HomeMy WebLinkAboutT12N R3W SEC 25 N2NE4SW4NW4NE4T12N R3W SEC 25
N2 NE4 SW4 NW4
NE4
017-411-04
WORUSWESTERN DISTRICT OFFICE
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
June S. 1990
Mr. Bruce Corwin
Corwin i Associates, INC.
1000 E. Dimond Blvd., Suite 205
Anchorage, AK 99515
SUBJECTS Submittal of Final As -Built Data for Approval
Ginamis NE 1/4, Section 25, T12N, R3W, S,M „
(9021 -DA -093) (9021 -FA -068)
Dear Mr. Corwins
563-6775
for 12600
Anchorage
The Department has reviewed the engineer as -built plans for the
subject project and -hereby gives'final approval for the sewer and
water systems. The "Certificate to Operate• for the Class 'C'
Water System and •Certificat of Approval' for the on-site waste
disposal systems are attach", Any future expansion of the subject
project will require additional approval from this office.
Sincerely,
�.
Michael ,Lewis, 8.8.
Environmental Engineer
MPL3 bas
cc Vera Craig, AWDO
ENCLOSURES':'
4.1
ciy yr4:
III
of 7
'-ALA"
LA"s
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
CONSTRUCTION AND OPERATION CERTIFICATE
for
PUBLIC WATER SYSTEMS
A.: -APPROVAL TO CONSTRUCT /
Plans for the construction or modification of _%/�L,¢
3 tt/,J V. y% , . ��.�J ,� 11!iiiZ/—A%�-G/,? Dublic water system located .
in/)/A��N Oso ) Alaska, submitted In accordance with 18 AAC 80.100
by (- `i`r~:n ¢ �(/oc_ .1r/4 _ ,/�� have been reviewed and are
❑ approved.
❑ conditionally. approved (see attached conditions).
If construction has not started within two yearsof the approval date, this certificate Is void and new plans and
-specifications must be submitted for review and approval before construction.
B. 'APPROVED CHANGE ORDERS
Change (f trwt order M. W dewdptlo mlemKe) 'App'rov.ed by - Date
C. APPROVAL TO OPERATE
The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water
Is made available to the public.
The construction of the public
water system was completed on (date). The system Is hereby
granted Interim approval to operate for 90 days following the completion date.
BY TITLE .. DATE
As -built plans submitted during the interim approval period, or an Inspection by the Department, has confirmed
the system was constructed according to the approved plans. The system Is hereby granted final approval to
operate.
BY TITLE DATE
DISTRIBUTION: 1. WHITE - ENGINEER (Complete Swtlon C)
2 YELLOW - WATER SYSTEM FILE (Complete Swt1011 C)
1 PINK - ENGINEERIMUNI.BOROUGMH�.(�Canplete 3w000 C)
160107 (11". 111&7( - ♦ GOLDENROD - MUNI -BOROUGH ,-----.•Plate Swtbn A)
Of ' STATE OF ALASKA `-/
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
.. .APPROVAL OF ONSITE RESIDENTIAL•WATER AND SEWER SYSTEMS
GQLA°
Il
PROPERTY DESCRIPTION.
At. BIGok l suomrbion a U S bump- -
j . fcf•un Z �j /�Z /(// /.'.3.w j• /r•/
Xqe If -'7e ��Z BGG vin a.e•.%
conific.b bw10 fm Appacati" NP:
yoz /- 144- Gy'
This approval does not constitute a guarantee of any kind, explicit or Implied, as to the performance
of the water supply and wastewater disposal systems.
WATER SUPPLY'
A recent water sample was teste ound to Department of. Environmental Conservation drink-
•ing water standards for total coliform a.
WASTEWATER DISPOSAL
The domestic wastewater system was:
.O :Inspected by the Department of Environmental Conservation and found to be In compliance with
applicable requirements of 18 AAC 72;
Inspected by a Professional Engineer who certifies that the.system complies with -applicable re-
quirements of 18 AAC 72;
0, Installed by a Certified Installer who certifies that the system complies with applicable requirements
of 18 AAC 72; or
:.. ❑ tested by a Professional Engineer who certifies that the performance of the system is satisfactory
and that the system complies with the minimum separation distances specified in 18 AAC 72.
This approval Is valid fora O single family' multi -family unit with a total of S bedrooms..
�.m. Title�CC11L Dn6/l yG
16440.114". &b5) DISTRIBUTION: WHITE—BANKILENDINO INSTITUTION; CANARY—APPLICANT, PINK—DEPARTMENT
RECEIVED
MAY 31 1990
ANCHORAGE/WESTERN
& associates,inc. DISTRICT OFFICE
Consulting Engineers
P.O. Box 230608 - Anchorage, Alaska 995230608 - (907) 2798866 - FAX: (907) 2792882
May 30, 1990
Mr. Mike Lewis
Alaska Department of Environmental Conservation
Anchorage Western District Office
3601 C Street,'Suite 322
Anchorage, Alaska 99503
SUBJECT: SUBMITTAL OF FINAL AS -BUILT DATA FOR APPROVAL FOR
12600 GINAMI, NE 1/4, SECTION 25, T12N, R3W, S.M.,
ANCHORAGE (9021 -DA -093) (9021 -FA -068)
Dear Mr. Lewis:
We are submitting herewith documentation that the work required
for an approved water and sewer system .is now complete. We
refer you to our original submittal dated 5/9/90 which showed
the actual construction of the sewer system and well location.
In essence, the project was constructed as described in that
submittal. Subsequently, your office requested additional work
and changes which were completed as follows:
1. The subdrain located near the NE corner of the residence was
excavated and verified to not be in any conflict with, the
sewer system on.the subject lot.
2. The concern with the steep gradient on the line to and from
the septic tank has been verified to be of no concern.
3. A vent has been added to the well and the electrical wiring
has been installed in conduit.
All other as -built data is shown on our earlier submittal and
we trust that a final certificate to operate can now be
issued. We apologize for the problems encountered after
submittal and look forward to resolving these problems in
future submittals. We are attaching final as -built data with
this submittal.
Ve truly ours,
C & SSOCIATES, INC.
ruc Corwin, P.E.
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
APPLICATION FOR ONSITE WATER AND SEWER
SYSTEM APPROVAL
Approval of individual water and domestic wastewater disposal systems is offered by the Uepartment of Environmental
Conservation to the public for their convenience. This approval may not be required by the Department, however it may
be required by other authorities.
INSTRUCTIONSTO THE APPLICANT
1. For a water supply system, complete Sections 1, II and IV of this application form and attach the following items as
part of your application.
al as built plans signed by a registered land surveyor or engineer.
b) a well tog for all new systems and, if it is available, for existing systems.
C) a photograph of the well casing to clearly show its height and the sanitary seal.
die copy of the test results for a water sample taken from this water system.
2. For a wastewater disposal system, complete sections I, III and IV of this application farm and attach the following items
as part of your application:
al as built plans signed by a registered land surveyor or engineer.
b) a copy of the adequacy test report (if appropriate).
e) a copy of the receipt for having the septic tank pumped (if appropri3te).
3. This application form with the appropriate attachments should be submitted to the local district office of the
Department of Environmental Conservation at the address listed below:
Box 2420
Room 203 State Office Bldg.
Box 450
Sitka, Alaska 99835
Juneau, Alaska 99803
415 Main Street
Ketchikan,Alasks23901
(907)747.8514
1907)7893151
(907) 225-6200
Box 1601
Fairbanks, Alaska 99707
Box 1711
Nome, Alaska 99762
Box 186
Tok, Alaska 99780
(907) 452.1714
(907) 443.2600
(907) 8834381
437 E. Street 2nd Floor
Box 1207
Boz 515
Anchorage, Alaska 99501
Soldotna, Alaska 99669
Kodiak, Alaska 99615
(907) 274.2533
(907) 262-5210
(907) 486-3350
Drawer 1709
Box 1064
Valdez, Alaska 99686
Wasilla, Alaska 99687
(9071 8354698
(907) 376.5038
16.0307(R�.6/12)
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
APPLICATION FOR ONSITE WATER AND SEWER
SYSTEM APPROVAL
1. GENERAL INFORMATION
Legal Description of the Location
7-12,IJ/
AT
Ttaatme
Wabr (Check all that Apply)
Well (Drilled or Driven) ❑ Surf.. Identify))
❑Priv
one,
Applicant N mer
A;
1'
(J
Publle (S.nr" mou Man on.
A Ilunt is (Check n
Bank Certified Installer No.�GI /Or
Owner/B011der
Atldbu ($Deet or P, O. B
Oa
T / Q
D // 2-
family)
Type o1 gesitlenc. Total No. o/ Bedrooms
❑Single
City, Sub d zip Co
Wear Data
Family Multl.Family 5
Telephone
Yes ❑ No
Is a unitary seal Installed on the wall cuing?
Sll ¢�
Z76 —6 5'S2
Se�enntd/A�iProve) t0:91
laT Pppllunt ❑ Other: (Give Nem. d Address)
Yes ❑ No
11. WATER SUPPLY SYSTEM
Sourced aur and Containment (Check ell that Apply)
TYp. Of Water Supply System
Ttaatme
Wabr (Check all that Apply)
Well (Drilled or Driven) ❑ Surf.. Identify))
❑Priv
one,
[]Chlorination11,
❑ Roof Catchment
Other (Identify)
Publle (S.nr" mou Man on.
❑Fllt,stion
❑Mineral Removal
❑ Holding Tank
family)
❑Otho:
Wear Data
le the Height of the Well Cuing more than 12" above the Ground?
Yes ❑ No
Is a unitary seal Installed on the wall cuing?
Yes ❑ Na
Is drainage directed away from or around Mt using within a radius of 10 fast Of the wall casing T
Yes ❑ No
Dat. Drilled Depth of Well (Fee I If I I I III I r Lava (Feet) Yield (If Available) Pump flab (lt Aveileble)
, t
Ila,
!/�
Gtl/Min D GH/Min
Seoaratlon Distant" fpm the Well Casing to each of the Following Source of Contamination:
Septic/Holding Tank on Lot '
Urso
Sower Linn or Lot
Abprption Aro on Lot
> 16'
�> Iso'
Clouse Septic/Holding Tank on Adjacent Lot Closest Sewer Line on Adjacent Lot
S
Closest Edge of en AbsorptiorI on Adjeant Lot
OI > t6
7 5�
If tax lc materials are stored on the property, Including full tanks, paints, lubricants and Omer petroleum
based materials, pesticide, fungicide or herbicides. Indicate distance from
On Lot On Adjacent Lot
contaminants to wall using:
A rJ�
WaterSample Taken v- Name
Semplo is:
s
❑ Buyer ❑ Engineer
Address
/
S(J
13 Banker 11Governmant Offlclal
Wes" Sample gesulb:
Attach Copy Satisfactory. D.t.: QO ❑ Unsatisfactory • Dat.:
Commonts/Recommandnio is
be signed by aCertified Installer, Professional Engineer, Department o/ EnYirdnmente/ Conservation or the OwnerBuilder
Ill. WASTEWATER DISPOSAL
Septic Tank/Abwrptlon 5Ya1em
Packs TraaImam:
ge
❑ (Specity Brand Name or Process)
❑ Noldinq Tank
Capacity of Tank
Where West. is Disposed
FrpuencY of Pumping
Specify:
❑ Owner/Builder CertifiW friq,, Other:
O ¢
Type/Ma /attar,*
`
❑ Septic Tank Curtail
Discharged To:
Other (SpeclfVY
❑
Q
(Outhouse, Incinerator, etc.)
DO mew av
ams ofIn ,alio
Dtle Inrtelletl
Date Installpd
TVP,/Monufaetu,or
/ o
'W �
No.
�O
❑ Owner/Builder CertifiW friq,, Other:
O ¢
Type/Ma /attar,*
`
No. —
TYP* Soil ADwrptiDn System
Q
TVP./Quantity Backfill Material ussO for Soil
Septic Tank Site (Gallons) Number of Comparpnenv
Soil Type Or Ra[In�q,./ `
Absorption System
OQ
AdpuaeYT est Performed BY:IAttac i Copy of Report)
L/
11Pass 13 Fall
Type Soil Absor ti n SVste
Dlmensions/Site Soll Abwrptlon System
"T
Li
Type/Quantlty Backfill biaterlal U-35
se for Soil
�••
6 /
Septic Tank
Foot
Absorption System /)r Lag / �Y n'
i 'L+
PerF/oj/ntion Test Results
Percolation Test by: I Name) %
Comments/ R¢Ommwtlaoons
Y/?
Jf
TY d/Printed N TitlReg./Cert. No., Inn. No. Date
Minimum Ground COver ever A orp•
,,an aru i 1
Minimum Grountl Cover overSeptic
Tank
Clunout Pl Installed on
Sp V. Tan
laanout P s/Caps lnstallad on
bwrpli SYnw
Fut
�� Fut
s
❑ No
Vas ❑ No
Separation
wets, Supply Source on Lot
N&*rest Water Supply Source on Adjacent
Nearest ody of Water
Wo[o Table/BW rock
Lot Line
Distance to:
PIP
So Fut
Lot
•�7
C /
FeetX111
Fut
/ Faet
cJ Foot
Com_m�Ier'n.[sj/Resommentlniom�j '+ _
e'I N/ %e e— 4` CYVfar a.{..�'el/lr ��'✓t
Cad
716
5�effAOt
/71 1
144nillffi Jphe abroVejKforritiftion is correct: - Ot
5 n
TYP Printed Name
Title, Req. /Con. No., Inst. No.
Date
JV NOT. Must be signed by a certifiedinstaller, professions! engineeror DECSta//.
No. of 1 er
. -
Dtle Inrtelletl
❑ Owner/Builder ❑Certified Install*, ❑ Other:
TVP,/Monufaetu,or
No.
Septic Tank Site (Gallons) Number of Compartments
Soil Type or Rating
TYP* Soil ADwrptiDn System
Dimensiont/Site Soil Absorption System
TVP./Quantity Backfill Material ussO for Soil
Absorption System
AdequacyTest Rewitc
AdpuaeYT est Performed BY:IAttac i Copy of Report)
ate Septic Tank Pumped (Ana[h COPY of Receipt)
11Pass 13 Fall
rte'
Minimum Ground Cover over Absorp. Minimum Ground Cover over Saptie Cleanout PiPes/Capa Installed on Cleanout Pipas/Cws tmoillad on
tion Area Tank
Septic Tank
Foot
Absorption System
Feetri Yes NoYas - No
Wolof Supply Source on Lot Nearest Water Supply Source on Adjace t Nearest copy of Water er WatTable/Batlrock Lot Line
Separation
Let
Distant* to: Feet a _Feet
Comments/ R¢Ommwtlaoons
Feet Fut Fut
ve' formation is correct:
*OT
TY d/Printed N TitlReg./Cert. No., Inn. No. Date
`:Must
De signed by •Pro /ess,ona/ engineer. ease
Idl
■
ssional
W HIRNSWESTERN DISTRICT OFFICE
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
563-6775
June S. 1990
Mr. Bruce Corwin
Corwin 5 Associates, INC.
1000 E. Dimond Blvd.. Suite 205
Anchorage, AX 99515
SQBJECTt Submittal of Final As -Built Data for Approval for 12600
Ginami. NE 1/4, Section 251 T12N, R3W. S.M., Anchorage
(9021 -DA -093) (9021 -FA -068)
Dear Mr, Corwini
The Department has reviewed the engineer as -built plans for the
subject project and hereby'gives:final approval for the sewer and
water systems. The "Certificate to Operate' for the Class 'C'
Water System and •Cartificatyr'of Approval' for the on-aite waste
disposal systems are attache . Any future expansion of the subject
project will require additional approval from this office.
Sincerely,
TKi�'�-
Environmental Engineer
MPLt bas
cc Vern Craig, AWDO
SNCLOSQRES•: :
STATE OF ALASKA
DEPARTMENT & ENVIRONMENTAL CONSERVATION
CONSTRUCTION AND OPERATION CERTIFICATE
A.'. APPROVAL TO CONSTRUCT
for
PUBLIC WATER SYSTEMS
Plans.for the construction or modification of /U� ZV4 '712
/f f� /fes �)
�/ t 3 W//�ffy • i - ' • • ' C_ ���J /� / ' ( Z� /i�-e public water system located . .
In "e: f ae"gfo Alaska, submitted in accordance with 18 AAC 80.100
BY
been reviewed and are
❑ approved.
❑ conditionally approved (see attached conditions).
TITLE DATE
If construction has not started within two years of the approval date, this certificate Is void and new plans and
specifications must be submitted for review and approval before construction.
B. 'APPROVED CHANGE ORDERS
". Y
Change (eonVael old" 110. a OsepHpu.. nbnnu) "ApplOVed by �' Date
C. APPROVAL TO OPERATE
The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water
Is made available to the public.
The construction of the
public
water system was completed on (date). The system is hereby
granted interim approval to operate for 90 days following the completion date.
TITLE DATE
As -built plans submitted during the Interim approval period, or an Inspection by the Department, has confirmed'
the system was constructed according to the approved plans. The system Is hereby granted final approval to
operate.
BY TITLE
DAZE
DISTRIBUTION: 1. WHITE • ENGINEER (complete Sa tlon C)
2 YELLOW • WATER SYSTEM FILE (Complete Section Q
160407 him 11187) • A PINK • ENGINEERfMUNLmNl
BOROUGH tCope Saab C)
. , . • - .. A GOLDENROD • MUNI -BOROUGH (ComPWO S.O. A)
OF
2 6 ` STATE OF ALASKA .0
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
w �
,APPROVAL OF ONSITE RESIDENTIAL WATER AND SEWER SYSTEMS
G•nLwSy'w .
PROPERTY DESCRIPTION
at, SI=k • SuCElviemlt or U.S. Survey
A7G1r/A�fC f iZGGG Gjino1014i ✓/.
Certificate IeeueG for Appiloeti n Nm
This approval does not constitute a guarantee of any kind,. explicit or Implied, as to. the performance:
of the water supply and wastewater disposal systems.
WATER SUPPLY'
A recent water sample was teste ound to Department of Environmental Conservation drink
Ing water standards for total coliform a.
WASTEWATER DISPOSAL
The domestic wastewater system was:
❑ :inspected by the Department of Environmental Conservation and found to be In compliance with
applicable requirements of 18 AAC 72;
Inspected by.a Professional Engineer who certifies that the.system complies with, applicable -re-..
quirements of 18 AAC 72;
❑ Installed by a Certified Installer who certifies that the system compiles with applicable requirements
of 18 AAC 72; or
:. ❑ tested by a Professional Engineer who certifies that the performance of the'system is satisfactory _
Nand that.the system complies with the minimum separation distances specified In 18 AAC 72. ' •::.; .'. ;
This approval is valid for a ❑ single familyR multi-famlly unit with'a total of S bedrooms.. _. .
Title Date
(o G
184MN fRev. 81115) DISTRIBUTION: WHITE—BANK/LENDING INSTITUTION; CANARY—APPLICANM PINK—DEPARTMENT
Y�
T4416
M
.'�unicipafty of Anchorage `/" p ....1'.-sA;?
DEPARTMENT OF HEALTH S HUMAN SERVIC •3
825 "L" Street. Anchorage. Alaska 59502-0650`! _e
SOILS LOG —PERCOLATION TEST:.
(� lr
�FSI •..,�. ..: ' q
PERfORa:EO FOR: tj(2�G,t i SYS'MS �(JG . OA C�PLRf'QPMEL) V���2o/`O
LEGAL DESCRIPTION: �j a'
Township. Range. Section: SFC_ 7 . 2S -'n Z u A3 W S. Amt ,
DEPTH
SLOPE SITE PLAN
r�--r'�
(f CETI 1 1 1_ I__ I
2-
4-
4G4
COMMENTS
6-
4 b fe
7-
9
9-
13-
1314751617181920
14-
is-
16-
17-
1113-
is-
20 -
COMMENTS
WAS GROUND YlATER
ENCOUNTERED?
IF YES. AT WHAT
DEPTH?
fe o-XkLc7 Il
i
PERCOLATION (UTE
// TEST RUN BETWEEN
(^�t��1 PERC HOLE OtAMETER
'T AND FT
PERFORMED BY: '�CG `-^�� ""r% 1 ` RTIFY �T it1S WAS PERFORMED IN
ACCORDANCE VATH ALL STATE ANO MUIaPAL GU10ELIN M12S DATE DATE: 2
i
72408 (Rc..4S51
y l rl i� MUNICIPI ufl .fiPcA J0ff R, GOVERNOR
' I Ln 1 �� L� U \\ Lr ENvID PNMENTTALL PROTECTION
CCll LLL711 lll��� U J UUU IJ mAY 15 1990
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCIIORAGE WESTERN DISTRICT OFFICE RECEIVED
3601 C STr=T, SUITE 322
ANCHORAGE, ALASKA 99503 SG3-6775
:!ay 11, 1990
I:r. Bruce Corwin
Corwin & Associates, INC.
1000 E. Dimond Blvd., Suite 205
Anchorage, AK 99515
SUBJECT: Department Inspection On 12600 Ginami, PIE 1/4, Section
25, T121I, 8311, S.M., Anchorage (9021 -DA -093)
Dear PIr. Corwin:
On May 10, 1990, the Department performed an inspection on the
subject property to verify adequacy of the proposed on -lot
wastewater disposal system. The following comments are given from
the inspection.
1. An apparent subdrain system is discharging
approximately 25 ft. north of the NE corner of the
drainfield. Regulations require that all surface
waters must be 100 ft. from a septic system. This
discharge may or may not fall into this category
depending on the flow characteristics of the
discharge. If the flow is contributable solely from
storm runoff or snowmelt (not including
groundwater), and is intermittent throughout the
year, the regulation may not apply. To make this
determination, the system needs to be monitored
through the summer into the late fall to make an
accurate characterization. As an alternative, the
Department may consider the use of special
construction techniques to protect the water source.
A closed conduit may be used to carry the discharge
outside a 100 ft. radius from the drainfield.
In addition, we have concern on the exact location
and dimensions of the subdrain system. Primarily,
this information is needed to verify that collection
into the subdrain system is outside the discharge
gradient of the drainfield. Please provide
information to address this.
12600 Ginami
Page 2
May 11, 1990
2. In reference to the drainline coming from the house
to the septic tank, we have concern on the
significant grade running downslope into the tank.
There nay potential of solids build (dowatering due
to high velocities) and erosion on the inlet baffle
to the tank. Please comment on what considerations
were given toward these potential problems in your
design.
3. In reference to well, we noted several minor items
which need correcting. The first of these items
was the well vent. The vent needs to be turned
downwards with the placement of a mesh screen over
the inlet. The second item is an electrical conduit
lead into the well. The conduit is broken and
should be repaired.
In summary of our inspection, we have found the general
installation of the septic system to be satisfactory, however,
with the noted problems mentioned above, we feel that the engineer
needed to perform a more thorough site inspection of the property.
All these items should have been properly addressed and identified
prior to submitting for a plan approval. The Department relies
significantly on the registered engineer to present an accurate
detail of on-site conditions, and the best practical design for an
on -cite wastewater disposal system for a property.
Operational approval will not be given until satisfactory response
is received on the above items. If you have any questions, please
contact me at our Anchorage Western District office.
11PL: bas
cc Robbie P.obinson, DIIHS
Sincerely,
11i� . Lewis, P.E.
Environmental Engineer
MUNICIPALITY Of ANCHORAGE
CEPt Of HEALTH &
ENVIRONMENTAL PROTECTION
MAY 1.51990
RECEIVED
SH
GRE`ER ANCHORAGE AREA BOf
Department of Environmental Quality
3330 C Street
` Anchorage, Alaska 99503
on - 'LI 11-1)6
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING ADDRESS
PHONE
LOCATION `' 4M'lLC.vL LEGAL DESCRIPTION'"' ` /r WA
DISTANCE /rel` �/ y�, /4 -{-.0 NUMBER 1
FROM WELL MANUFACTURERSern qsl 'MATERIAL COMPARTMENTS '"CA
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I QUID CAPACITY 1000 GALLONS.
\ q WEE—
SEEPAGE PIT: af
NUMBER OF PITS
LINING MATERIAL
DIATkkTER OR WIDTH_, LENGTH_, DEPTH
C
BUILDING FOUNDATION—, NEAREST
ADDITIONAL ABSORPTION
WELL: G/ ih q711n( o ioV,
TYPE CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES:
INSTALLED BY: _ D:w') P z
PIPE MATERIAL: er CQ' i�7
LOT SLOPE -
REMARKS:
REMARKS: 7'�"`� 5 Qr'e
Form No. EQ -031
DIAMETER _DEPTH_DISTANCE FROM: WELL
TOTAL EFFECTIVE
'E (^-ABSORPTION AREA (WALL AREA) � 1 SQ. FT.
\ ` 7 _.. o,._I . ,r-%,-1 _ ,Lt 11 _G'LS na
DEPTH
DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE , TANK , SYSTEM_
REMA
DIAGRAM OF SYSTEM
(cad -ro
DATE'?- APPROVED
APPROVED .LY
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
✓mN
e —,
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99303
TELEPHONE 274.4361
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
INSTALLATION OF: 81I2TAMC �—
TYPE AND SIZE OF FACILITY TO BE SERVED
PERMIT NO.
MAILING ADDRESS af���UQ St. PHONE
SEEPAGE PIT
DRAIN FIELD OTHER
FINANCED THROUGH TO BE INSTALLED BY
7
SOIL TEST RESULTS 6— n 9Nc) Iij,1., — NOTEI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED 197 V
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.
K SIZE - TYPE A&"Z'7"Jy.'a QSEEPAGE AREA SIZE TYPE.
MINIMUM DISTANCES. REQUIREMENTS
I
FOUNDATION TO SEPTIC TANK .S
FOUNDATION TO SEEPAGE PIT •,/w DRAIN FIELD NAA
SEPTIC TANK TO SEEPAGE PIT WALL .4I//Tn
6iPZIC TANK SEEPAGE PIT .-. DRAIN FIELD —
TO NEAREST LOT LINE.
WELL TO SSPT/C TANK -l�(] SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TOXPTTC TANK /, SEEPAGE PIT
DRAIN FIELD
�/
SEPTIC TANK, �yj{L, 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.B.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 20.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE 7 _`' • % J1 APPLICANT'S SIGNATURE `"�• K1 /A/U-�!�"V�-("'c
FORM NO. 9"16
FAIRBANKSCONSULTANTS, INC. JUNEAU JUNEAU
299 EAST 61ST AVENUE - ►.0.110%6097 - ANCHORAGE. ALASKA 99507 - TELEPHONE 907-279.0995 - TELEX 090.55919
'September 21, 1974
Mr. William Breedlove
Star Route A, Box 390-B
Anchorage, Alaska 99504
R & M No. 462082
RECEIVED
SEP ;&4 1974 AM
GRF4ER ANCHORAGE AREA BOROUGH
91FI. OE RN:' .r '•NTAt QUALITY
Re: Test Hole and Soil Log Report for Sanitary System
N 1/2, NE 1/4, SW 1/4, NE 1/4, Section 25, T12N, R3W, S.M.
Dear Mr. Breedlove:
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at the subject site. This investiga-
tion was performed in accordance with your request of September 6, 1974
and those procedures outlined in a letter dated September 13, 1971 by
Mr. Rolf Strickland of the Greater Anchorage Area Borough Department of
Environmental Quality.
A single test hole was put down within the Section 25 building site for
the purpose of defining general subsurface soil conditions for the
proposed sanitary system. Excavation was accomplished with a tractor -
mounted backhoe and the test hole was extended to a total depth of 7.0
feet below ground surface. The final log prepared for the test hole has
been included in Drawing A-01.
Ground water was not encountered in the test hole.
We appreciate being given this opportunity to be of service to you.
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yours,
R & M CONSULTANTS, INC.
��yr..alJ /V
ames W. Rooney
V
xc. GAAB
TH-1
9-10-74
~
ORGANICS
SANDY SILT (ML)
s;
SILTY SANDS SOME GRAVEL (SM)
,F
BEDROCK (FRACTURED)
NO WATER TABLE
NOTE: Test hole excavated with tractor mounted backhoe
0.0
1.5'
2.0'
.
6.5'
7.0'
William Breedlove Project
Log of Test Hole
Anchorage Alaska
Engineering a Geological Consultants Inc.
ANCNORAOf FAIRBANKS ALASKA JUNEAU
DATE 9-11-74 lacAwE ",2' DwN eT B. H. a«D By W.E.D. PnoJ. NQ 462082 1 DWO No. A-Ol
D04227
GREATER ANCHORAGE AREA BOROUGH
G �
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received 7.r
Time of Inspection%
Date of Inspection
REQUEST FOR APPROVAL OF in 1-1- u 11-(C5�
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by: �./fJ1%tiC(�,c.,✓ /6�A
Mailing Address: S,04. x 34 9 Phone: BILI -3/9=-
2. Property Owner: Phone:
Mailing Address:
3. Legal Description: 77 /�V , Sc� /V, �7 d �/4/ /I F1�(f 4zye,
4. Location: %Cl w �w„1�„ 77/ 2All
5. Type of facility to be inspected Sr - 9 No. of bedrooms .3
6. Well Data:
A. Type B. Depth
C. Construction D. Bacteriia-l- Analysis's? '54"Am 9-15-75'-
7.
-75'767. Sewage Disposal System: 9 - 7
A. Installed 9-i6- 9t/ B. Installer
C. Septic Tank: 1. Size -'�0 / ®oc 2. Manufacturer��
D. Seepage Pit: 1. .Absorption Area %)1 D�— 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. 41e11 to: Stank 2� Absorption area Sewer Lines
Nearest lot line Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
GREATER ANCHORAGE ARIL BOROUGH 7G
Department of Environmental Quality. - 6,.V
3330 "C" St., Anchorage, Alaska 99503 - 274-4561 � %S
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
Ism
1. Type of Inspection: CPiRO VA FHA CONY XX
2'. Property Owner: William R. Breedlove & Doroty Breedlove
Mailing Address: St. Rt. A Box 309 Day Phone 344-3192 �. .
3. Name of Buyer: Anchorage, �)aaska
Flailing Address: Day Phone
4. Name of Lending Institution: National Bank of Alaska
Flailing Address: P. 0. Box 3-3859 Phone 279-2506 ext. 19
Anchorage, Alaska
5. Name of Realtor or Agent: n/a
Mailing Address: Phone
6. Legal Description:N h, NEk, SW k, NW k, NE k, Sec. 25, T12N, R3W, S.M.
Location:
7. .Type of Facility to be inspected: SFR No. Bdrms. 3
8. Water Supply
Type of Supply: Public Utility — Individual X
If Individual, number of dwellings presentiy .served 1
If Individual, depth of well
9. Sewage Disposal -System
Type.o:° System: Public Utility. Individual (on-site) X
If Individual, date of installation' 9-174
3XI
'Page 2 of two pages - ReqL� y'1or Approval of Individual Sem"'~& Water Facilities
Legal Description
I
44 /Y4 -
Comments
A
Disapproved
Date /, 7,,757—
Approval,Valid for one year from date signed
Greater Anchorage Area Borough. Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained In this request Tor approval to De a true ana
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
Fndull,
EQ -034 (1/74)
Date
PT
Municipality of Anchorage
Development Services Department
• ar a .[:... t.. r.'.
Bulldog Safety Division ••
On -Site Water and Wastewater Program s. `
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onske
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-411.04 COSA # No bLi'4 9
Expiration Date: /-4-07
1. GENERAL INFORMATION
Complete legal description T12 R3W SEC 25 N2NE4SW4NW4NE4
Location (site address) 12600 Ginaml Street, Anchorage, AK 99516
Current Property owner(s) Rick E. 6 Shannnon K. Wilder Day phone
Mailing address 12600 Ginami Street, Anchorage, AK 99516
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:
3. TYPE OF WATER SUPPLY:
Individual Well
El
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
✓❑
Individual Holding Tank
❑
Community On -she
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite Systems
Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil
engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
Ede (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 engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the onsite 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 Firm Watkins Engineering, Inc. Phone 907-349.1851
Address P.O. Box 110443, Anchorage, AK 99511-0443
Engineer's Printed Name Cindy W. Ellis, P.E. Date 9/29/2008
5. DSD SI NATURE
Approved for 3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following
Illy W. Ellis
CE. ms»
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory X Supplemental Engineer's Report
Nitrate Advisory Other
By: A/ P Original Certificate Date: O — ' O L'
i
(R«. I IM)
Municipality of Anchorage
Development Services Department
Bunting Safety DMsion
On -We Water 6 Wastewater Program
4700 Bragaw Street
P.O. Bak 196650
Anchorage, AK 99519650
vwvwxRjrd.oryonsft
(907)343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: T12N R3W SEC 25 N2NE4SW4NW4NE4 12600 Glnaml parcel 10: 017-411-04
A. WELL DATA
Well type PRI If A, B, or C provide PWSID S =
Date completed 1974+/- Sanitary seal MCI )L -
Total depth 266+• R Cased to =�+R
FROM WELL LOG
Date of test NA
Stage water level NA R
Wen production NA 9.p -m.
WATER SAMPLE RESULTS:
Conform 0 colonlea/100 mL Nitrate 1.30 mg/L
Arsenio: !0._005 mgll Date of sample: 9/19106
B. SEPTICMOLDING TANK DATA
Tank Type/Matedal Peet Greer septiC tank
Tank size 1500 gal. Number of Compartments 2
Wen Log (YIN) N
Wires properly protected (Y" Y
Casing height (above ground) 16 _1n.
AT INSPECTION
9/21!2006
36 R
0.71 recovery 94)m.
Other bacteria 0 cdonlesN 00 ml
Collected by: Rocky Trainor
Date installed SOW
Cieanouts (YIN) Y
Foundatlon deanout (YIM Y Depression over tank (YWKgh water alarm (Y714) NA
Date of pumping May 24, 2006 Purr Around the Clock Pumping
C. ABSORPTION FIELD DATA
Date installed 5N= Son rating (g p.d.Htr or Iebdrm) ISO System type bed
Length 60 R VYknh 20 IL Gravel below pipe 0.5 R
Total depth 28 R Effabsorption arca 1200 to Monitoring Ube Y Depression over laid N
Date of adequacy test gal= Results (PaaslFam Pass For 3 bedrooms
Fluid depth In absorption laid before test 0 le. Water add 4ed 74.5 gat New depth 0 in.
Elapsed Time: 0 min. Final Auld depth 0 in. Absorption rate >• 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN 6 type) N If yes, give date NA
D. UFT STATION
Date installed NA Size in gallons Manhole/Amu (Y"
"Pump on, level at _ in. 'Pump ofr level at,_ in, High water alarm level at in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAilt station on lot 240
Absorption field on lot 255
Public sewer main 100+
Sewer /septic service One 50+
Animal containment areas 100►
MOM slerm d droit requirements?
On adjacentlets 100+
On adjacent lots 100+
Public sewer menhole/cleanout 100►
Holding tank NA
Manure/animal excrete storage areas 100+
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 160 Property line 40 Absorption Held 65
Water main 100+
Water service one 200+ Surface water 100+
Wens on adjacent lots 100+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 7' Building foundation 5+ to aw amt* Water main 100+
Water Service line 100+ Surface water 100+ Ddvewy, parkingiveWe a wspe 10
Curtain drain None known Wens on adjacent Iota 100+
F. COMMENTS: Recovery well flow teat conducted. Deepest water level measured was 268 fl. Lot One waiver
requested for 7 R ltom dralnfleld to west let One. Drelnneld is 6 it from shed on slab - no concern.
G. ENGINEER'S CERTIFICATION
I car* that I have determined through geld inspections and
review of Municipal records that the above systems are in
conlbrmance with MOA COSA guidelines in effect on ibis date.
Engineer's Printed Name Cindy W. Ellis, P.E.
Date 9929/2006 CIO Y W. Elllx i
CE . its"
COSA Fee S r7 ' Waiver Fee S Q
Date of PaymentC1ry C� Date of Payment I
Receipt Number 0 &U6 Receipt Number. lo�ib�
(Rev. 11/05)
Municipality of Anchorage cs
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.anchorage.ak.us
(907)343-7904
Water Well Advisory
Health Authority Approval # 060479
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block , Lot of T12N R3W Section
25 N2 NE4 SW4 NW4 NE4 subdivision, the well's productivity was
determined to be 0.71 gallons per minute. The minimum well productivity
required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31
gallons per minute. Although the subject well currently exceeds this
minimum requirement, all parties concerned are advised that the production
capacity of the well may fluctuate. Restriction of non-critical water uses
such as washing cars and watering lawns and gardens may be required.
This advisory must be attached to all copies of the subject Health Authority
Approval.
SCS RrLN
1065607001
Client Name
Wain Engineering
Project Name/N
T12N R3W S25 N2 NIA SW4 NW NE4
Client Sample ID
T12N R3W S25 N2 NE4 SW4 NW NE4
Matrix
Drinking Water
PWSID
0
Sample Remarks:
All Dates/fimes are Alaska Standard Time
Printed Date/fime 09/27/2006 9:33
Collected Date/rime 09/19/2006 13:31
Received Datef lme 09/19/2006 15:15
Technical Director Stephen C. Ede
Allowable Prep Analysis
Parameter Results PQL Unita Method Containa ID Limits Date Data Ina
Metals by ICP/HS
Arsenic ND 5.00 ug/L EP200.9 C (<10) 09/19/06 09/23/06 MI
Waters Department
Nitmto•N 1.30 0.100
Microbiology Laboratory
Total Coliform 0
mg/L EPA 3532 D (<10) 09/19/06 ALR
cot/100mL SM209222B A (<I) 09/19/06 TLF
Watkins Engineering, Inc
P.O Box 110443, Anchorage, AK 99511
(907)349-1851 cwellis@gci.net
September 29, 2006
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
RE: T12N R3W Sec 25 N/2 NE/4 SW/4 NW/4 NE/4
12600 Ginami Street, Anchorage
Lot Line Waiver Request
To Whom It May Concern:
A lot line waiver is requested for the subject property to allow a 7 ft separation from the
drainfield to the west lot line, which borders the right of way for Jeanne Road.
I am not aware of any adverse effect that this would have on any of the adjacent lots'
water and wastewater needs.
Thank you for consideration of this request. If you have any questions or need further
information, please call me at 349-1851.
Yours truly,
��POO'
Cindy Ellis, P.E.
President
AltmiC1pality Of Anchorage
C0. IM,x 1!Mk;N) • :\nchurngc, dla.lm !Mr,19 (64() • Tcicphanc (!X)7)1'43 -K;01 • rnx (! X )7) 343fiC(X)
47(X) llraowSlmo •.lnchomgc, .\I:ului !M.A4117
Mayor Mark RQ( ich
10/3/2006
Cindy Ellis
Watkins Engineering, Inc.
A%%mmumLorg
Building Snfcty Dhislon
Subject: Waiver Request for T12N R3W Section 25 N2 NE4 SW4 NW4 NE4
Waiver Request #WR060063
Parcel ID #017-411-04
IIAA# 060479
Dear Engineer,
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 7.0 feet.
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,
Jeffrey W. Poet
Engineering Technician
On -Site Water & Wastewater Program
Community, Security, Prosperity
Municipality of Anchorage
Development Services Department
• ++ Building Sak-ty Division
On -Site Water and Wastewater Program
4700 Bmgaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchoragc.ak.us
(907)343-7904
Waiver Review Worksheet
WR#: 060063 PID#:017-411.04 HAM 0 7 Permit#:
Date Received: 9129/0
Legal Description: T12N R3W Section 25 N2 NE4 SW4 NW4 NE4
Engineer. Watkins Engineering, Inc.
Waiver Requested: 7 feet separation distance absorotion field to property line.
Criteria: Geology Points:
A. Water Table
B. Sal Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
...............................................................................
Waiver is Granted: Waiver Is not Granted:
Ust Conditions or Reasons for above:
Date: / 0 — 3 — 0 G
Me
..................... a........... .... .a.'se
Rec#: 9129/06 Amount: 5175.00 Date Paid: 9/29/06
...............a............
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CNQYD a R NO. F.EL NO./ij/SG• , GR%D
• AS—dU/LT
NE�41rISti/%INA/'/s/ A&12.
SEC. 25.
772 .d, ,e Bt✓ .SM.
/ •hereby cortity that an accurate Survey o/ the
Io//ow/ng descr/Ded property-
was made go 6 Zrz%y and, Mot the
/mprerem*4j* */roofed thereon ore Wthhr the
property /kms one de net oyer/ep.or encroach
on me prop*hy /J*r adjecrat thereto, Mat no
improremeahrorf properryty/ng adjacent Mer*to
eoerooch oN the prem/s*s In quesf/on and that
,her/s%h/i are
gtenpo yentdOsold �*�y/I+eept s Or other
h,d/tetwd Aereoo.
DOW at Anchorage, Alaska, INS 13 do)', or
LS No. 4107S
or/ GEODEM TECHNOLOGY
SURVEY/NG SERV/CES
2601 Turnagain Parkway
Anchorage, Alaska 99503
248-3390