HomeMy WebLinkAboutKENAI VIEW LT 1Kenai View
Lot 1
#018-332-04
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP241267
Work Type: SepticTank Upgrade
Tax Code Number: 01833204000
Site Legal Address: KENAI VIEW LT 1 G:3135
Site Mailing Address: 3401 TIESZEN AVE, Anchorage
Owner: LOUVIER JASON M
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
l)cpart]it It
9/19/2024
9/19/2025
11400
❑ Disposal Field ❑ Septic Tank Q Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: Date:
Issued By: Date: _)(� L
F
ON -SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 018-332-04
Property owner(s) Maria Louvier
Mailing address 3401 Tieszen Ave, Anchorage, AK 99516
Site address 3401 Tieszen Ave, Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Kenai View Lot 1
Legal description (Township, Range & Section)
Day phone 907-830-3235
Lot Size 11,400
Sq. Ft.
Number of Bedrooms 2
APPLICATION IS FOR:
APPLICATION IS AN: TYPE OF DWELLING:
(Z all that apply)
Absorption Field
F-1
Initial ❑ Single Family (SF) EX-1
(w/wo ADU)
Septic Tank
1:1
Upgrade RX Duplex (D) R
Holding Tank
RX
Renewal ❑ Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
El
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Separation to east -
property lines Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number: Receipt Number:
Permit No. 0 51r-' C Z Waiver No. 'Y C
Permit App_-'- :. :'-.,:c ;
September 18, 2024
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Kenai View Lot 1 - 3401 Tieszen Ave
Holding Tank Replacement
Dear On-Site Services Engineer:
The owner of the above lot has a holding tank that has reached its end of useful life, so we are
submitting this permit application for its replacement. We have excavated a test hole and attempted
a percolation test, but were unable to complete it due to the high groundwater. The soil appeared
to be tight silt and was classified by a lab as “Silty gravel w/ sand” (GM), with 37.2% classified
as silt/clay.
The attached site plan identifies the location of the home as well as the wells and septic location.
We’re replacing the existing tank with one sized for 2000 gallons. Based on our measurements in
the field, we are able to achieve 100’ separation from both the well on this lot and the lot to the
south. We have specified that the surveyor stake both well radii prior to installation. If it is
determined that the new tank cannot fit without encroaching on a well radius, work will stop and
we will pursue a well waiver.
In order for the tank to fit without encroaching on the wells it is necessary to place it within 5’ of
the east property line. The proposed location of the tank is far from the home or any structure on
that lot, and it will not adversely the neighboring property. For that reason, we are requesting a 1’
waiver to the east property line.
With this waiver, the new holding tank will be a minimum of 100’ from all wells and surface water.
Please refer to the attached plan for the design, as well as the attempted perk test log and lab
analysis. If this design is followed, there will be no adverse impacts to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241267, Curtis Townsend, 09/19/24
Municipality
i
Ue�rimrni '
P.O. Box 196650 0 4700 Elmore Road
Anchorage Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997
http://www.muni.org/Onsite
Develol2ment Services Division
On -Site Water and Wastewater Program
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV241040 COSA#:
P I D#: 018-332-04
Legal Description: KENAI VIEW LT 1
Engineer: Forcle engineering
Permit#: OSP241267
Your request for a waiver of the required -5 feet horizontal separation from the holding tank to
the property line has been approved. The approved separation distance is 1.0 feet.
This waiver approval applies to the existing holding tank only. Any future upgrade to the on -site
wastewater disposal system will require all separation distances be met or another approval from
this department.
Waiver is Gran ed: X Waiver is not Granted:
2 z L�_
Date: Approved by:
Name of Reviewer
**** VARIAN C EMAIVE R REVIEW ****
INVESTIGATE PIPE AND
REMOVE AS NEEDED
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=20'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
KENAI VIEW, LOT 1
FEET
0 20 40
TIESZEN AVENUE
2-BDRM HOME
SEPTIC PLAN
8/13/24
CAR PORT
3' R/W EASEMENT
10' UTILITY EASEMENT
CA
R
L
S
O
N
S
T
R
E
E
T
EXISTING 2000 GAL
HOLDING TANK
INSTALL NEW 2000
GAL HOLDING TANK
EXISTING WELL
NEIGHBORING WELL LOCATION
MEASURED BY HAND
SURVEYOR MUST STAKE BOTH
WELL RADII PRIOR TO
INSTALLATION
1.0
8.5
INVESTIGATE PIPE AND
REMOVE AS NEEDED
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241267, Curtis Townsend, 09/19/24
SEPTIC TANK BALLAST
(NO SCALE)
KENAI VIEW, LOT 1
BOUYANCY CALCULATIONS, FOR WATER @ OVER TANK:
(NEGLECTING WEIGHT OF TANK)
BOUYANCY FORCE ON EMPTY TANK:
2,000 GAL CAPACITY x 8.35 LB/GAL = 16,700 LBS
WEIGHT OF CONCRETE BALLASTS:
10'x2.0'x2.0' x 150 LB/FT3 x 2 = 12,000 LBS
WEIGHT OF SOIL ABOVE TANK:
3'x17'x5.3' x 125 LB/FT3 = 33,790 LBS
SAFETY FACTOR: 2.7
4 SETS OF EYE BOLTS
2" NYLON RATCHET STRAPS
TIGHTEN OVER TANK
10' L X 2.0' W x 2.0' D
CONCRETE BALLAST
2,000 GALLON STEEL TANK
3.0
(WITH INSULATION)
OTHER METHODS TO SECURE TANKS WILL BE PERMITTED AT THE
DISCRETION OF THE ENGINEER.
NOTE:
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
9/16/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241267, Curtis Townsend, 09/19/24
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
DEPTH
(feet)
TEST HOLE 1
DATE READING START TIME NET TIME
(minutes)
DEPTH to
WATER NET DROP
PERCOLATION RATE: (MIN/INCH)
(inches)(inches)
DATE OF MONITORING
WAS WATER ENCOUNTERED?
DEPTH TO WATER AFTER MONITORING
IF YES @ WHAT DEPTH?
----
--- ---
GM (SILTY GRAVEL W/ SAND)
Professional Engineers Stamp:
YES
KENAI VIEW LOT 1
5/13/2024 018-332-04
A.C.E.S.
--- ---
2' OB
---
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
PERC TEST LOCATION
TECHNICIAN: J.OPHEIM
---
3'
0.5'
5/20/2024
COMMENTS:
SITE PLAN
---
USCS SOIL CLASSIFICATION WAS DETERMINED BY LABORATORY ANALYSIS
5/21/24
PERC TEST ATTEMPTED, BUT UNABLE TO BE PERFORMED DUE TO HIGH GROUNDWATER
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241267, Curtis Townsend, 09/19/24
% GRAVEL 36.4 USCS GM
% SAND 26.4 USACOE FC N/A
% SILT/CLAY 37.2 % PASS. 0.02 mm N/A
% MOIST. CONTENT 30.4 % PASS. 0.002 mm N/A
N/A
N/A
N/A
SIEVE SIEVE TOTAL %SPECIFICATION
SIZE (mm) SIZE (U.S.) PASSING (% PASSING)
152.40 6"
76.20 3"
38.10 1.5"100
19.00 3/4"89
12.70 1/2"81
9.50 3/8"76
4.75 #4 64
2.00 #10 60
0.85 #20 56
0.43 #40 49
0.25 #60 45
0.15 #100 42
0.075 #200 37.2
ELAPSED DIAMETER
TIME (MIN) (mm)
0
1
2
5
8
15
30
60
250
1440
SOUNDNESS OF AGG.
(ASTM C88)
DEGRADATION
(ATM T-313)
LA ABRASION
(ASTM C131/C535)
SP. GRAV. COARSE AGG.
(ASTM C127)
CLASSIFICATION:
DATE RECEIVED:
TESTED BY:
REVIEWED BY:
UNIFORMITY COEFFICIENT (Cu)
COEFFICIENT OF GRADATION (Cc)
ASTM D1557 (uncorrected)
ASTM D4718 (corrected)
OPTIMUM MOIST. CONTENT. (corrected)
PROJECT CLIENT:
PROJECT NAME:
PROJECT NO.:
SAMPLE DESC.:
NGE-TFT ID #:UNKNOWN
UNKNOWN
Forge Engineering, Inc.
HYDROMETER RESULT
N/A
SIEVE ANALYSIS RESULT
2024 Materials Testing
6927-24
Kenai View - Lot 1
24-S-8
Silty gravel w/ sand
5/13/2024
Chance Van Zweeden
Chuck Hayter
TOTAL %
PASSING
11301 Olive Lane ꞏ Anchorage, Alaska 99515 ꞏ Phone: 907-344-5934 ꞏ Fax: 907-344-5993 ꞏ www.nge-tft.com
N/A
N/A
The testing services reported herein have been performed to recognized industry standards, unless otherwise noted. No other warranty is made. Should engineering
interpretation or opinion be required, NGE-TFT will provide upon written request.
N/A
115
120
125
130
135
140
145
0246810121416
DR
Y
D
E
N
S
I
T
Y
(
p
c
f
)
MOISTURE CONTENT (%)
MOISTURE-DENSITY RELATIONSHIP ASTM D1557
SILT or CLAYCOBBLES
GRAVEL
Coarse Fine
SAND
Coarse Medium Fine
0
10
20
30
40
50
60
70
80
90
100
0.0010.010.1110100
FI
N
E
R
B
Y
M
A
S
S
(
%
)
GRAIN SIZE (mm)
PARTICLE SIZE ANALYSIS ASTM D6913 / C136 / D422
#200#40#101.5 1/2363/4 #4 #20 #60 #1003/8
U.S. SIEVE OPENING IN INCHES U.S. SIEVE NUMBERS HYDROMETER
TIESZEN AVENUE
CA
R
L
S
O
N
S
T
R
E
E
T
KENAI
V
E
I
W
SUBD
Taylor L. Dosch
No. 189892
R
E
GISTEREDPROFESSIO N A L L A N D S URVEYOR
Municipality of Anchorage Page of a
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: S W 99 033 $ PID Number: 011? --33-a-04
Name:Wastewater
L.)a I /n
System: ❑ New Upgrade
/•a G G
Address: 3 dl T; es z e!I Ave Ani
S 6 ABSORPTION FIELD 77
Phone: 1 o
No. of Bedrooms:
l
D Deep Trench ❑Shallow Trench ❑Bed ❑ M d ❑Other
LEGAL DESCRIPTION
SOII Rating:
Total Depl original grade:
GPD/S Ft.
Lot:I Block: Subdivision: A Depth
to pipe bottom hom original grade:
gravel depth beneath pipe
C 'Ick1 /
14111.
1 Ft,
Township:Range:
Section:
Fill added above original gra
Gravel length:
I
Ft.
Ft.
WELL: ❑ New ❑ Upgrade
Gravel width:
Number of lines:
oatanal beteeeo fim:
Ft.
Ft.
Classification (Private. A.S.Ct: total D
Cased To:
Total olotion area:
Pi material: (�
X17/• Dao
�X I .1 /It, /'t ✓d1� Ft.
Ft.
SO. Ft.
I
Driller: Date Drilled:
Static Water Level:
Installer
Date installed: /�� 9�±
IG--a6-`i -1
Ft.
ween . CQ y4 f?'
Yield:
Pump Set at:
Cuing lkight Above Ground:
TANK
GPM
FI.
FI.
SEPARATION
DISTANCES
❑Septic PLHolding 0S.T.E.P.
To
Septic
Absorption
LIR
Foldbq
bIINPmile
Men Iadturer:
Capacity In gallons-.,,,
OQO
From
Tank
field
Stenon
Tank
Sewrlirros
/7e,6r, !�Q /7
Well
.�
�•
""
AA
1
1 $ v+
T
Materiel: �'
e
Number of Compartments: ^
p(
Watery
lour+
NA
LIFT STATION �
Lot
N
Size in gallons:
Manufacturer.
Line
—
R
Foundation
�.
�•
Sa�
h, /A
"Pump on' level at:
'P "level al:
High water alarm at:
Curtain
,-.
NIA
Pump Make el
Electrical Inspections performed by: i
Drain
HlA
Remarks: TANK- i r 1-45va-4444
BENCH MARK �
AA,A fiAS 3 of CovE/e
Location and Description:
rl^rTl — FLa47-AT/0N LJIE.G-HrS
Assumed Elevation:
r S7.94,L0-O.
1Ft
r .�� OF AL,a lit
•.
JAW (.g�J 1
••'I�+f ��
17034 Eagle River Loop Road2 Nli tg
Inspections performed byZaale, River. Alaska 9987.1. Dath 1stf�"a6—`i9
�iy1
2nd
rl•
y y i 20CERT C. COWAN
ftit�s'f E 1801
Department of Health and Human Services approval
..•r�=
Reviewed and approved by: Date: /D-2-7- 1
eo,711 Ir
72-013(Rev.99t( MOA 25
PERMIT NO. SW990378 PACE 2 OF 2
Municipalit of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Te'l�ephone 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LECAL LOT 1, KENAI VIEW P.I.D. NO. 018-332-04
D ORA AVE.
(NOT BUILT)
3' ROAD R.O.W. `
EASEMENT SURFACE WATER
10' UTILITY EASEMENT
F��-I I RADIUS i� I3
75' WELL co
LD co 3
O ISY YS'
THREE e s�
I I BEDROOM `C0
w HOUSE
8 0
A z
0
ALARM
IV) LOT 2
o I EC
C0 " 2000 GA LON
POI
ALARM HOLDING TANK c
SCALE: 1• -I30' p
E� E— E— E— E— E— E— G IN A t't
TIESZEN AVE.
p ROBERT C. COWAN
i� CE -8801 .•i% -
(1l1
I I
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-S@e Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Oct 07, 1999
Expiration Date: Oct 06, 2000
Permit Number: SW990378 Parcel ID: 018-332-04
Legal Description: KENAI VIEW LT 1
Design Engineer. 0003 S & S Engineering Site Address: 003401 TIESZEN ST
Owner Name: Eric Wallace Lot Size: 11400 SQ. FT.
Owner Address: 3401 TIESZEN AVE Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE, AK 99516-4042
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 DHHS at least 2 hours prior to each Inspection. Provide notification by calling g
(907) 343-4744 (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:
Date:
Date: 10— Z-?'?
IEALTHAUTHORITV
APPROVALS
SEWERS WATER
MAN DITENSIONS
SEWERS WATER
PSPEcRON
ENGINEERINGST DIES
AND REPORTS
WELL INSPECTION
S FLOW TEST
SITE PIANS
r:. r.1
SM TEST
PERCOLATION
TEST
STRIX.RIA ALI
MECHANICAL.
INSPECTIONS
CN SITE
WASTEWATER
DMPOSALSYSTEM
DESIGN
ROBERT C. COWAN, P.E.
CML ENGINEERS
(907)694-2979
FAX(907)694-1211
September 27, 1999 i
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519
REFERENCE: Lot 1, Kenai View SID
This letter is a request to issue a permit to install a holding tank serving the three
bedroom residence on the referenced property above. The existing 2000 gallon holding
tank is to be pumped, crushed and abandoned. Replacing it will be a 2000 gallon steel
holding tank.
We do not anticipate any adverse effects on neighboring wells, septic systems or
drainage patterns by the installation of the proposed septic system.
The proposed 2000 gallon holding tank is to be placed outside the 75' protective well
radius. Attached is a site plan which depicts the locations of the existing and proposed
tanks.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P. E.
RCC / jhm
Enclosure
17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577
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HEATHALfNORRY
APPR(NAS
SEWERSWATER
LONEXTENSKM
SEWERSWATER
NSPECTION
ENGINEERINGSTUDIES
ANDREPORTS
WELLNSPECTIGN
A FLOW TEST
SITEPWS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURALS
MECRANMN.
I SPECTICNS
ONSITE
WASTEWATER
DISPOSASTBTEM
DESIGN
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
ROBERT C. COWAN, P.E.
and
CML ENGINEERS
MATERIAL SPECIFICATIONS
FAX(694-29AX(907)694-
4-1211
Lot 1, - Kenai View S/D
September 27, 1999
1. The scope of this project includes the installation of a 2000 gallon holding tank to serve
the three bedroom residence located on the referenced property. The existing 2000 gallon
holding tank is to be pumped, crushed and abandoned.
2. Construction shall be in accordance with the approved site plan and design drawings,
Municipal permit with any special provisions or conditions, and all applicable State and
Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any necessary underground utility
locates. 1
4. Unless specifically agreed otherwise, the property owner shall be responsible for final
grading areas subsequently depressed from soil settling.
5. Contractors installing wastewater disposal systems must be certified by the Municipal
Health Department for system installations. Owners installing their own systems must
also receive prior approval from the Municipal Health Department.
,ING TANK INSTALLATION:
1. A holding tank is to be constructed by a certified wastewater holding tank manufacturer.
Construction shall include a 6" cleanout for pumping access, and water -tight manholes.
2. The holding tank shall be sufficiently bedded to prevent settling or shifting If the tank.
3. All standpipes on the holding tank shall extend a minimum of 12 inches) above final
grade.
4. Holding tanks installed with less than 4 ft. of cover shall be insulated.
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER ALASKA 99577
PAC-&-- 1
5. The holding tank shall be equipped with a high-water alarm which registers both visually and
audibly inside the dwelling. The alarm shall be positioned to allow at least 150 gallons of
storage per bedroom or a minimum of 300 gallons after the alarm has been activated.
6. Final grading over the holding tank shall be such that a positive slope exists away from
the holding tank.
MININIUM MATERIAL SPECIFICATIONS:
1. Any holding tank proposed for installation must be constructed by a Municipally approved
holding tank manufacturer.
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Type of Pine Perforated $41id
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Doi Chemical
Company Styrofoam HI or equal).
4. Tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal).
INSPECTIONS:
Typically there will be a minimum of two (2) inspections required during the installation of the
wastewater disposal system. These inspections will occur as follows:
1. The first inspection must be conducted after the tank has been set; lines, cleanouts,
standpipes and insulation are in place; and prior to backfilling.
2. The final inspection is to occur upon final grading of the property.
The inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If
necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not
coordinate, direct or control in any way the contractor's activities.
The owner shall contract with the contractor to perform the work outlined in these specifications
and plans and in accordance with the attached M.O.A. permit. There will be no !contractual
arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be
the owner's representative and will inspect the work as stated above to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor to
carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTORIOWNER
�UrlICIPALITY OF ANCHORAGE
ilea. , and Environmental Protec' Sn
Fourth Floor wcst
825 L Street
't Anchorage, Alaska 99501
264-4720
IN_SP_E�oC.TTIIO�N' REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING ADDRESS
V LEGAL L'ESCRIPTION_.
LOCAT 10:1---- --
1.1Sli\NCL L NUMBER OF
C I
I1 qr.1 l'JLLL }�� _- F.IANUT'ACTURER4'�— MATFRIAL �.__ COMPARTMENTS
I:1 �I:JE LENGTH -_._
TILL DRAM FILLO:
DI:,11.rICE I F101.I 1:LLL
t of Lincs
IDN ARLA
INSIDE vJ101H LIQUID DEPTH LIQUID CAPACI
a
TQTAL LENGTH
—FOUNDATION —_NEAREST LOT LINE— OF LINE
DISTANCE 6ETWEEN LINES TRENCH YNDTH_— IN. TOTAL EFFECTIVE
1G1. 01' TILL 101INISH C ADE
5LLPAGL PIT:
SQ. FT
LENGTH OF EACH LINE. —
ULPTII OF FILTER
—MAILRIAL-BENEATH TILE
IN. ABOVE TILE E _ - - IN.
DIAMETER —OR WIDTH _. LENGTH_, DEPTH '
bog Crib pings_ Crib Size: CIAM1ILILII---ULi'T11_DISTA"ICEFROMI WELL
TOTAL EFFECTIVE
Ut1:1DA110.'1_—_, NEARLST LOT LIME /',[,SORPTION AREA (WALL AREA) SQ. FT.
:))
Depth:
,)) Distance To: Lot Linc _
dg: Saler Line:
:,c tlatcrials: ��
of I edroo:ns:
DAILID'3�--F-7,IPRGVFT _ .
t
IIS
-I
i l i 1 1 FT, ! !
f�-i-
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1
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DAILID'3�--F-7,IPRGVFT _ .
t
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99501
TELEPHONE 274-4561
j mPrl1.
�v 3 ►-�7 /Yin
�l1g.
PERMIT NO.
79k2-,
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT MAILING ADDRESS ! PHO'p ;t�-�/
INSTALLATION LOCATION
LEGAL DESCRIPTION
G�/�✓L� ��.L/
INSTALLATION OF: SEPTIC TANK /S EEEEE-PAGE PIT DRAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED • ���
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
TO BE INSTALLED BY
I
NOTEI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
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.
TYPE
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT
TO RIVER, LAKE, STREAM.
o7pG'4
DRAIN FIELD
DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
DRAIN FIELD
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
G.A.A.B.
OR
LICENSED DESIGNER
EA SIZE TYPEI_
i
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE APPLICANT'S SIGNATURE
FORM NO. EO -0I6
ORDINANCE NO. 28.68 AND THAT THE ABOVE
October 24, 1977
Everett IIoneger
2820 C Street
Anchorage, Alaska 99503
Subject: Lot 1 Kenai View Subdivis&on
Dear Mr. Iionegar:
The circumstances of high -ground water tabal, no septic
tank and unknown location of the cesspool serving the
sub4ect property dictates the installation of a 2,000
gallon holding tank before this department could grant
an approval.
A permit is required prior to installation. A $20.00
fee is charged for this type of upgrade permit.
If there are any further questions, please contact this
office at 264-1720.
Sincerely,
Les V. Buchholz, R.S.
Sanitarian
L:I3/l j h
cc: Peoples Bank, and Trust
Mortgage Loan Section
Pouch 7-007 99510
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519519 `
-6650 \U<
www.muni.org/onsite
(907)343-7904
CERTIFICATE
FOR A
RUSH
OF ON-SITE SYSTEMS APPROVAL
SINGLE FAMILY DWELLING
Parcell.D. 0m-?)a2_•Dq_ COSH# Ug)t4gL1
1. GENERAL INFORMATION Expiration Date: _1z q_06
Complete legal description KENAI VIEW SUBDMSION: LOT 1,
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
3401 TIESZEN AVE. ' ANCHORAGE. AK 99516
GARY AND DIANE SNELL Day phone 345-5020
3401 TIESZEN AVE. • ANCHORAGE. AK 99516
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
❑
Individual Holding tank
N
Community On-site
❑
Public Sewer
❑
------The Municipality of Anchorage Development Services Department JDSD) 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 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 seat affixed hereto and as of the validation dale shown below, I verify that my
Vn✓estrgation, basedaon procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
fhows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
or the-AVmber of bedrooms and type of structure indicated herein. 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
Engineer's 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 8 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 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 Me
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 porson or party Is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for --3— bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fllowing stipulations:
�`�ttt��`t1tOF qNC viii
ON-SITE
• v,m*rrP AND
wASTEwAI trc
Attachments: `/
f OSA Checklist ArsenieAdvisory
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
By: QZ __ Original Certificate Date: 41-217-06
,n- I'M%
Municipality of Anchorage
• Development Services Department
Building Safety Division
On-Ske Water b Wastewater Program
4700 Bragaw Street
P.O. BOX 198850
Anchorage, AK 995198650
www.muni.orglonsite
(907) 343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: KENAI VIEW SUBDIVISION: LOT 1,. _Y; - 4" _ Parcel ID: 0 / 9 - 3 3 2 - 0 y
A WELL DATA
Well type SATE If A, B, or C provide PWSID# N/A Well Log (YM) NO
Date completed PRE 10/1977 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES
Total depth 90+ ft. Cased to 40+ R. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test
9/20/2006
Water added
_gal. New depth
Static water level,
ft.
85
ft.
Absorption rate >=
O
Well production tJ
g.p.m.
3.2
g.p.m.
WATER SAMPLE RESULTS:
Coliform * colonies/100 mL
Nitrate _htD—mgA.
Other bacteria
--(k—colonies/100 ml.
Arsenic: jAdfUg./L.
Date of sample: 9/20/2006
Collected by:
GEG. Ltd.
S. SEPTICIHOLDING TANK DATA
Tank Type/Material HOLDING/STEEL Date installed 10/26/1999
Tank size 2000 gal. Number of Compartments 1 Cieanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (Y/N) NO High water alar (YM) YES
Date of pumping 9/11/2006 Pumper NORTHLAND PUMPING
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./it'or ftlbdr) _ System type
Length
Width
Total depth ft. Eft. absorption area _ ft'
Date of adequacy test
ft. Gravel b4Wff (i"pe ft.
Depression over field
For bedrooms
Fluid depth in absorption fieldbsorption fletd be
_ in.
Water added
_gal. New depth
—in.
Elapsed Time:
Final fluid depth
_ in.
Absorption rate >=
g•p.d•
treatment (past 12 mo.) (YIN 6 type) If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at _in.
Datum —
E. SEPARATION DISTANCES
Size in gallons
"Pump ofP 1 �� High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAih station on lot N/A On adjacent lots 100'+
Absorption held on lot N/A On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Public sewer manhole/deanout N/A
Holding tank 75'+
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 held 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 75'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Building foundation Water main
Water service line
Wells on adjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I car* that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effed on this
date.
Engineers Printed Name JEFFREY A. GARNESS
Date 'T h7 -IOL
COSAFee a q3o tu;� 4 17-4.(r.>
Date of Payment �� G
Receipt Number y ri r,
(Rw. 1 1105) ' h A
Waiver Fee E
Date of Payment
Receipt Number
parking/vehicle storage
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.muni.org/onsite
(907)343-7904
Arsenic Advisory
Certificate of On -Site Systems Approval # 060474
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
1 of Kenai View Subdivision. This inspection revealed an arsenic
concentration of 16.6 micrograms per liter (ug/L) for the property's well
water sample. The Environmental Protection Agency (EPA) has established
a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water
systems. While private wells are not subject to this regulation, EPA
standards are based on existing health information and can therefore be used
to gauge the relative quality of water from private wells. Information on
arsenic is available from the On -Site Water and Wastewater Program
website (www.muni.org/onsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
09/ll1/.06 110\ 14:02 FAX 907 561 4284 Buyers Real Estate
s _
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IM 003
AS -BUILT. NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
of the lot lowing described property: Le> r 1,
/(SNR! : •v1MLa/ Su(3D1V 1510^1
•, p`� +� a•0 Anchorage - Recording Precinct, Alaska, and that the
t ' improvements situated thereon are within the property lines and
:'� t \ .•Y-tr.^^•i•�'� do not overlap or encroach on the property lying adjacent thereto,
r• r+•y,�f,;r„ +' that no Improvements on property lying adjacent thereto
+ !7� encroach on,;the premises In question and that there are no
y �lU. jtS6d (� ra
>G4Lt` da=�d�'•.� - ,.•'.: t �' .roadways,, uensmission lines o other visible easements on said
30/. e�{1�1••LY�gt;t•�>'nrtpi+ properly ezcopl as Indicalod hereon.
t,••`- q»,va; �,. Dated at Anchorage, Alaska
.this'd@y of OGr--�BE� 19 Y4
EASFMFr(4TS OF RECOD, OTHER TI IAN FR6D WALATKA 6 ASSOCIATES
THOSE SHOWN ON T14E RELOADED
PLAT ARE NOT SHOWN HEREON. r1ge1,- q. GQ (907) 246.1666.— Engineers and Surmyors
' vS 55
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IM 003
AS -BUILT. NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
of the lot lowing described property: Le> r 1,
/(SNR! : •v1MLa/ Su(3D1V 1510^1
•, p`� +� a•0 Anchorage - Recording Precinct, Alaska, and that the
t ' improvements situated thereon are within the property lines and
:'� t \ .•Y-tr.^^•i•�'� do not overlap or encroach on the property lying adjacent thereto,
r• r+•y,�f,;r„ +' that no Improvements on property lying adjacent thereto
+ !7� encroach on,;the premises In question and that there are no
y �lU. jtS6d (� ra
>G4Lt` da=�d�'•.� - ,.•'.: t �' .roadways,, uensmission lines o other visible easements on said
30/. e�{1�1••LY�gt;t•�>'nrtpi+ properly ezcopl as Indicalod hereon.
t,••`- q»,va; �,. Dated at Anchorage, Alaska
.this'd@y of OGr--�BE� 19 Y4
EASFMFr(4TS OF RECOD, OTHER TI IAN FR6D WALATKA 6 ASSOCIATES
THOSE SHOWN ON T14E RELOADED
PLAT ARE NOT SHOWN HEREON. r1ge1,- q. GQ (907) 246.1666.— Engineers and Surmyors
' vS 55
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH A HUMAN SERVICES
Division of Environmental Services R c JL, jjo /J y
On Site Services Section 7
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744 /o
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. u 018-332-04 HAA*
1. GENERAL INFORMATION
Complete legal description Lot 1, Kenai View
Location (site address or directions) 3401 Tieszen Avenue .
i
Property owner Eric -Wallace Day phone 762-9504
Mailing address 34b1'-Tieszen Avenue, Anchorage, AK 99516
Lending agency p�s�n4~piAL ~'SRT —540,1 SrA,,A"PDayphone
Mailing address
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well XXX
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 XX%
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(Ft".I/91) Flans MOA#21
5.
6.
M
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 bf this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
S 6 S ENGINEERING
Name of Firm ee,Phone
Address Eagle River, Alaska 99577
Engineer's signature
DHHS SIGNATURE
_L'f Approved for T HREF bedrooms.
Disapproved.
— • Conditional approval for
Additional Comments
•
Date
OF
yp � ROBERT G COWAM 1 W cf � CE -8801 , f•�•;
IIIl1���SiL�iJ�•� y'�•�
bedrooms, with the following stipulations:
Date ,/D -27- 11ti
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasersof 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.
r2 -025M., W) 6. MOAm
e Municipality of Anchorage [ I"C D
DEPARTMENT OF HEALTH & HUMAN SERVIC C v G
Environmental Services Division 2
825 L Street, Room 502 • Anchorage, Alaska 99501 • (9073-ri34V99
Municipality of Anchorage
Health Authority Approval Checklist Health & Human Services
Legal Description: 7- / k ENA 1 V I Eu 51D Parcel I.D.: Q I % — 3 3 >- . 0 jL
A. WELL DATA
Well type A o *4 A T E If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/lVN 0
Date completed
Total depth $ ? t Cased to
Sanitary seal L9/N) y f, f
4o 4 -
FROM
FROM WELL LOG
Date of test
Static water level
Weil production g.p.m.
v / x -
r
Casing height (above ground) f --
Wires properly protected &N) Y 6.S
AT INSPECTION
101 j-Ig9
S' 3
3,5—
•S i g.p.m.
WATER SAMPLE RESULTS:
Coliform Nitrate 0.6)-j Other bacteria
Date of sample: )0/ V/ B c% Collected by: S i S ENGINEERING
17024 • River Loop Road No. 204
8. 8ePT OLDIN ANK DATA Eagle River, Alaska 99577
Date Installed 101at /q l Tank size a 00 O Number of Compartments / Cleanouts(f 1) YE1
I
Foundation deanout&N) V4 f Depression (YA@ rjV High water aiann&N) 1 46 1
Date of Pumping id - N4 "' Pumper
C. ABSORPTION FIELD DATA
Date installed
Soil rating (g.p.dJW or ft2/bdnn)
Length Width Grav=pze:nt
pe iotas aepm
I
Effective absorption area Monitorin Depression over field (Y/N)
Date of adequacy test Results (Pass(Fail) For bedrooms
Fluid depth in absorpti d before test (in.); Immediately after_ gal. water added (in.):
Fluid depth (ins) Minutes later: Absorption rate = a:p.d.
e treatment (past 12 months) (Y/N) If yes, give date
72-020 (Rev. 3198)'
D. UFT STATION
Date installed
Manhole/Access (Y/N) _
High water alarm level at" _
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at' "Pump ofr level at'
'Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
i
SepticIfFof tank on lot �l Q On adjacent lots
Absorption field on lot N �� On adjacent lots
Public sewer main A' 14
Public sewer manhde/deanout
/00
o 4-
N 14
Sewer /septic service line a- S r 4 Lift station N 1,4
SEPARATION DISTANCES FROM STANK ON LOTTO:
Foundation S ,} Property line S ,} Absorption field �4
Water main/service line fU Surface water/drainage /00 t Wells on adjacent lots S
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Surface water
Curtain drain
F. ENGINEER'S CERTIFICATION
Building foundation
paridng/vehide storage area
Wells on adjacent lots
I certify that I have determined tinu field inspections and review of Municipal records tmli!� 0
in conlomrance M AJ{gqquidplines in effect on this date. y�p.Y ,, •• ••..,
/�� �•.
Signature a// Lam• C- 4/tJ►� �L
/C i,QiA.T C. C QWM✓ r ..
Engineer's Name "
'a • 08;M C. 'COWAN
Date /o / a /�I/01911�i
CE -8801
HAA Fee $ _ ,5 CV ' 5D
Date of Payment /DI/2-7/'T7 1c,
Receipt Number
72-026 (Rev. 3/96)'
Waiver Fee $
Date of Payment
Receipt Number
T
1%SnPnT
�-1a-79
S. L AL DESCRIPTIO
t 116i
MUNICIPALITY OF ANCHORAGE
GES T. G: .- 7
STRE CATION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Q,, CTION
826 L Street - Anchorage, Alasks 88501
S. TYPE OF RESIDENCE
•
r2/
J`P ;J
SINGLE FAMILY
ENVIRONMENTAL ENGINEERING DIVISION
I
❑ Three ❑ Six
Telephone 264-4720
RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
i
DIRECTIONS: Complete all parts on page 1. Incornplele repuens will not be proceoed. Flet allow, ten (10) days for processing.
1. PROP TYOWNER
depth (attach log if available.)
S. SEWAOED POSALSYSTEM
[INDIVIDUAL/ON-SITE"
PHONE
O •
_ 0Ami—
❑ PUBLIC UTILITY
cfq5,5
MAILING ADDR
-7 LaPROPE
RESIDENT (If different from above)
PHONE
G6
2 BUYE I
PHONE
MAI LIN DDRESS
3. L ING INISTITUTIO
PHONE
Q
e�
MAILING ADDRESS
C TOR/AGENT
PHONE
MAI G ADDRESS
A c,
S. L AL DESCRIPTIO
t 116i
STRE CATION
S. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
r2/
❑/One 13 Four ❑ Other
SINGLE FAMILY
L 2j Two ❑ Five
❑ MULTIPLE FAMILY
❑ Three ❑ Six
7. WATERR SrLY
CC? 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. SEWAOED POSALSYSTEM
[INDIVIDUAL/ON-SITE"
"If individual/on-site, give installation date I% 7%
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(3n8)
i
THIS SIDE FOR OFFICIAL USE ONL.
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ 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
1� ��
INSTALLER
_
SOILS RATING
❑Se tic Tank or ❑Holding Tank
Size: a If Tank is homemade
give dimensions:
TYPE OF TANK
MANUFACTURER ^'
✓T'1_'r�A_
TOTAL ABSORPTION AREA
MATERIAL
��+
1 l�
4. DISTANCES
WELLTO:
Septic/Holding Tank
Absorption Ar
Sewer Line
earest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
4�—APPROVEDFOR Z BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany rY icate)
1:1 DISAPPROVED
DATE
BY Title
LEGAL DESCRIPTION
— v1-ev. wret
CIPALITY OF ANCHORAGE e--.,
DEPARTMEN EALT VIRONMENTA ROTECTION
4W �j 825 V St t, Ancho cp.. Alaska- 99501
\
x{=472
C
VVI Dat Received: October 1#1: Time n #2: #3: Time -
Date 1- U. 1. ate - 10" Date -
1.
2.
Insp u `ns i�„�hh,-�a Insp
I
REQUEST F APPRO OF INDIVIDUAL SEWER AND WATER FACILITIES
I
Lending Institution Request: Peoples Bank and Trust
I
Mailing Address: Pouch 7-007 99510 Phone: 279-7511/242
Property Owner: Glen L. Carlson Phone:
Mailing Address: $ Everrt Honeger 276-8188
3. Legal Description: Lot 1 Kenai View Subdivision i
i
4: Single Family Residence: (x) Number of Bedrooms: Two
Multiple Family Residence: ( ) Number of Bedrooms:
5. Well System: Individual Well (x) Community/Public System ( Y
I. Permit # Njr, Depth of Well 0 Well Log on File ('►)�'
+, Construction ap p-U-y�) Bacterial Analysis /c
6. Sewage Disposal System: On-site System (x) Public Utility ( )
staller
Permit # �-� Installed /-----7 [_[_�y�
i c T nk Size rJ Manufacturer
Absorption Area Soils Rate Yom► Material
7. Distances: Well to Septic Tank to Absorption Area
l to Sewer Line Nearest Lot line Absorption Area
I 6
i to Nearest Lot Line /��
I *
PA
4.
5.
Q
19
9.
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF'�TORAGe
DEPT, OF HEALTH &
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ENVIRONMENTAL PROTECTION
825 L Street, Anchorage, Alaska 99501 1
279-2511, ext. 224, 225 OCT 101977
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES RECEIVED
Type of Inspection: VA FHA CO IV XXX
Property Owner: GLEN L. CARLSON
Mailing Address:
Day Phone:
Name of Buyer:
1
Mailing Address: 20, mre!r ('4th 4VENU£
—Day Phone:_344=6=5
Name of Lending Institution: PEOPLES TANK Z
TRTTST
-
Mailing Address: POTIrTT 7nm
Phone: 970-g.11_F,XT 242 -
Name of Realtor or Agent: FVFRRT HONE FR
Mailing Address: 2920 C STRFFT
Phone: 976—RT RS
I
Legal Description: LOT 1 KENAI VIEW SUBDIVISION
Location: ANCHORAGE ALASKA
Type of Facility to be Inspected: WELL R, grpTr SYSTEOS—No. Bdrms. ' 2
Water Supply
Type of Supply: Public Utility Individual
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System WELL & SEPTIC SYSTEM
Type of System: Public Utility Individual
If Individual, date of installation
72 007(3/76)
(on-site)
I
Page Two I .
Department of Health and Environmental Protection I
Request for Approval of Individual Sewer and Water Facilities
I
I
Legal Description:
Comments:
Affadavit Attached: ( ) Letter Attached: ( )
Approved:
Date: lO-3/-7 7
Disapproved: Date:
I •
Department Worksheet:
2 July, 1904
lir. Loren L. Carlson
Box 4-534 j
rcncrd. Alaska
i
tear ttr. Carl ncn r
It had teen hrourht to ay attention that a scwa;;e preblf.., exicta at Fond
View Sutdivision. Upon an inveatirutica, I found tt:at the present oyster,
that servos tt.a duelling; on Lot 4, owner, Clen Carlson. In contrary to,state
o: 1.1aska health regulations as folle"31
i
Administrative Coder Title 7; Chatter 2. LuLcha'�ter 2, Section 301
(n) "I.o kitchen waste. laundry wrt:r, or sewnre chr:11 lie allowed to
dischar;e or flow in any f,uttcr, streat, rord%my or public place-"
ro3aiLly tt;ere is a r.isurdarstandin^ rc;ardint the furrtinn of a se?tic tank.
ct aly rate,, "septic tank-- do not purify eeur.re. The tank effluent ray con—
tain elsorae bacteria and will still Le rutrosciLle." e;tic tanks Ara
claulpned to retain e..wr;,.r fo- 2r: hours Burin,^, which tine 60-70S of the
cur,pended solids settle to the Lcttor., as aluara an(! ®cre torn f)oatinr ecu-.
Loth tl.c alud;•C end sour., are acted upon by enzerobic bacteria to form canes
and liquid. Lignetion is riot ICo� cor,lete. The trn} will fill eventually
and willhave to Le PUT..rad- The main pur ore of a Ce tic trek is to condition
Via nowane so that the effluent deer riot clo- the drain field or so:Papc Pit,
in other words, it r:rolonr3 the life of t1:A drama;a arca. Tharefcra. the
rractice of disclvarrinl- septic tank efflu^nt into ditct.cs er on the rround
czuser u nueiance and rzy be d:_n crcus to the pee?le ir, 0.03 iss:ediate urea.
Cattinr Lack to the rmbler.. I sura --t that effort be r..�!n tc earreet tt:e
situation e:: aeon as Possible.. It MnV be mdvi.^.r_blc Tc diF a drain titch
co,l ietely aroun4 the lot and tlaa n:ay allow the lot t' Jry out rind than
you coup install at least 100 feet of drain Lila. j
i
I urider3tand that you have six lots in that zuLdivisicn. and un�l r tt•c rrcaent
situation* unless thin proLlen iz corrected, this derartr.2nt will be forced
to Put a ttop on any further roaic'ontial Luileinr in that arra or sell Int of
lots.
I trust that this proLlam will to resolved without eny resort to leehl actlon-
If you thrive eny ;.rollers, rlsase Peel free to cm..11 this cfficc-
PSrcw
Eircerely,
DAVID F. L. LUNM:, !'.%
K1cL.,r,;' Stitt
Cwner of property where nuisance exists
Nner's Street P.dcress rhone No. Box 1I0.
Location of aofiplaint: - -
Street Address � �' Fhona ::o. ._r Box t O-.
/
Terson receiving; cowlaint (1(�ii p�CO `L�r1 ,s _ d'G S'i Date (� 6
1
I certify that such statOw.ent of facts is true to the best of ry belief incl know-
ledge. I request that the for_p.oin, r::ttcr be investigated, and th.t rpnropriate
action thereafter he taken. 1 am willing to testify to the facts stated in the
forsoing conmlaint in court if necess:_ry.
Ar 47
orp la Diant
Date invastigatcd.
1
Action taken_
1
F,F.FQP'r 4 ACT 10:7 TAKEN
Date complainant- was called re&ardinL disposition of complaint
orch Cgrlso►� —t�ti� Sybd.
for ?G^Qfe
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c 4►�='..e �; say
6"
d CI i
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