field Rock
Course Sand Liner
x-87.0
NOTEi Existing Septic Tank and Lift Station Inspected
and Verified Sound for Continued Use.
Ftor Diverter Vatve Ptaced and Existing Drain Fletd Tied In.
81.0
PROFILE AS -BUILT
Scale: NONE
96.1
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET. ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: Lot 1 Block 1, Turnaaain Park No. 2
PERFORMED FOR: John Andrews
DATE: 7/5/2006 PROJECT No.:
PARCEL ID#: 018-241-30 TECHNICIAN: M. Anderson
DEPTH
READING
TEST HOLE # 1
(r,xp
DEPTH of
WATER
(INCHES)
NET DROP
(INCHES)
7/5/06
TEST HOLE PRESOAKED PRIOR TO TESTING:
Grass/Organics
1
1
1:14
2
y•, ._
cHARGE
2
3
'.`.i ; ".
7.75"
2.13"
4
1:45
5
': Y: r
4
2:15
30
a.,
2.06"
7
;at
5
2:16
9.75"
8
6
2:46
Silty Sand
9
'°'''
Dry and Loose
f.�4
SM
).0 ..
GROUND WATER ENCOUNTERED+
10
'� '�
IF YES ®WHAT DEPn{+
11
'• "y
DEMI ®MONITORING
.. .. _
DATE OF MONRORING
J
COMMENTS:
I -liars I
SLOPE
SITE PLAN
SEE SITE PLAN
NO SL oef�
None
71506 pPCFE
DATE
READING
NILROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH of
WATER
(INCHES)
NET DROP
(INCHES)
7/5/06
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
1:14
9.88"
cHARGE
2
1:44
30
7.75"
2.13"
3
1:45
9.63"
RECHARGE
4
2:15
30
7.57"
2.06"
5
2:16
9.75"
RECHARGE
6
2:46
30
7.75"
2.00"
PERCOLATION RATE;— 15 (MIN/INCH) PERC. HOLE DIA. 6 tNcHES)
TEST RUN BETWEEN: 4_0 Fr. and --UFT.
HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS TEST
WAS PERFORMED IN ACCORDANCE WITII ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 7/6/2006
MUNICIPALITYOFANCHORAGE�
Development Services Department `
On -Site Water 6 Wastewater Program ` 1\
4700 South Bragaw Street 1
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 10, 2006
Expiration Date: Jul 10, 2007
Permit Number: SWO60195 Parcel ID: 018-241-30
Legal Description: TURNAGAIN PARK #2 BLK 1 LT 1
Design Engineer: 0014 ANDERSON ENGINEERING Site Address: 014401 OLD SEWARD HWY
Owner Name: JOHN & SHARON ANDREWS Lot Size: 22121 SQ. FT.
Owner Address: 14401 OLD SEWARD HIGHWAY Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE, AK 99515 -
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.
PROCEDE AT YOUR OWN RISK. PLEASE PROVIDE 7 DAY WATER MONITORING.
Received By:
Issued By.
Date: 1
Date: 7 d Q6
July 12, 2006
Michael E. Anderson
Anderson Engineering
P.O. Box 240773
Anchorage, AK 99524
Subject: Waiver Request for Turnagain Park #2, Block 1, Lot I
Waiver Request WR#: 060031
Parcel ID # 018-241-30
SW060195
Dear !Michael E. Anderson:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to the property line has been approved. The approved separation
distance is 1.0 foot.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
W(/t ft
Deb Wockenfuss
Civil Engineer
On -Site Water & Wastewater Program
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchoragc.ak.us
(907)343-7904
Waiver Review Worksheet
WR#:060031 PID#:018-241-30 HA/Permit# SW060195
Date Received: July 12, 2006
Legal Description: Turnagain Park #2, Block 1, Lot I
Engineer:
Michael E. Anderson
Anderson Engineering
P.O. Boz 240773
Anchorage, AK 99524
Applicant: John and Sharon Andrews
Waiver Requested: lot line
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Waiver Is Granted: X
List Conditions or Reasons for above:
Total:
Waiver Is not Granted:
Date: 7/12/06 By: Deb Wockenfuss
Name of Reviewer
r ................... smugness ... ....s.. ... season ..... seem ....... ...s.......
Rec#: 82714 Amount: $175 Date Paid: 7/12/2006
Municipality of Anchorage
Development Services Department
_Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Ir Anchorage, Alaska 99519-6650
x(907) 343-7904 ite
L " ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018-241-30
Property owner(s) John and Sharon Andrews Day phone 227-3102
Mailing address 14401 Old Seward Highway Anchorage, AK 99515 Zip Code
Site address 14401 Old Seward Highway Anchorage, AK 99515 Zip Code
Legal description (Sub'd., Block & Lot) Lot 1, Block 1, Tumagain Park Subdiviison No. 2
Legal description (Township, Range & Section)
Lot Size 22.121 Sq. Ft.
THIS APPLICATION IS FOR (® all that apply):
Absorption Field
Septic Tank ❑
Holding Tank ❑
Privy ❑
Private Well ❑
Water Storage ❑
Number of Bedrooms Four (4)
THIS APPLICATION IS AN:
Initial
❑
Upgrade
i]
Renewal
❑
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.
F
(Signature of property owner or authorized agent)
Permit/Rush
Waiver Fees:
Date of Payment: t - (O` (YQ Date of Payment:
Receipt Number. PA T I )1 Receipt Number.
(Rev. 11105)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
MEMORANDUM
DATE: July 10, 2006
TO: Deb Wockenfuss
FROM: Mike Anderson, P.E.
SUBJECT: Lot 1, Block 1, Turnagain Park Subdivision No. 2
Septic System Construction Permit
Attached is a lot line waiver request along with a drawing showing the location of the
neighboring septic system. An inspection of the monitor tube in the test hole this
morning revealed no groundwater. We are confident groundwater will not develop in
this test hole during the remaining monitoring period, but will continue to inspect water
levels until the full seven days has passed.
WAIVER FEE:
PAYMENT DATE:
RECEIPT #: 3.23 W
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
-7773 677-7766 (F/
July 8, 2006
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Lot 1, Block 1, Tumagain Park Subdivision No. 2
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer:
The location of the existing failed absorption bed along with the location of the well on
this and adjacent lots restricts the area available for a new absorption trench. We are
therefore requesting a waiver be issued allowing the absorption trench to be within 2' of
the southern lot line. The septic system on Lot 2 to the south is more than 25' from the
proposed southern end of the new trench and will not be impacted by placement of the
new trench.
The existing absorption system will remain in tact and may be used in the future should
the need arise. All separation distances can be met from wells, surface water and
septic systems in the area. We therefore recommend the lot line waiver be issued.
Sincerely,
Michael E. Anderson, P.E.
`�1[/ wLv I
49th 71 -
V CALL E. A%,^,ERSC4
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
July 6, 2006
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Block 1, Turnagain Park Subdivision No. 2
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The existing absorption system on the subject lot has failed and must be upgraded.
The owner has sold his house and a Certificate of On Site Systems Approval (COSA)
can not be issued until the system meets Municipal requirements. We are therefore
requesting a permit be issued for the upgrade of the septic system to accommodate the
four-bedroom home on the lot. The attached Site Plan and backup documentation
identify the location and configuration of the existing septic tank, lift station and
proposed absorption trench. Also identified on the plans are the locations of the
existing well and absorption bed. Both the septic tank and lift station encroach into the
100' protective radii of surrounding wells. They will be exposed and inspected and if
found unsuitable for continued use replaced. New tanks will be constructed outside the
protective radii. Drainage arrows are shown indicating the current drainage patterns.
The drainage patterns will be maintained after construction.
The test hole placed on the lot at the location of the new absorption trench indicated
silty sand with minor amounts of gravel (SM). The percolation rate was determined to
be 15 minutes per inch. No groundwater was found to depths of 18' and none has
accumulated during the monitoring period. We are proposing to construct a new 42'
long by 3' wide absorption trench with 9' of gravel beneath the distribution pipe. The
distribution pipe in the trench will be placed at 3' below the surface with the total depth
at 12'.
The ground surface on the lot slopes slightly to the east to the west at a grade of 5%.
The new trench will be constructed parallel with the slope as much as possible in
conformance with Municipal requirements. The new absorption trench will be
Lot 1, Block 1, Turnagain Park Subdivision No. 2
July 6, 2006
Page Two
constructed a minimum of 100' from the existing well and any surface water in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely, n '
E.l�i.--dam
Michael E. Anderson, P.E.
Attachments
•
1 49th -a �-
YC4AEL E. ANOE?SCN
\ \\ 9A g
6
\\
9B
1
9- \
2
TRACT 12A
i
i
2
11 P \
10
AREA MAP
SCALE V = 100'
3
Moo
Existing
wed
Existing 40'
x 45' Bed
ni
ON
•
well
13,
Home Home
42' Long x 3' Wide
x 9' Effective Depth
Absorption Trench
NOTE:
Expose and Inspect Septic Tank
& Lift Station. If Damaged Place
New Tank & Lift Station Outside
100' Well Radii.
Place Ball Valve in Distribution
Line to Existing Bed and to New
Trench.
SITE PLAN
SCALE I' = 40'
LOT 1, BLOCK 1,
TURNAGAIN PARK ADD. NO. 2
49th
E. ANDERSON
CE -4381 .
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: Lot 1. Block 1, Turnagain Park No. 2
PERFORMED FOR: John Andrews
DATE: 7/5/2006 PROJECT'No.:
PARCEL ID#: 018-241-30 TECIINICIAN. M. Anderson
D17rnl I TEST HOLE # 1
(r�cq
V-7—=
1
2 T,� •.:ti.
3
4
5
7 ;.,.
8
9
%A
13
14 ". �•'•.
15
fE1=�
1
Grass/Organics SLOPE
Silty Sand
Dry and Loose
SM GROUND WATER ENCOUNTERED?
IF YFS ® WHAT DEPnI?
DEPTH ® MONITORING
DATE OF MONITORING.
SITE PLAN
SEE SITE PLAN
s
NO
None_ 5�
7/10/06
DATE
READING
INE
NET TIME
(MINUTES) I
DWATERF
(INCHES)
NET DROP
(INCHES)
ROS TIME
(MINUTES)
7/5/06
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
1:14
9.88"
CHARGE
2
1:44
30
7.75"
2.1311
3
1:45
9.63"
RECHARGE
4
2:15
30
7.57"
2.06"
5
2:16
9.75"
RECHARGE
6
2:46
30
7.75"
2.00"
PERCOLATION RATE;— 15 (MINANCII) FERC. HOLE DIA. 6 rINCIIES)
TEST RUN BETWEEN: 4.0 FT. and i_O FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS TEST
WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 7/6/2006
i1
• MUNICIPALITY OF ANCHORAGE
�' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
❑NEW
•3yy_•715
UPGRADE
sit
MAILING ADDRESS
t Sfo oc. sELYi
LEGAL DESCRIPTIONkorl. "PARK
I
LOCATION
NO. OF BEDROOMS
L/yv I Qlb s
Well
Absorption area
Dwelling
PERMIT NO.
DISTANCE TO:
DY
HZ
Manufacturer `
Material
No. of compartments
LLQ
7
W
�
Liq, capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
Well
Dwelling
PERMIT NO.
G Y
DISTANCE TO:
O Q
Manufacturer
Material
Liquid capacity in gallons
Ci r
O
W =
DISTANCE TO:
Well ���
Foundation O
Nearest lot line
PERMIT O
y, O if
W
u. W
No. of line
Length of each line
Total Iwngth of lines
A �j(�
7(e c wir]�h
y ,x iris
Distance between li a
Q ¢
sF
Top of tile to finish grade
Material beneath tile
Total effective absorption area
�eoO
O
, inches
Length
Width
Depth
PERMIT II
w
D
i11,-
Type of crib
Crib diameter
Crib depth
Total effective absorption area
Wd
r"
Well
Building foundation
Nearest lo[ line
H
DISTANCE TO:
Class
Depth
Driller _-
Distance to lot 6ne
PERMIT NO.
J
J
t"
3
Building foundation
Sewer line
Septic tank
Absorption steals)
DISTANCE TO:
OTHER
Yt
PIPE MATERIALS
7
�
SOIL TEST RATING
T-
N
30 5
w
r
Q
I
INSTALLER
REMARKS
.► OF Al.
may:
*: 45TH {
...... .. ;
.. ',:�
22E :•if
APPROVED OAT LEGAL
as 4L. r arc/ 7"a-1VA6�41 �A�K a
72413 (Rev. 3/781
a1 GRED°R ANCHORAGE AREA BOR'7GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME r MAILING ADDRESS Rot -4177 S_Rd� PHONE J
LOCATION 'CueQlE� LEGAL DESCRIPTION 06�' / 099 / ti/[�,R3a✓
SEPTIC TANK:
DISTANCE 1, NUMBER OF
FROM WELL Iyev MANUFACTURER- / MATERIAL COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYL!'S GALLONS.
TILE DRAIN FIELD:
/ TOTAL LENGTH /
DISTANCE FROM WELL /'" F UNDATION ?� NEAREST LOT LINE /sf OF LINES S�
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTHS IN. TOTAL EFFECTIVE
ABSORPTION AREA O 08/
SQ. FT. LENGTH OF EACH LINE ...r
/ DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE__!1_MATERIAL BENEATH TILE IN. ABOVE TILE 6 IN.
WELL:
TYPE _Qr CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM ,
CESSPOOL , OTHER SOURCES
APPROVED f%�� DISAPPROVED REMARKS _.
DISTANCES: 5{* DIAGRAM OF SYSTEM
INSTALLED BY:
SEWER
-LINE
O ,DEPTH:
PIPE MATERIAL:— =r iO
LOT SLOPE:
Y F/orm E"32/(AX eZ4, r=i' �
�y
YT' r
DATE/�,7APPROVED 1-4L!o:9 u
G.A.A.B.
n
motq I C I F= AL I TY c3r-- �1�1CF lQFZF`+G�
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
B25 L•STREET, ANCHORAGE, AK 99501
264-4720
Ohl—S I T1=
r- r -;z 9 I T
/ ��'rEWr_--r2
PERMIT NO: 850067
DATE ISSUED: 03/15/85
APPLICANT: TOP•BEN SPURK.LAND
ADDRESS: 203 W 15TH #203
ANCHORAGE, AK 99501 SlLE��
CONTACT PHONE: 279-3916
LEGAL DESCRIP: SUBDIVISION: TURNAGAIN PARK. #2
LOT: 1
BLOCK: 1 .
SECTION: 32 TOWNSHIP: 12N
- RANGE: 3W
LOT SIZE: 22050 (SQ.FT. OR ACRES)
LOT LOCATION: OLD SEWARD HIGHWAY.
MAX BEDROOMS: 4
Listed below are the options available to you
in designing your
septic
system. Choose the option that best fits yL60
.
- - - - - - - - - - - - - - - - - - - - - -
- - -
- - - - - - - - - -
TFzZF=PIC 1-1D
W _ 33F�A 11' 1
DEPTH TO PIPE BOTTOM (FT.) 3.0 *w.0
4.0
GRAVEL r. -PTH (FT.) 9.0.5
3.5
TOTAL DEPTH (FT.) 12.0.5
7.5
GRAVEL WIDTH (FT.) 2.5,0
5.0
GRAVEL LENGTH (FT.) 07.0 �.0
169.0 **
GRAVEL VOLUME (CU.YDS.) 76.6!9
125.2
TANK SIZE (GALS) 1,250.0 *
.0
1,250:0 *M
SOIL RATING (SQ.FT./BR) X9105
391
*�r DEPTH TO PIPE BOTTOM .1.3.5 FT. REQUIRE
M
** DEPTH TO PIPE BOTTOM < 4.0 FT. MAY REQUIRE
A LIFT STATION
#* GRAVEL LENGTH ? 75 FT. REQUIRES MULTIPLE
RUNS (NOT EXCEEDING 75 FT. EACH)
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
- - - - - - - - - - - - - - - - --- - - - - -
- - - - - - -
- - - - - - - - - -
I certify that:
1. I am familiar with the requirements for on-site sewors and wells as sct
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
1. I will adhere to'all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for a maximum of 4.bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED 'IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE'DONE BY A LICENSED ELECTRICIAN.
SIGNED / --- DATE:
---------------------------- ---------------
APPLICANT: TOBBEN SPURKLA)ND /
311.ISSUED BY CX-.�-t�fl�� DATE: /gJ /`
... ,... /�.- "( 4:•. v_<—�, 'T. - - sort.. ... r. Y.. -.,.. 1....,...<�..' I ... . .... •....i
GRE NER ANCHORAGE AREA BG, UGH II��
'PERMIT NO.
DEPARTMENT OF ENVIRONMENTAL QUALITY
• t� " 3330 "C" STREET ANCHORAGE, ALASKA 99303
02 : 3
TELEPHONE 274.4381 v
f 7—ff� S
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMI G
//c
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE
FINANCED THROUGH
MAILING ADDRESS - - PHONE..
� b
1
T
SEEPAGE PIT/ DRAIN FIELD OTHER
TO BE INSTALLED BY
SOIL TEST RESULTS
O`r ��/Yv+-r NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
-
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE TYPE �� /1'1 .�.7 L'u... �.i SEEPAGE AREA SIZE,; ' TYPE
1 /
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT �ii DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT (J DRAIN FIELD
TO NEAREST LOT LINE.
I /
WELL TO SEPTIC TANK ���" .SEEPAGE PIT /L�n
DRAIN FIELD �ir - ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK / SEEPAGE PIT
DRAIN FIELD ��1 r
SEPTIC TANK. SEEPAGE PIT /�'DRAIN FIELD
TO RIVER. LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS,
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.S.
OR
LICENSED DESIGNER
C�
DIAGRAM OF SYSTEM
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ' 1(
DATE •� -25 APPLICANT'S APPLICANT'S SIGNATURE/ J� �'JJ jJ(� /►�) //�1 'may///I�//y�)�'�`^���
FORM NO. EQ -0%6 N/I ),14 P-9G:::Pi j(4 A) [7p�g nye•_,.,_ ' I�jl /1 •_1/. (�� L/
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
�•
825 L. Street, Anchorage, Alaska 99501 264720
- SOILS LOG - PERCOLATION TEST
PERFORMED
LEGAL
(FEET)
t
2-
3-
4-
5-
6-
7-
a-
9-
10-
11
34567891011
12-
13-
14-
15-
16--
17-
181
21314151s1718
19 �..
20 oil
COMM
SLOPE
Silty
SotiaC�
C�mJ
WAS GROUND WATER i1 O
ENCOUNTERED? �V
OA
l ••,�
0 2225-L
IDNE 25.1971
IF YES, AT WHAT
DEPTH?
SOT LOG O G�
PERCOLATION
TEST
DATE PERFORMED:
T
SITE
N6
Reading
Data
Gross
Time
Net
Time
Depth to
Water
Net
Drop
3 yam
%30
e S
JI/
94/
''
6'5- 4
6's
V"g
M.A
PERCOLATION RATE '7 7 �� (minutes/inch)
TEST RUN BETWEEN 04 FT AND 2 FT
e ', S /,,a 4 t tl« Av%G
PERFORMED BY: �N r CERTIFIED
72008 (6/79)
DATE: 3
Performed for
Legal Descript o
This form reports:
Depth
Feet
2
3 - —
4-
GREATER ANCHORAGE AREA BOROUr''-1
Jepartment of Environmental Q6. ty
3330 "C" Street
Anchorage, Alaska ' 99503
SOILS LOG - PEROLATION TEST
S ►og x v
519 �cc `7
5 _e7✓cCcc� l uµ// f
9
10 -
12 -
13 -
Was ground water_ encountered? n v .' If yes, at what depth?
s,0pe
ation
Performed 15 2 7 i S
til
Reading.
Date
Gross Time
Net Time
Depth to Water
Net Drop
Percoiatlon rate__ _minute.
Proposed installation:_
T Seepage Pit Drain Field
Depth of Inlet Deptli tol;ottom of pit or trencit
COMENTS: -•�
verrormou by: i
ECI-040 (6/74)
te:
Munk. pality of Anch,)rage �ll
Department of Health and Human Services
Tom Fink, 825 "U' Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
November 16, 1993
Tobben Spurkland, P.E.
203 West 15th Avenue #206
Anchorage, Alaska 99501
Subject: Waiver Request for Lot 1 Block 1 Turnagain Park #2
Waiver Request #WR930069, PID #018-241-20, HA930636
Dear Mr. Spurkland:
Your request for waiver(s) of the required 100 foot horizontal
separation of a septic system to a private well has been approved.
The approved separation distance(s) are the well on Lot 9B Block E
Sunset Hills West to the septic tank and lift station on Lot 1
Block 1 Turnagain Park #2 of 95 feet and the well to the septic
tank on Lot 1 Block I Turnagain Park #2 of 95 feet.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
re uire all separation distances be met or another approval
q
from this department.
�Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
ljm:#6
Concur:
John S ith, P.E.
Program Manager
On-site Services
MUNICIPALITY OF ANCHORAGh
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR930069 PID# 018-241-30 HA# HA930636 Permit #
Date Received: October 14, 1993
Legal Description: Lot 1 Block 1 Turnagain Park #2
Engineer: Tobben Spurkland P.E.
203 West 15th Avenue #206 Anchorage. Alaska 99501
Applicant: Keith Taton
Waiver Requested: Private well on Lot 9B Block E Sunset Hills S/d
and the septic tank located on Lot 1 Block 1 Turnagain Park #2 of
of 95 feet; private well to septic tank on Lot 1 Block 1 Turnagain Park #2
Lriter�a�l to tl ? m8p8j66ypiserVfrom the well onp�yq tl.BLock 1
4S
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: Waiver is NOT Granted:
List Conditions or Reasons for above: SFS '09 7 `l CH670
Rec #: 25325 Amount: $ 625.00 Date Paid: 10-14-93
e
t �
ti
w
r�
R REQccEST FOR LOT ikRNA4hW
WI}/VER l4EQuESt NutvER WRR9-71069
filVE/l REQuEfr FOR %kE WF_LL ON LOT / DLk / Tkk.v yGN/'" f4R.K
/4N /= 0 TetL. ELL ew Lor 9b OLA r-f4NSET 14/411 /,,.EsT to TIaF_ fgpT
Ti4,v/l O,v L1T / OHc / 7'kem-4toA/w SARK Ir -2 OF �iS �� t6tPFcr.✓E/
RI -50, rkF-
WELL
Ow LOT 16
Cat
c fm�J6T N/Ltt 1.f_ST %O Ei/`7'S7'vT
av Lir l
OiK %
TkRVh GR/.
pgRK�
O/` is �.
$EPT/C. D14rt9--
THF SugTEGT fSrT/c TANk v.tf Coe xrriAe7-C i /A� 9KL 1975; I/ /f
/%N E SP14A p2g Covcr?ETE T-6AA-� /25-49 GRcc oa.s, T -KF tePTic
rnivk ANO L//`T fTHT/Ou /w VuEfrOv AR£ le,vsrRKf-TO /,y SOIL! ru.}T
P61C(-. AT FrpRVY. 30S SOfr,10tp 4.rt.LM A fA.RLT l.LTytO/C, AAi
tEgl.AbE S/lOktO /4F_C6/✓E TRE/4TArE.vT h.TH/N N F6w t�ET of
Ti�E T/}�.0 eR LirT tT'Hr/oA,
NO Syf}LLOw l•+f}TER Tr!/)L�S /A/ THIS /MHEA/ArE f}/4EA TC TH/
vFFiLE1 k,vv,,,.L�nvE,
Z
Pcp?f � )U
z
w F_ L L. PA -TA- —
TkF r v wEus /N QwEsnpv Po Nor 1//9✓f t+•FLL Lobs AVi4itNgU
ji# •CVER, n -w SuR/jow.✓p/A./� `AGIoIriNb, LOrf 11MVE tvF_LL
rkrtF 4 ELL. Lobs aRF AEL4r1✓6ty C#Als/fT6.vT ,A, r�ss�R�.acE
foil. srn/¢Tk1'S. A/ItAs5R01`f LAYCIfs 4F kCtgr' pA,p �fi}voySi.r•
F_KtsT /u TKF irRA-rl4 9Ej w6EA, rki F GROAe"O tstRFACE 19AI
rKF- L -4 -TER B6i91?In.G O'-¢alF,cR 9T /A
&PP5,4jes TO DE A coNs:ivE/J �q.rIFEiQ.
-= KE :4 0Pf of ruE 6otow l�L FRO•. 77-e& 4, -r --r7—
lfl-NNt9Ro Ta 77eEG.EsT. 2tcEtTio„/ f/?on 77ii
F, xi STIMb wEct LObl FoLto&..f rKE G�uAcn.Otan�,��E Start ,•,
SLo%tG pv✓..srr9R0 7Tir-s9/f0 t(�E M•tST. TItF_ E,vcXo�aC,viw�G
IaEtOr, L r /},.-P L ( PT sT, 0, 771 o,,., pat. ,v6of t0/&T f/tvyc 7 s
ra. o wE(-t_ r IN I rlC'A"
WF -1-1 TH4r No B?cTFRt.q E«�i6rr /v n+£
� �¢-Np /'NE Nlranrfs ti`RE ��„y/r.
r'
S or .4. o E. C. S. P
O/L SoaarloN
/t
(toa)3 t(to )600
`
41)3 A
_ /}TER % f) 6,4 Rd4 !
/v a /,v Fo.
�hgjj Zv&TRL SEPARAr/oN
( ONCLkS/dN
61?#N7- wo,AFP
f��zs=
tav
8,14, O 7a74L
POi� s
7.o
.,z
C
2.8
/7.6
31/3
T _ SFlUFZKLFIND F' _ E
6751 W. DIMOND BLVD.
ANCHORAGE, ALASKA 99502-3904
(907) 248-5095
Municipality of Anchorage
Division of Environmental Health
Department of Health and Social Services
820 L Street
Anchorage, Alaska 99501
Subject: REQUEST FOR WAIVER OF SEPARATION
PRIVATE WELLS TO DRAIN FIELD
LOT 1 BLOCK 1 TURNAGAIN PARK, 82
Gentlemen;
2q 4J�
October 14, 1993
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
DISTANCES FOR
OCT 14 1993
RECEIVED
We are submitting a request for waivers from the separation
distances stated in Title 18, Alaska Administrative Code, Chapter
80.020.
During a HAA inspection it was found that the required separation
distance between the well serving Lot 9B, Block E Sunset Hills
Wowk-, and the septic tank located on lot 1 Block 1 Turnagain PArk
#2 was less than the required 100 feet. The direct measurement
between center of well casing and the pumpout for the tank was 98
feet. The tank, according to Municipal files, is a 1200 gal
Espinosa concrete tank. I do not have information showing where
the pumpout is located on the tank. The distance between the
tank pumpout and the well on lot 1 was measured to be 101 feet,
it is therefore possible that part of the tank is encroaching
into the 100 feet separation space.
The septic tank was installed in 1959 and the well on Lot 9B in
1969. No well log exist, but an inspection report from 1969
indicates that the well is 80 feet deep. We have not been able
to locate a well log for Lot 1 either, but we have collected logs
from surrounding properties. Copies of these are enclosed.
The ground slope away from these two wells, surface contamination
from the septic tank can not reach any of the wells. All the
well logs show dense materials which will effectively prevent
percolation into the wells.
I request three waivers to 95 feet for the septic tank on Lot 1
to well on lot I and to well on Lot 9B. To prevent any future
problems I request a waiver for the lift station also. The meas-
ured distance between the well and the manhole riser is 100.5
feet. Here again, part of the tank may be closer than 100 feet.
I, Spurkl and E.
LOrb LOT 7
�
BL. K E SU, SET RILLS WEST
�e
s '
rc
\G �
N �V�„Pu„•, tQ� 3
cic
[.
..
�� �� �. CE -2225 .' �- ✓
25 0 25 50 75 100 125 150 �(;o^ '••..,,,,..•'. �.:
SCALD 1' = 50 FT.
TUBBEN SPURKLAND P.E. LOT I BLOCK 1 TURNAGAIN PARK #2 I I SEPTIC SYSTEM DESIGN
203 W 15TH. AVENUE 14401 OCD SEVARB HIGHVAY DATE, OCT. 14, 1993
ANCH. AK. 99501 KGTH TATON SHEET, 1/1 GRID- 3033
KEN'S COMPANY
WATER WELL DRILLING
PUMP SALES & SERVICE
3163 LINDEN DRIVE
(907) 243-7493 ANCHORAGE, ALASKA 99502
KEN JOHNSON
may 31, 197"-'
Jim rlthinrton
Lot 2 blk 1 •Turna,ain t:-rk Cio. 2
Anchora e, Alaska ;ALL LOG
0 ft. to 2
ft.
1 ft. boulder ... hand du,..
6
ft.
cobbles .--ay silt with course _ravel
2 ft. to
6 ft. to 7
ft.
Boulder.
and moray silt v;itll course ;ravel
7 ft. to 20
ft.
Cobbles •�•
( 4" to 6,, ) with ,ray silt
20 ft. to
30 ft.
course -ravel
co -''acted., very tight..drill and drive
to
34 r
•:,velwith ^raysilt..drills o^en ( 4' )
b.e1. ,- -
30 ft.
.t.
34 ft. to
53 ft,
cement _ravel ( very tiE;ht )
53 ft. t0
65 ft .
"ravel and ;ray silt ( ti -ht )
65 ft. to
35 ft
sarie, but looser ( can drive
65 ft. to
95 f:.-
but tighter
ft.
I!eci. sand..so:ae -ravel..weers ,rater, no head.
95 ft. to
105
105 ft to
107 ft- dark bro•rrn silt wi—ch sand
107 ft. to 117-6 ^ravel and :ray silt
J.
'and and;r..vel 12 ft. 'r.•:ad bails down
117-6 to
113
cle:,n
with plow recovery
116 ft. to 124'
cer..crnt -ravel ( very tight )
124 ft to 139 ft•
bro:n silt with some s_ravcl
:
ti: )
,o 164
r vel ( very -ht
-t. c.::&nt , vrat::r bearing.
sand and ;r gel..
16:'t.
4 ft,
to 165
ft. clean course
stAtic...65 ft
rest bailed 2 hrs. at 10 GPM
)
r
20 ft. ( good rete•, c:ry
Bottom stable
.;;:ter cicaring ra?idly..
:It 155 ft.
"MMUTATIRIT ImaillipcD Womulo
Bos. 13609 STAR ROUTE A ALV CHORAtmo ALASKA 00502
344-7'714
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 125 Tcet.
DRILLED AT THE RATE OF $20.00 PER FOOT.
PROPERTY OWNER a• Lance iockatd. 345-2454 345-9661
LOCATION OF WELL SITE Lt. 4 i;U. 1 Sub. TuAnagaia PaAL /!2
DRILLER BeArt .e C%au4 of, Ranpatt Dei Ll laq Vo4L4.
WELL LOG:
0-----21' lla&d ctwl wd th 15°.' gravet and anaU bou tdcu.
21=---46' Ila-tdpan. /I eeln.en.ted q tawet.
46----79' g vet. Seuc ML 4ma.LL b0utdcA4. 207.' ctarl.
79---108' SVbj aarubl, etmr . lTet ma teAta.L.
108--124' �4zvc t. Seue�tat bou.tdcti and 30;0' c taV.
124--125' Watelt &CZtiAq gAawe.t 4how.in.g a y te.ld of 10rtPf1 Ldith 30 sect of wa,tet
.stand in.g. o{.. bot toa. 1/2 llon4e Sutrae44 tote PUmp .oh.ou td Ge iiwta Lted 4 feet off.
ba.t toa.
Gled.L pa td to Pi,U: $2500.00
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF ---------------
THANK YOU VERY MUCH.
BERM AUS OF RAMPART DRILLING WORKS
DATA' �211t i L 2ndp 1981 l
SERVICE CHARGEOF 1%a% PER MONTH WILL BE ASSESSED ON PAST DUEACCOUNTS.
Set test puma
Pumn6d one hour at 8 GPL""
No drawdown
Clean and clear in 15 b:in.
Set pump at 115'
KEN'S COMPANY
WATER WELL DRILLING
PUMP SALES & SERVICE
3163 LINDEN DRIVE
(907) 243-7893
ANCHORAGE, ALASKA 99502
KEN JOHNSON
August 14, 1973
,7ArER 4ELL LOG_
Oliver Tovsen
Sunset Hills
Sub.
0' to 21'
Gravel and brown silt
L1' to 33'
Glacial till, _^,r::wel and dray silt
�. to 43'
same, but more ;.,ravel ( firm )
iJ
43' to 47'
cement ;ravel ( very ti^ht )
'•7' to 50'
ioul0ers ( basalt )
50' to 56'
cement gavel with cobbled
lame boulder ( basalt ) t- of- hole ing bit
56' to 58'
-;ut on buttcn bit & j:.r::... drill :ole thru
boulder & shoot
58' to 59'
ght )
cement ^,ravel ( tig
89' to 95'
Glacial till ( tiht, but drills open )
95' to 103'
Sandy silt with gravel mixed
103' to 113
Sandy silt with dark brown peat
113' to 116'
clean sand and gavel-; med. 10' water...
head
cont. drilling to establish more
116' to
Clean toed. sand and .-ravel, water bearing
17' of water
test bailed one hour at 10 GP.«:
no drawdown and.6learin
Set test puma
Pumn6d one hour at 8 GPL""
No drawdown
Clean and clear in 15 b:in.
Set pump at 115'
s:
T ir.
ATr
lit
E?c>e1 '1:34i:J, �Tnx II:�><�Ta•: _� P.:a�aaoarA�>F:, A%ABIiA"BflSOE �`
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 120 feel „yn
DRILLED AT THE RATE OF—$L8000 -_- PER FOOT.
PROPERTY OWNER—- Mrt doh+ *rquP_fdt .. „3006 'd 34th avet 27b=NQ6
LOCATION OF WELL SITE_. Lt.ojA BlY. C_ -Sub:._ .S�!sf`C? Itlq-� _ -_—_--
DRILLER __.Bernie Claus of kspar: Dri111n5_Work,..-----
WELL LOG*
0----42s Hardpan with 40p gravel and wall boulders.
42"-671 Gravel and cobbles*
67....1020 Sam clay with 2073 gravel.
102+.108' Wet so -A. --...__. ._-.. _---•__,._ ._.._. - . _ -
108-119' Silty gravel.--- ._.__ .-...__ .._...._ _—.._.—._..-- •--._
119-121' Water bearing gravel producing 10 GFT: -rith a 25 foot head. —
Well Seals $$22.50 -- -.— -•.—
Cost of drilling: $2160.00
.1rr_1
COST INCLUDES A..L LABOR AND ALATr• l,PL. POi! COMF!_ETION OF SAID GRILLING.
WRITE CHECK PAY/,L-'.LrTO RAmrA'.T DRILL INC wrmieS $2182.50 FOR THE SUM OF - _. --_
THl. 4K YOU VcRY `".UCH.
,4i'
.iF_12!JIE CLAVI, (:F* 2AMPAftTLING WORKS .
JAfI_ .YCslu. 1>a/(i ..���3)
6EnVICE CHAR'.A"L! I!i9G >": i2 Ml:•Nf1; VJI:.I_ Lit 0.f i;17''.CU 6h PAST DV17jr.CCOUNTS.
Municipality of Anchorage
C Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onske
(907) 343-7904
Parcel I.D.
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
018-241.0
1. GENERAL INFORMATION
COSA # 0(oD��
Expiration Date: /d — a. 6 — fp
Complete legal description Lot 1, Block 1, Tumagain Park Subdivision No. 2
Location (site address) 14401 Old Seward Highway Anchorage, AK 99515
Current Property owner(s) John and Sharon Andrews Day phone 227-3102
Mailing address 14401 Old Seward Highway Anchorage, AK 99515
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four (4)
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
— ---Community Class - .- - -- Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
❑
Individual On-site
❑
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 sample results. (Certificates may be reissued for a period of up to one year with valid water
samples. Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that 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 files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Finn Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
6. DSD SIGNATURE
✓ Approved for bedrooms.
Disapproved.
Phone 522-7773
Date 7242006
Conditional approval for bedrooms, with the following stipulations:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
Original Certificate Date:
rsa.,,M)
Municipality of Anchorage
• Development Services Department
Building Safety Division
On Ske Water & Wastewater Program
4700 Bregaw Street
P.O. Bar 19665D
Anchorage, AK 99519650
www.muni.org/onske
(907) 3437904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 1, Blade 1, Tumegaln Park Subdivision No. 2 Parcel ID: 018-241-30
A. WELL DATA
Wen type Private ff A, B, or C provide PWSID S _ Well Log (YIN)
Date completed 1975 Sanitary seal (YRS Y
Tote) depth 298 fL Cased to >40' ft.
FROM WELL LOG
Date of test
Static water level rt.
Well production 9.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate 1.22 mg/L
Arsenic: PUD mgR Date of sample: 8/28/2008
B. SEPTICIHOLOING TANK DATA
2
Wires property protected (YM) Y
Casing height (above ground) >24 in.
AT INSPECTION
7/1712008
92 R
4.9 9 -
P.m -
Other bacteria 0 colonies1100 mL
Collected by: J. Anderson
Tank TypeJMaterial SeatWCa+aets Date installed 7/12/1975
Tank size 1.2W gal. Number of Compartments? Cleanout (YIN) Y
Foundation cleanout (YM) Y Depression over tank (YM) N High water alarm (YIN) Y
Date of pumping 7/25/2008 Pamper Isaac's
_.-.C.-ASSORPDONFJELDDATA
Date installed 7/12/2008 Sal rating (g.p.d.fie or tt=Podnn) .8 GPD/SF Sym type Deep Trendy
Length 42 R Width 3 A. Gravel below pipe 9 ft
Total depth se' /Z M Effabsorption area 758 fe Monitoring tube Y Depression over field N
Date of adequacy test New Const Results (Pass/Fan) For _ bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Arty rejuvenation treatmant (past 12 mo.) (YIN & type) If yes, give date
O. LIFT STATION
Date installed 5/7/1955 Size in gallons Soo Manhole/Aeeess (YIN) Y
'Pump on' level at 29 in. 'Pump aft' level at 19 in. High water alarm level at 33 in.
Datum Top of Tank Cycles tested 5+ Meats alarm 6 dnwit npuie7 Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankfiift station an lot -mw i5
Absorption field on lot >1W
Public sewer main N/A
Sewer /septic service line >26
Animal containment areas None
On adjacent lots
>1W
Public sewer manhole/deanout N/A
Holding tank WA
Manure/animal excrete storage areas None
SEPARATION DISTANCES FROM SEP71CIHOLDING TANK ON LOT TO:
Building foundation >9 Property Une>5— Absorption field >10'
Water main >10 Waterserviceline >Ur Surface water >1W
Waft an adjacent lots _ ant' 47
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 1. Building foundation >10' Water main >VY
Water Service line >10' Surface water >_ 1W Ddvewsy, pukYpNehide storage >25
Curtain drain Now Noted Wells on adjacent lots
F. COMMENTS: ' See Lot lire Walver.
G. ENGINEER'S CERTIFICATION
I ce that I have determined 49th rt
rdTy through tient 6rspecttons and
_ _... __r ,*w.d_Munk*W records .Wat_the .above -systems -am in
oadbrmance wRh MOA COSA guidelines in effect on this date.
a -an
Engineer's Printed Name Michael E. Anderson. P.E.
Date U24=0541wi p�
COSA Fee E Waiver Fee S
Date of Payment I A 4 Date of Payment
Receipt Number 83 59a Receipt Number
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Municipality Of Anchorage.
• Department of Health and Human'Services
Division of Environmental Services', • ` `
On-Site Services Section 825 V Street Room 502
P.O. Box 196650 Anchorage; AK 99519-6650 --
www wwwci.ari6horage.ak.us -
(907) 343-4744::.,'_
CERTIFICATE OF HEALTH AUTHggiTY APPROVAL ;
FOR hSINGLE (FAMILY DWELLING' ;,
Parcel I.D.O(. 9> - Z' { ( --3-6 ? HAAa 1-1 A o to 19 7
Expiration Date: g- g -01
1. GENERAL INFORMATION
Complete legal description 1 o-1�- l I'LL wq ai» Par 1U -#- Z
Location (site address or directions) %��/ d Lp ✓� . E �w cn
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Day phone�-
Day phone
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of
Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent
professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are
required for the transfer of title (except between spouses) on properties served by a single family on-site
wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners.
Certificates of Health Authority 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 sample results less than 30 days old. 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.
72025 (Rev. OVDO)'
I
Individual On-site
❑
Individual Holding Tank
eq
❑
❑
Community On-site
❑
❑
Public Sewer
❑
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of
Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent
professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are
required for the transfer of title (except between spouses) on properties served by a single family on-site
wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners.
Certificates of Health Authority 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 sample results less than 30 days old. 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.
72025 (Rev. OVDO)'
I
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
based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval
adequate for the number of bedrooms and type of structure indicated herein. I further
application show that the on-site water supply and/or wastewater disposal system is safe, functional and
verify ed
information obtained from the Municipality of Anchorage files and from my investigation a
nd t that at baba sed the on the
site water supply and/or wastewater disposal system is in compliance with all applicable
codes, ordinances, and regulations in effect at the time of installation. Municipal and State
Name of
Address 41 i
Engineer's Printed
6. DHHS SIGNATURE
_JC Approved for ---7— bedrooms.
Disapproved.
Conditional approval for
Additional Comments
r • - ^ _ I Phone33.,2
Date
F��•0F Aid i1,
.lp
CE 4
�'�� PRCFfSSI"Y•�"�=�
bedrooms, with the following stipulations.,`'
Attachments:
HAA Checklist l/ Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
—9PJ TE .
WATER AND
:-WASTEtf M -R -
PROGRAM
By:
OD/ —�--- Original Certificate Date: r,-- R - n�
Expiration Date:_ 9 - P, - 0 / Reissue Date:
75025 (Rev. OvDoy
Municipality of Anchorage
' Department of Health and Human Services
Division of Environmental Services
On -Site Services Section 825 "L' Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-4744
HEALTH AUTHORITY APPROVAL CHECKLIST
ca
Legal Description: CAA-i-rJrr,gs of�n Polk OL Z Parcel I.D.:
A. WELL DATA
Well type JLIvo . If A, B, or C provide PWSID # Well Log C -1I
Date completed A 7S Sanitary seal Y Wires properly protected Y
Total depth -y 43 it Cased to J 4 `3 it Casing height (above ground) '3r0 in.
FROM WELL LOG AT INSPECTION
Date of test /5 0 /
Static water level ft 4r, It
Well production g.p.m S g.p.m
WATER SAMPLE RESULTS: *r rakfr.&".L ity .9a.c `P_ �Yk
Coliform �colonies/100 ml Nitrate (_ mg/I Other bacteria-4—colonies/100 ml
Date of sample: / 9 0 ( Collected by: M9 �.
B. SEPTIC86i%6WG TANK DATA a
Tank Type/Material Gvn erck_,
Date installed Tank size 12S -O gal Number of Compartments
Cleanouts _Foundation cleanout Depression over tank /4 High water alarm
.nwet
Date of pumping 3�' 0 / PA r4 A Pumper h(o T+4% ( an c1.
C. ABSORPTION FIELD DATA�t
Date installed Soil rating (g.p.d./ft2 or ft2(gD '1100 IF System type arC-4.
Length UO ft Width u ft Gravel below pipe
Total depth 5 r ft Effective absorption area /ayttO ft2 Monitoring tube-X—Depression over field
Date of adequacy test A." / Results (Pass/Fail) _ P For Y bedrooms
Fluid depth in absorption field before test ZY2• in Water added Goo's gal. New depths in.
Elapsed Time: -I&& min Final fluid depth 2YZ in Absorption rate >_ (vc;c; 'g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) ry . If yes, give date
72-026(Rov. 01/W
D. UFT STATION
Date installed 467-91,05- Size in gallons 5av Manhole/Access
APump on" level at 2_ in APumpofr level at Sl in Akigh water alarm level at �3 in '
Datum i «,., Cycles tested S r4 Meets alarm & circuit requirements_
E. SEPARATION DISTANCES A� M eesu.ed-t►rr.+ �+(�+r..+ o4- Tom /tom,
SEPARATION DISTANCES FROM WELL ON LOT TO: � ��:r 11/l6( 4 3
Septic tanWliff station on lot lov On adjacent lots 6� Q
Absorption field on lot /OD 1-4- On adjacent lots 10C21 +
Public sewer main 100'* Public sewer manhole/cleanout 160 t f
Sewer /septic service line ico 14- Holding tank l4 /,
SEPARATION DISTANCES FROM SEPTIC/ANK ON LOT TO:
Building foundation 20 1 F- Property line So (4- Absorption field -14-
Water main foo 1 -j- Water service line 1w 4 Surface water loo
Drainage loo ) 4 Wells on adjacent lots R r (.off cit 6 --0 4 a a-
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property,fine to 14- Building foundation "5 3` Water main 1,00(4 -
Water Service line foo (j. Surface water roc r + Driveway, parking/vehicle storage�-
Curtain drain t' 1A Wells on adjacent lots loo (4-
F. COMMENTS
G. ENGINEER'S CERTIFICATION
�p��•' " ' • QS�I+
•
h .y
I certify that I have determined through field inspections and
*:.fS
:..
review of Municipal records that the above systems are in
• • • • •
conformance with MOA HAA guidelines in effect on this date.
/ . ......
e
M
Engineer's Printed Name ,ei�ec( 41 ef.+64
q0• AVCHALL N. AMJRSCN
•��
,l CE 9' 9
.4tej
,•.• \'
fit '� 0/.•�'
Date
"..
4
HAA Fee $ 30 O Waiver Fee $
Date of Payment i7b1 O k Date Payment
of
Receipt Number 002,049 Receipt Number
72.026 (Rev. 01/00('
MRY-03-Ul a:::4W YM
95::2 F -:V-
ME t jviri����a �°fV L InC.
:7d.E Ref
:1:en:NAME
PreJeet \:Illl•!Y
Client 51111W IU
St.tlit
Ordered By
vWSD/
5:::�:Ic iLusaks
%;wa.4v
.t:1 I mow
Stsan 00.4% d_ A:xJXIeS
. nv Uhl S%w 112! 1 TLLra¢al t 1
.{.{01 OW SWJ Ll 131 Tum;eai.l I
DiiAtlr : waltl
C
M.t,ra Lealrtla.ft
N lrtlae� L0=
f'.UI
1-261 P.02/13 c -3S6
c ecat r0a
erlutcd Daten'Ime 0510, 20ct 16.59
rallmedDnle/Pilde OJ26i2f.•0! 16:41
Recehed D:IvrTima w 27/2001 10:15
Teebldcll�Ditactarr 5te;thell C. Edc
Release"
..n1u N.•fMA Inuac !^uta Dal: LI:1
0.500 mg L EPA 700
101rar 04.,2'101 5C1.
Hicrobiolo7i Laboratory 04"778 SKW
� U cof UN)^d. SERE 0222[i
7a" Crllfm.a
!/MUNICIPALITY OF ANCHORAGE
• .r DEPARTMENT OF HEALTH i£ HUMAN SERVICES AEM
Division of Environmental Services um
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcell.D.# Cl1R-x+11—�Yi-P7^f�
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions) I g4o
HAA# 1A(ca°1Sflln S
Property owner V, I a4e-,i Day phone
Mailing address
IA 2
Lending agency ty Day phone -
Maiiing address �cuy Sol -ray
Agent ' d Day phone 3 YS-3(oay
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: T
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
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.
72-0t5 (Rn. 1N1) Front MOA 1Y1
S. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I 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 �Vr p�Q t- Phone a X4-3 q l.�
Address 00 3 l,�/ Is -
Engineers
Engineer's signature =�A c ��r Date O 3
6. DHHS SIGNATURE
Y_ Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
By: Date-//- M_
CAUTION
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 Statn of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
nau rn... uv,r B. k raw m
Municipality of Anchorage AL
AML
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: I I I 1 Vrvto�g0.iN ?a.rh 11 Parcel I.D.
A. Well Data
Well type R If A, B, or C, attach ADEC letter. ADEC water system number N�A
Log present (YM) N Date completed 19 75 DrillerL)"
Total depth q3 Cased to Q 3 Casing height 311
Sanitary seal (YM)
FROM WELL LOG
Date of test
Static water level
Wires properly protected (YM)
Well flow 9•p•m•
Pump level
SEPARATION DISTANCES FROM WELL TO: ,
AT INSPECTION
MUNICIPALITY OF ANCHORAGE
10%1 g 3 ENVIRONMENTALSERVICES DIVISION
9 Z OCT 14 1993
5.5 g..m.
93 RECEIVED
Septic/holding tank on lot 10 1 ; On adjacent lots �� D
Absorption field on lot i I t O ; On adjacent lots �� D
Public sewer main NSP Public sewer manhole/cleanout NIA
Sewer service line NIA— Petroleum tank !q 10
All wa_a ,,.t.c w�..... , -4 , 4WP;res
WATER SAMPLE RESULTS:
Coliform Nitrate Other bacteria
Date of sample: 101/ 011 q .3 Collected by: S "r-+
B. SEPTIC/HOLDING TANK DATA
Date Installed 712/ 7J Tank size 102 5 17 Compartments `
Cleanouts (YM) _Foundation cleanout (YM) N Depression (YM) N
High water alarm (Y/N) NIA Alarm tested (Y/N) N/^
Date of pumping &18195 Pumper iz 4, 1'P---4,,_v-
SEPARATION
P---4 e.vr
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Wells) on lot '?W-0 On adjacent lots 98 L 4&> 9 $) Foundation 33
To property line > .2.D Absorption field 1 O Water maintservice line >Z0
Surface water/drainage f4 I o
72-M(393)1Fwt CONTINUED ON BACK PAGE
C. LIFT STATION
Date Installed 6A I8'S Manufacturer 4" CA
Size in gallons dt7 Manhole/Access (Y/N)
Vent (Y/N) 'Pump on' level at A I 'Pump oft' Level at 18
High water alarm level Cycles tested
If
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
2L
Well on lot > I Utz On adjacent lots 4 l V -0p S Surface water r-41 O
D. ABSORPTION FIELD DATA
Date Installed b l'7 I 8 S Soil rating (GPD/Ftz) 30.5 System type
i r
Length 4 O Width Li Gravel thickness l2 Total depth t4 � S
Z
Total absorption area 19&0 Cleanout present (Y/N) Depression over field (YM) (�
Date of adequacy test q61 I q 3 Results (pass/fail) for _ �i Bedrooms
Water level in absorption field before test .9 ) / After test If) %t
Peroxide treatment (past 12 months) (Y/N) N If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 1
Well on lot -2110 On adjacent lots i I o-tD Property line i 1 O
To building foundation ) 3:3> To existing or abandoned system on lot 0
On adjacent lots > 20 Cutbank 0 o K e Water main/service line > ,i O
Surface water N to Driveway, parking/vehicle storage area �> I t]
Curtain drain 1`\ I
E. ENGINEER'S CERTIFICATION
HAA Fee $
1500
Waiver Fee$ % rnQS•rn
Date of Payment /o -iv/- 93 Date of Payment In_ ILI •I 2.)
Receipt Number -2 S 3 -D S— /b,6i Receipt Number Az,,2,ge,
72.026 (397)• Back
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in elfe�toE theabate R this inspection.
,.........,,•,S
of .
c Lt
Signature
Engineer's Name /L spoof yCtaLA
Date t'�c l.'2. l 953
��'��°'••...... ; <
•:.
651'
HAA Fee $
1500
Waiver Fee$ % rnQS•rn
Date of Payment /o -iv/- 93 Date of Payment In_ ILI •I 2.)
Receipt Number -2 S 3 -D S— /b,6i Receipt Number Az,,2,ge,
72.026 (397)• Back
r
r^.
,4( MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
21144720 Q
Application Date
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 1 Block 1 Turnagain Park 0 2 Subdivision
Location (address or directions)
14401 Old Seward
(b) Applicant Name R� hrhr P? Tolley Telephone:Home 345-5734 Business
Applicant Address
(c) Applicant is (check one): Lending Institution ❑ ; Owner/buildedO ; Buyer ❑ ; Other ❑ (explain); -
(d) Lending Institution Alaska Pacific Mortg. Telephone 564-0384
Address Terry Dubel, 101 W Bensen
(e) Real Estate Company and Agent 1 nn Week
Address P=h WhItE 7NS3c k lJJh6 �(-_ 3201 C Street
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RES(lSENCE
Single -Family &j( My lti-Family ❑ Other
Number o1 Bedrooms'� r (r
3. WATER SUPPLY
Individual Well R( Community ❑ Public ❑
Note: It community well system• must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite n Public ❑ Community ❑ Holding Tank ❑
Note: If community well system• must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 4111,84)
r
e^.
S. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, l verity that my Investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my Investigation and Inspection, the on-site water supply and/or
wastewater disposal system is In compliance with all Municipal and State codes, ordinances, and regulations In effect on
the date of this inspection.
NameofFirm Tobben Spurktand P.E. Telephone --279-1916
Address 203 W 15th
Date
Engineer's Seal
This office has received written confirmation from the engineer ( Tobben Spurkland P.E. )
that the conditions of June 1, 1985 have been met. Therefore, this property meets
MOA requirements.
6. DHEP APPROVAL
Approved for Brooms by41PLZ / 4
Date
Approved Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
MUNICIPALITY OF ANCHORAGE
• ' DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date �/��5
(a) Legal Description (include lot, block, subdivision section, township, range)
&VT / aIcfr 7*012NAFtA&N PAr21-4 Ajz SF,T/2N,R3W
Location (address or directions)
/yyoI O/cz S«a%�
(b) Applicants Name Qa 4.eL / o /li U Telephone - Home Business
Applicants Address
(c) Applicant is (check one) Lending Institution ; Owner/badder ;
Buyer E:j ; Other [-::I (explain);
(d) Lending Institution Ale ck..- P..c;t4e JW- �l ./ Telephone >by-d�jay
Address /o/
v
(e) Real Estate Co. 3 Agent
Address A
Telephone S (o 2 - r c el
(f) Hail the HAA to the following address:
"01,
2. Type of Residence
Single -Family W Multi -Family
Number of Bedrooms r
3. Water Supply
Individual Well � Community El
Other (describe)
Public M
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite W Public M Community F-2 Holding Tank M
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
(Page 1 of 21
n MUNICIPALITY OF ANCHORAGE
CEPT. OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MQ44WIRONMENTAL PROTECTION
HEALTH AU'MRITY APPROVAL (HAA) MAR 2 61985
CHECKLIST - FEBRUARY 1984����
Legal Description.
Wk I
A. WELL DATA
1 i40 0Cn7[9
Well Classification ?':V If A, B, or C, D.E.C. Approved(Y/N) '11A,
Well Log Present (Y/N) N Date Completed ffiYield y*Dsy t
Total Depth Cased to 1/0 f Depth of6bitiN N o N L
Static Water Level Pump Set At $ol4mwi
Casing Height Above Ground Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) n/
Separation Distances from Well:
To Septic/Holdirg Tank on Lot (o0 On. Adjoining Lots /oo
To Nearest Edge of Absorption Field on Lot /eof ; On Adjoining Lots lou +
To Nearest Public Sewer Lira N ON To Nearest Public Sewer
Clearcut/Manhole N 0 H L To Nearest Sewer Service Line on Lot NONE
Water Sample Collected By j: S Date ,2 •%9g
Water Sample Test Results
Caments
B. SEPTICS TANK DATA
Date Installed -/75 size No. of Cc partments Of4
Standpipes (Y/N) V Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) (J
Depression over Tank (YIN) Date Last Pumped J40L4,&4 /9&5
Pulrping/Mainteraroe Contract on File (Y ) ; for rVA
Holding Tank High -Water Alarm (Y/N) bYA Temporary Holding Tank Permit (Y/N) K
Separation. Distances fran Septic/Holding Tank:
To Water -Supply Well [O -O To Building Foundation a 5
To Property Line 50+ To Disposal Field
To Water Main/Service Lire /U f To Stream, Pord, Lake, cr Major Drainage
Course
Comments
Receipt # 3l 3
Date Paid:- k
Amount:
[Page 1 of 21
2-15-84
1
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata J c2rd D Type of System Design 74.A44e�4
Date Installed
��% Length of Field —�6
Width of Field -z- Depth of Field /ill
Gravel Bed Thickness 91
Square Feet of Absorption Area /00 9, Standpipes Present (Y/N)
Depression. over Field (YIN) N Date of Last Ad:quacy Test 11x $�
Results of Last Adequacy lhst 004 '?else, 8 ,
Separation Distance from Absorption Field:
To Water -Supply Well I'a O To Property Line 50 f
To Building Foundation Lf j To Existing or Abandoned System on
Lot N (.3 t4 C' ; On Adjoining Lots /60
To Water Main/Service Line 50 To Cutbank(if present) 1\1 O N C
To Stream/Pond/Lake/cMajor Drainage Course [�(0 ►� 1=
To Driveway, Parking Area, or Vehicle Storage Area 1 5
Ccmments
D. LIFT STATION N O yl 2
Date Installed Dinensiors
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Ccdes(Y/N)
Coments
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (YIN)
Pumping Cycles during Adequacy Test. Meets MSA
** Chedc Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect
on the date of this inspecticn.
0=• �'� �s?1
Signed Date ! �� r 1Q:•'� /tom :;� 1,
Company MOA No. S- 'Si -O 1 * ac*
OF
..
KB1/d5/s
[Page 2 of 21
2225-E:
T'. YE 25, 011 :
2-15-Q4
. ly:
5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I a:'
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein. I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm
Address
(ENGINEER SEAL)
6. DHEP Approval
Approved for u 'r • bedrooms
Approved Disapproved
of Condiconal Apprc
r, n .1 ALl ckrVP
By /1 L.,
Telephone P-%/ -&91t,
t' 1 .
* .`4, M
� •.nee • ./��!
a� o� 2225-E
JUNE 25, 1971
El I I t.,Y /,\ v care•_, Tr:
Conditional 4
I1C !,AL ^ tT.c. (1!c` -a i<' r l
1. ��C ✓ �: o -P 1 nJ i r r r4
+-, �1//Jnr_/�' w.►++"i �r/<.rr[1-�C-a-t-l. /%r.�:_ ♦).rI�C.i':
CAUTION v
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 21 7-19-84
3 W. 15th AVE "C" SUITE 203
NO TING ENGINEER ZY J-j nuu g Paige �20 ANCHORAGE,
2A99398
MUNICIPALITY OF ANCHORAGE MARCH 22,1985
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND SOCIAL SERVICES
SUBJECT: LOT 1, BLOCK 1, TURNAGAIN PARK NO.2
RACHEL TOLLEY, 14401 OLD SEWARD HIGHWAY.
CONDITIONAL APPROVAL OF SEPTIC SYSTEM.
Gentlemen;
On behalf of my client, Mrs. R. Tolley , I request a conditional
approval of the septic system installed on her property at Lot 1,
Block 1, Turnagain Park No.2.
WhenI performed an Health Authority inspection of this property I
found that the required stand pipes to the drain field could not
be located. The As Builts from the Health Department indicate
that the stand pipes were installed, but the drawing may be in
error or the pipes may have been cut off and buried.
I also found that the water depth in the septic tank was 61
inches, substantially deeper than the 40 inches that is normal in
a tank of this type. When water was discharged from the
residence it became obvious that the tank was surcharged and the
line to the house submerged.
This could have been caused by a blockage in the pipe between
the tank and the drain field, but an attempt to clean the line
did not indicate that a blockage existed.
At the present time the system perform adequate for the residents
of the dwelling. There are no signs of over flow or backup into
the house. However the system do not meet the operational
requirement of the Municipality and must be up -graded in order to
obtain a Health Authority Approval. This up -grade can not be
performed at this time due to the depth of frost. The owner of
the house intends to establish a escrow account to pay for the
work after break up.
dua rnurwAIJ
SMART EXCAVATIM
615 Lynnwood Drive
Anchorage, Alaska 99502
563-7833
proposal submitted to: Phone Type of Job Date
Rachel Tolley 345-5734 Sewer Upgrade 3-25-85
':Invoice to: Job Location
14401 Old Seward Highway
Meiling Address Legal Description
Lot 1 Blk i Turnagin Park No 1
City, State, Zip Legal Owner of Property
Install 500 gal tank with pump and alarm
Bed- 30 x 60 with 60 yards of rock. Insulate, backfill same.
This bid does not include topsoil or seeding.
Job to be started after break-up.
Payment in full upon completion.
I propose to furnish material and labor complete$,
specifications, for the sum of
with the above
Acceptance of proposal: The above prices, specifications and conditions
are satisfactory and are hereby accepted. You
are authorized to do the work as specified.
Signature Date
wij RKLAAD9 pvCo
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99601
TELEPHONE: (907) 279-3916
MUNICIPALITY OF ANCHORAGE JUNE 7,1985
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Re: Conditional Health Authority Approval, Lot 1, Block 1,
Turnagain Park #2
Madame;
On March 22, 1985 a conditional approval was given for subject
lot. The conditions for the approval have been met. The existing
absoption system has been replaced with a ded per the attached
as -built report.
Please furnish this office with an unconditioned approval.
Yours
Tob n Spurkland E.
(13' 13A3
�i A Nnr,
Nouano11d 1V1Nre#4OWM
I HiWW d0 'law
3VrdoKWW i0 Auwdowm
k
t. -
T _
cu4arL dc's
rte; bc-of
s�
S. LEGAL DESCRIPTION
MUNICIPALITY OF ANCHORAGE &�� -� DEPT. yIROK:,'CN L ; t.
: �.::=CTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONT:�L
•
On L Street • Andwrepe, Alaska E9501 APR 5 1979
S. TYPE OF RESIDENCE
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 284.4720 RECEIVED
REQUEST
FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will net be prPlease allow ten (10) days for processing.
1. PRO► Ty OWNPR
- I_
L . /lP7G/1,
PHONE
6i 89a3
MAILING ADORE
*ATTACH WELL LOG. A well log is required for all wells drilled
PROPERTY RESIDENT Iff different
from ab )
N
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
2. BUYER )PHONE
"If individual/on-site, give installation date
MAI LI NG A DDRESS
❑ PUBLIC UTILITY
3. L NI N INSTIT
�Q��(�j �
PH N2E _ /
J'•��7(/O
(l1T�1/
MAI ORE5�9j /t
s
//o2D, ///Vfi • /'/` 9/J/D ?///V.r /
4. REALTOR/AGENTNN
PHONE V
MAILING ADDRESS
S. LEGAL DESCRIPTION
_
XAWWI
STRMOT f��/ �✓ j� /
zx— I X.;J AD S" W
/�oZ
?�
S. TYPE OF RESIDENCE
N B
❑ One ❑ Four ❑ Other
SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATERS PPLY
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.)
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE"
"If 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 REOUEST BEFORE PROCESSING CAN BE INITIATED.
72-01017/78)
,Ci rl &JLDAPI 4(&h.t^�lJ- 3rd /n� l/LouGe r3~„ WiX Q� .
�Ik_P b-14- PC -%q LOL40)1xj.� ICrJ. / l
CIL bacl,
THIS SIDE FOR OFFICIAL USE ONLY
•
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE ..
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE • NUMBER OF BEDROOMS
❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE` ❑ OTHER
❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
- -
❑ PUBLIC UTILITY
. Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED '-
LOG RECEIVED - -
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
❑Septic Tank or 1:1 Holding Tank
Size: / If Tank is homemade
give dimensions:
TYPE OF TANK
MANUFACTURER,
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Simer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
6. COMMENTS
APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must a compan cer ificate)
❑ DISAPPRO ED
l.�
DATE
BV Title
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
I
5. LEGAL DESCRIPTION
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH B ENVIRONMENTAL PROTECTION
•
826 L Street . Anchorage, Alaska 991
N B
ENVIRONMENTAL ENGINEERING DIVISION
❑ One Four ❑ Other
Telephone 264.4720
REQUEST
FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incompleb requests will not be processed. Please allow ten (10) days for processing.
1. PR�TY NE R
PHONE
-89a3
MAILING D RE
C_ &kx I
�� '• j� G%/I�' �/. �� �b 'G�
dz\
PROPERTY RESIDENT Iff d fferent from obo )
NEl
H
❑ PUBLIC UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
2. BUYER A)m
INDIVIDUAL/ON-SITE**
PHONE
MAILING ADDRESS
If system is over two (2) years old an adequacy test is required
3. LEN N0 INSTITUTION
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
MAI DR S,4j
r
4. REALTOR/AOENTT�
MAILING ADDRESS
5. LEGAL DESCRIPTION
#,
5. TYPE OF RESIDENCE
N B
❑ One Four ❑ Other
SINGLE FAMILY
❑ ,Two Five
❑ MULTIPLE FAMILY
❑ Six
ER 8
7. WATPPLY
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.)
S. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
eeIIindividual/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,
72-010(3/7) Ae �0'/ )
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLEFAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMITNUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
INSTALLER
SOILS RATING
IJ Septic Tank or 1:1 Holding Tank
Size; If Tank is homemade
give dimensions:
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Barest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
❑ APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY Title
LEGAL DESCRIPTION
72-010 tr\ev. J//ai
Municipality
of
Anchorage
April 6, 1979
POUCh 0 X00 Ozc)L0 rn
ANCHORAGE, ALASKA 99502
(907) 2792511
GEORGE At SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
1825 "L" Sveet)
Frank E./Rachel L. Tolley
Star Route A Box 1465A
Anchorage, Alaska 99507
Subject: Lot 1 Block 1 Turnagain Park Subdivision #2
Approval for your individual sewer and water facilities
will not be granted until the following items have been
completed:
(1) A well log is submitted to this department.
(2) The outside faucet was not on at the time of the
inspection, therefore, we were unable to get
a water sample as scheduled. Please notifty us
when it will be turned on so that we can re -schedule
an appointment.
(3) The septic tank is pumped with a receipt submitted
to this office.
If there are any further questions, please contact this
office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: Alaska Mutual Savings Bank
Post Office Box 1120 99510
Attention: Debbie Johnson
SOME
WILLIAM A. EGAN, GOVERNOR
U0 V RUM / / "
'S1. - SOUTHCENTRAL REGIONAL OFFICE
111ONMENTAL CON MACKAY BLDG.
I*UBT. ol" ENA 338 DENALI STREET
February 27, 1973. ANCHORAGE 99SOI
Mr. Allen Diershaw
Box 1932
Anchorage, Alaska 99510
SUBJECt: Let Hc- 1, Blk. 1, Turnag,�In Park Subdi'vision, Additicr #2
Cear Mr. Diershaw:
This is to ccnfirri recent conversaticnS wit� 11-Irs. Diershaw
regarding the subject lot. It is our Interpretation that you had
acquired ownership on or before FebrLary 5, 1973 (January 24, 1973
being the date as a matter of fact). Based on the latest inTerpre-
tation of 'he Waste Water peg,--laflons frcri our central office in
Juneau which stated that if a person had acquired a lot on cr tefcre
February 5, 1973,and intends to build a personal residence on -his
lot that the 40,000 Sq. Ft. -,40,CCO Sq. Ft. require-�ent wou!d rot
apply in this case. This is in effect to say that Section 18 AAC-
72.030 is not applicable. However, the remaining porticn of tne
Regulation is still applicable. Likewise all Borough Regulations are
applicable exceP� where the regulation as proposed by thd new
State Waste Vlater Regulations Is more strigent.
if you have any . further questions regarding the interpretation
of this Regulation please do not hesitate to call on us or ask for
further assistance.
Yours truly,
a
Kyl2rC e rry
Regional Environmental Engineer
KJC/cO
cc: �AAB-DEQ
