Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
ROBINDALE #1 BLK 1 LT 4
Robl*ndale #1 Block 1 Lot 4 #051-052-49 Municipality of Anchorage IN'r"°°--�--_ On -Site Water and Wastewater Program ° (907) 343-7904 � .1 of 3*' ON-SITE WASTEWATER INSPECTION REPORT DEC 0 7 2018 Permit Number: OSP151178 PID Number: 051-052-49 Dwelling: ❑9 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New 9 Upgrade Name: Michael Mercier ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 22611 Robinson Drive Chugiak, AK 9567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Robindale No. 1 1 4 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well >100' N/A >100' N/A >25' TANK ❑ Septic A S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 11,250 Gal. Surface Water >100' N/A >100 N/A Material Number of compartments Lot Line >5' N/A >5' N/A Steel 3 NA Foundation >5' N/A >10' N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Anchorage Tank/Orenco 1,250 Gal. Remarks ST. E. P. Tank Only Replaced Under Pump on level at 42 in. Pump off level at 38 in. High water alarm at 44 in. This Permit. Existing S.T.E.P. Tank Decom- missioned per MOA Code. Pump make and model OSH P2005-11 Electrical Inspections performed by Power Lighting & Cont. PIPE MATERIAL House to tank D3034Tank to D3034 drainfield Installer G & S Excavating Drainfield CO/MT D3034 Inspector Wade Roberts BENCH MARK (Assumed elevation) 100 ft Inspectionis' 6/17/15 6/18/15 Location and description dates: 2„d 3'd 4 t Bottom of Siding. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL OF C Conditional Approval: Date 4V'• 49 th .......r ......... ..'! .uro.uuunnuuu........ou..no..uu. 10 MICHAEL E. ANDERSON mr �z Ar No. ©�J,':e•°• No. CE -4381 12-7-18 Approved Date 1 a 0'% l� eo a0 pR•r...�1mA ®® ®® 11e :�•��®® inspection rteport_y-i-i2.aoc PERK8[T#DSP151178 / / PID #O51 -O52 -4Q � | ~~~~ | LOT �� � ~ u�*�x �� -* | / | � . 48,573 S.F. � / S 89*5�5'WW 308.02' � / \ | / | ~'~ EXISTING 8zs�TANK ' EXISTING WELL —' ��� � / D�O���ED�nM��� � u��,x �� / | m8N8'T.E-p. TANK ONLY PLACED UNDER / THIS PERMIT, pov&ABSORPOOm | ' SYSTEM ARE EXISTING. / / � � MICHAEL E. ANDERSON NOTE NOSLOPES >2596WITHIN 5O'DRSURFACE WATER WITHIN 1O0'OFTHE LEGEND����� PROPOSED SEPTIC SYSTEM C0 -CLEANOUT 2CO'DOUBLE CLEANOUT ALL WELLS ONSURROUNDING LOTS WITH IMPACTS TOTHIS FCO - FOUNDATION CLEAN0i PROPERTY ARE SHOWN. NDCONFLICTS WITH WELLS ORSEPTIC MH - MANHOLE SYSTEMS. MT'MONITORING TUBE 0 50 O FDV-FLOW D|VERTERVALVE FEET SV-GEPT|CVENT TH'TEST HOLE EXISTING WELL BARN SvI 93.5 108.2 SV2 98.4 114,0 to EX STING NEW 1,250 SYSTEM GALLON S.T.E.P. / S 89*5�5'WW 308.02' � / \ | / | ~'~ EXISTING 8zs�TANK ' EXISTING WELL —' ��� � / D�O���ED�nM��� � u��,x �� / | m8N8'T.E-p. TANK ONLY PLACED UNDER / THIS PERMIT, pov&ABSORPOOm | ' SYSTEM ARE EXISTING. / / � � MICHAEL E. ANDERSON NOTE NOSLOPES >2596WITHIN 5O'DRSURFACE WATER WITHIN 1O0'OFTHE LEGEND����� PROPOSED SEPTIC SYSTEM C0 -CLEANOUT 2CO'DOUBLE CLEANOUT ALL WELLS ONSURROUNDING LOTS WITH IMPACTS TOTHIS FCO - FOUNDATION CLEAN0i PROPERTY ARE SHOWN. NDCONFLICTS WITH WELLS ORSEPTIC MH - MANHOLE SYSTEMS. MT'MONITORING TUBE 0 50 O FDV-FLOW D|VERTERVALVE FEET SV-GEPT|CVENT TH'TEST HOLE MMRUW* MAO ;-;,.T.E.P Tank only replaced under this permit. Existing S.T.E.P. Tank Decommissioned per MoA Code. ............. 49th MICHAEL E. ANDERSON No. CE -4381 On -Site Water and/or Wastewater System Permit Permit Number: OSP151178 Tax Code Number: 05105249000 Work Type: SepticTank Permit Effective Dates: June 16, 2015 Design Engineer: ANDERSON ENGII Subdivision: ROBINDALE #1 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade to June 15, 2016 Site Legal Address: ROBINDALE #1 BLK 1 LT 4 G:1561 Owner/Address: MERCIER MICHAEL S & KUSTURA GEORGIA A 22611 ROBINSON RD CHUGIAK AK 995675535 Site Mailing Address: 22611 ROBINSON RD, Chugiak This permit is for the construction of: Lot Size in Sq Ft: 48573 Total Bedrooms: 3 N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received 2:14t�rr)I BUSH! MUNICIPALITY OF ANCHORAGEg RUSH,' Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: Fax: ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I. D. 051-052-49 Property owner(s) Michael Mercier & Georgia Kustura Mailing address 22611 Robinson Road Chugiak, AK 99567 Day phone 250-5886 Site address Same Legal description (Sub'd., Block & Lot) Robindale #1, Block 1 . Lot 4 Legal description (Township, Range & Section) Lot Size 48,573 Sq. Ft. Number of Bedrooms Three APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ERUpgrade FXDuplex F]Holding (D) Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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: Nq_ Waiver Fees: Date of Payment: G 1161 1$ C� Receipt Number: Oq-551 G Permit No. otif`1 J W1% Permit App_:- : Date of Payment: Receipt Number: Waiver No. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX June 15, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 4, Block 1, Robindale Subdivision No. 1 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The 1,250 Gallon STEP Tank on Lot 4, Block 1, Robindale Subdivision No. 1 has failed and must be replaced. We are proposing to replace the tank and lift station with a new 1,250 -gallon STEP tank to serve the three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new tank to sere the home. The attached Site Plan and backup documentation identify the location and configuration of the existing septic system and the location of the new STEP tank. Also identified on the plans are the existing wells in the area. No conflicts exist between the wells and septic system on this lot and those on adjacent lots. The existing tank will disposed in accordance with Municipal Code. The drainage patterns on the property will be maintained after construction. The ground surface on the lot is basically flat in the area of the new tank. The tank will be placed near the same location as the existing tank at nearly the same elevation. It will then be tied in to the existing service line. The tank will be constructed in conformance with Municipal requirements. If the tank is constructed in accordance with our design the following statements apply: The tank, 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 tank, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. Lot 4, Block 1, Robindale No. 1 June 15, 2015 Page 2 of 2 3. The tank, 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 tank, if constructed as designed, wilChave no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, - =t Michael E. Anderson, P.E. Attachments T h yS �:��•• 49th ••••�?� MICHAEL E. ANDERSON ��D 06' L9 l Mg, L 1.00 N U > 1 � C \ Y O Lb N > 1— \ aUwQ p Z O Wawl mjd> J ti `1 N.a, m m `o �=0=o n m .c J o o J Oa O Ot? y N 0 Z:2 mom" r IOw� 0 LL �x w g g w) I I �o > Q 'n Zp Y e �W -1:2 oma n 3 c m o _ U I w E OZ m w mp aE:m. O U J U N O U C w in DQd O w o60 6 z \ _ � /10- �___ E ��LLI LO N �� LO J / U / \\ 00 N LO ~ \ / \ F- 0 r � W � r 4 � J r 1 "3 0 / W \ / moo ip Z OVON NOSNIGOH 0 Municipality of Anchorage Development Services Department \ Building Safety Division ' On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Boz 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO10131 PID Number. 051.052.49 "'n"' Wastewater System: ❑ New ® Upgrade ME I Robinson Road. Chuglak. AK 99567-5535 ABSORPTION FIELD ptwne: Number of Be* oone: O Deep Tnnrll o sn.oaw TnerrA ®thee 0 Lloiate D oxer; LEGAL DESCRIPTION Taropathan agew. 3 0.4 cnaFt n. 11 tl La suEEeoan: Depel to ppa bo0am than afpnel gree•: Gravel depth beneath pps: 1 4 Robindale #1 2.5 Ft. 0.5 Ft TavnNp: Range: so 9 n; Fe Wase above atgeul gratia: Grevet Length: 1.95 Ft. 75 Ft. Well: ❑New 11 Upgrad Grinel.em: 15 ra W hne.: � tance� 2 8 Ft. FL a.sseo.an (P 18. A S. C): Taal Depa: c»W b: Toul.waWcn arse: P"Matenal: Private I Ft. Ft. 1125Fr D3034 & SCH40 Oryx, tS�l Dete DralW: star water Laval: MnWler Dan tnW.ati: c Ft. RPC - Richard Person 512812001 Velli: Peng Sat eL c." H.Ot �a°'" : TANK GPM FL FL SEPARATION DISTANCES ❑ Septic ❑ Holding ® S.T.E.P. then To From Septic Tank Absorption Feld Lin Station Holding Tank PublictPrivat Sewer Line 'a'"•r t, Anchorage Tank 14 1250c.1. Wait 100'+ 100'+ NA NA 25'+ S1t 2 Steel c s,naaew.W 100'+ 100'+ NA NA LI TATION Wute 5'+ 10'+ NA NA 1250 «a.w: 5'+ 10'+ NA NA •P""'P '"" M: 'Pump Or level al. nm High water alaOL Fowdatbn ti. in in. NA e50'+ NA NA Pump a MWeI EbcarN thepxme pena'nwd by cute., Drain * 'non none known BENCH MARK Liftstation Integrity verified and alarm and cycles tested Lorew, era Deeap": Top of manhole cover •LBt Station 100 FL Engineer's 1\\mp OF ALgII �E •• h ,r ••. fy f� Inspections performed by: KND Engineering Dates: 1' 5/2612001 % *; 9Ih 2nd 5/28/2001 . •ti «» ... • Development Services Department Approval Kenneth Uf Reviewed by: Date: 5,31'0 , .;����' fF''ee .����.� and approved AS-BUILT SYSTEM DETAILS/SITE PLAN Permit SWO10131 ROBINDALE S/D, BLOCK 1, LOT 4 PID0051-052-49 9-7'8 IOW WELL RNR US SLOPE = FLAT 4 K D A DRIVE E TING FCO HX KND9�- NEW SYSTEM EXISTING R 3 BDRM MT HOUSE E TER B EXISTING 1230 EXI$i1N rSTEM STEP TNN' HX 'N094-02 L00' WELL RADIUS SCALE: 1 = 50' W 00. Arm[ RCft IT nfl 1 IWITOk TUB[ FINAL GRADE ,annw Tu 01.5 IRKI /At•K / �~'� vYttt A-C=147.4' 1250 GAL B-C=155.5'S.T.E.P. A-D=210.6' TANK O (EXISTING) SEVER ROCK B-D=211.9' g6. 4 96.6 Ts• OF Lqs 1 PREPARED FOR: /�`;.•'• 1 �.jjA��. 9 �'49 BONNIE KING 22611 ROBINSON RD. 88.6 n �,�,,,_k,� PETERS CREEK, AK 99567 / SCALE- NTS 447:��?V (907) 688-2276iB��VY5I flELO BOOKS cww+co:Eb 1R1�1......__........ ENGINEERING CE-711`r Baro we DRAW V LY! ��� / ' ••..•• ................. .. / _ voc symA _ To<«TD: KMp 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 1 per,,` Asimp.. - GAR:5/30/01 o.c. ru: CIO. NW7561 ._... .._... _._...... ...... :.................:..: 01039.DWG '0° "" 01039 (907)696-6111/FAX (907)696-8111 5-26—o/ / �',vAu,, MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permlt Number: SWO10131 Legal Description: ROBINDALE #1 BLK 1 LT 4 Date Issued: May 25, 2001 Expiration Date: May 25, 2002 Parcel ID: 051-052-49 Design Engineer: 0070 KND Engineering Site Address: 022611 ROBINSON RD Owner Name: LISA DAWN KNIGHTEN Lot Size: 48573 SO. FT. Owner Address: 22611 ROBINSON ROAD Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567-5535 This permit is for the construction of., R Disposal Field F� Septic Tank Holding Tank ❑ Privy ❑ Private Well E] 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 (1 BAAC80 ). 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 fora 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: '--- 2 ef --O/ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. D$/ -05o? -119 Permit NumberSWO/Ol3/ Property Day phone log$ -Sy/9 Mailing address (1) 97(0// Kb 10t wy"q� hrxc_P Mailing address (2) 0_4,tt4l ahl Ad< Zip Code 99,516 7- 3535 Legal description (Lot, Block & Sub'd.) L y Rfk �oiac c1da- e, Legal description (Section, Township & Range) Lot Size q4 7-5L� /Sq.Ft. Number of Bedrooms —TS73 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. (Signature of properffAner or authorized Permit Fees: 1� 3Z0. OL7 Waiver Fees: Date of Payment: ��� Date of Payment: Receipt Number: Receipt Number: (Rev. 12100) ITM ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 May 15, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Sewer Upgrade — Robindale #1 blk 1, lot 4 Gentlemen: The owner has requested we proceed forward to obtain a septic permit to upgrade the existing septic system for the subject lot. The integrity of the existing lift station will be investigated during construction to assure that it is in accordance with municipal standards. We will utilize the existing testhole information for the proposed system. The results of this test is attached. The general slope of this lot is flat. We have designed our system utilizing the testhole excavated on 5/13/94 for the 3 - bedroom house. The lot is served by an individual well. We propose to install a pressurized bed system. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, END Engineering Kenneth M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PL0 R❑BINDALE S/D, BLOCK 1, LOT 4 PRESSURIZED DISTRIBUTI❑N SYSTEM HOLE SPACING DESIGN Ta PUSLM WELLS WITHIN ew or PROPOSED SYSTEM WO PRIVATE WELLS WITHIN 200. Or PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WIrMIN 200• Or PROPOSED YELL EXCEPT AS MOTED. ►—_� ���..°F..l�4 1 KENNETH 1(. DU IF 11 `• cE-nlB A: 'O - �sss1DN�� ► 1. RESIDUAL HEAD - 5' 2. HOLE SIZE = 3/16' = 1.00 GAL. PER HOLE E 30 PSI 3. 30 GALS (PUMP DELIVERY)/1.00 GALS./HOLE = 30 HOLES 4. 138 LF LATERAL + 30 HOLES = 4.60' SPACING PER HOLE 5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS. 6. HOLES AT END OF LATERAL SHALL BE CONST. W/O CAPS AND PLACED DOWN. 7. CONTRACTOR SHALL USE 1 1/4' PVC FROM TANK TO FIELD AND IN FIELD. DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/0.4 GPD PER SO. FT. (22.8 MIN/IN.)= 1125 SO. FT (562.5/15'(W)) = 75.0 FT. BED USE BED - 75 (L) X 15' (W) Total depth of system Is 3.0' from original grade. NOTES: 1. USE EXISTING 1250 S.T.E.P. TANK. INSULATE TANK IF (4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER 1F REQUIRED. PREPARED FOR: BONNIE KING 22611 ROBINSON RD. PETERS CREEK, AK 99567 (907) 688-2276 nEU) BOOKS STARNa — AmuLr: _ DIG, rLr. ACRO 1Lf: nT n 2n C DRAIN VaG ocoRn: KMO DATE' 5/15/ OXa NW156 JOB N": 01039 Scale: 1'= 100' PAGE 1 OF 2 ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 WASTEWATER DISP❑SAL SYSTEM DETAILS R❑BINDALE S/D, BLOCK 1, LOT 4 . F 9S * '';t9 T *' CE -7116 '� �� •. ww AV ........Ay�op`' �EsstDN= PREPARED FOR: BONNIE KING 22611 ROBINSON RD. PETERS CREEK. AK 99567 (907) 688-2276 FIELD BOOKS touwrzo: lDIMDMh DAA DH[om KMO ASBYIf: _ DATE 1 D.c mt: cm NW15f Am `01 039.DWG Joe Ds: 01039 Scale: I'= 20' PAGE 2 OF 3 Lbil.111111 ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 1 Municipality of Anchorage Page I of Z 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%94-0125 PID Number: Name: John & Karol Kolehmainen Wastewater System: klxNew ❑ Upgrade Address: 310 N. Harriette StreetFwassilla ABSORPTION FIELD Phone'. 688-22 76 No. of Bedrooms: 3 O Deep Trench ❑Shallow Trench Had ❑Mound ❑Other LEGAL DESCRIPTION Soil Ralm b.4 Total Depth from ori inal grade varies -5.21 GPD/S' Ft Lot. Block: Subdivision: Depth to pipe bollom from original grade Gravel depth beneath pipe 4 1 Robindale varies 3.5-4.7 Ft 0.5' Ft Township: 15 Range: IW I Section: 3 Fill addedabeova original grade: Gra jTpgth: FI FI WELL: ❑ New ❑ Upgra Gravel width: 15-16' Number of lines: 2 Distance between lines: 7.5 Ft Ft Classification (Private. A.B.C): Tota n: Cased To: rotal absorption area: Pipe material: Ft. Ft. 1125 s2- Ft D3034 sch 40 vvc Driller: Date Drilled: Static Water Level. Installer: Date installed: Ft. held. Pump Set at: Casing Height Above Ground. TAN K GPM Ft FI. SEPARATION DISTANCES ❑Septic ❑Holding E.P. To Septic Absorption 411 Holding vblNPnvale Ma{�7UfaefureC apaClty in gallons: From Tank Fiero Station Tank sewer lines �CPM.C.© t 12S'a Well 117 102 16.5 Material: Cmsrt�D Number of Compartments: A Surface Water 100+ 100+ 100+ LIFT STATION Lot 11 13 24 Size in gallons: Manufacturer: Line Foundation 112 86 - "Pump on" level at: 28" "Pump oll" level at: 22" High water alarm at: 3411 Curtain Pump Make & Model Electrical Inspections performed b Drain 100+ 100+ 100+ 2t?I.t 0 ->zt'�l- 4�cc.`1ttx�o'L RemarkS: BENCH MARK system with design and permit. System - Loddon and Description: „ , Top of back porch @ Sider door 76'1. Connected to 4" CI line from tank. Assumed Elevation: 100.0 EN, lWRIKtSEAL _ e OF�AL,q�t)©U v�CQS� 0 y f .�, •ati �oo Inspections performed by: xM0 Dates: 1st 5/14 a « N..........»....... 5/16 .. 2nd i t i Karl M. Du W F • �,% C 7114 Department of He t and Hu Services�o0a�l�7 OQ� yFo�a�N/s•Y.���-� Reviewed by: Date: 4�Oo�od�;o�.4 and approved 22-013 (Rev. 9/91) MOA 25 WASTEWATER AS -BUILT PAGE 2 OF 2 LOT 4 BLOCK 1 ROBINDALE SUB PEP.MIT SW940125 PID # 051-052-49 A 196.0 .rtA D 119.0 two Rlbr ca C 186.0 D 96.0 tarn nRrrr . ct F RwN+t ILen rAL IIIMRW9 TAYr r rrlrm. ry r YN 7 n rmn Irrrr WA&F I- p' 1015 lot b /0I.8 109.1�OGIGINAL AND FINISHED GPAIX Y RD IMM. rmt. rArrc DYLR mot rrcL! 99.I BOTTOM Of PIPE F CL W 2' PVC � t II=F- 97.9 96 0= 96.7 96.0 Q 2 d 121. GAL LIFT STATIUI 83.5 HEASIK'CD GPOWD WATER 87.I BOTTOM OF TEST HOLE 90.0 MRtfgn ORLq OF Z4 \. /' p IRAUFRM � .fJ, e1 II�rR Mfr r er! A * 49 IU } II 0• ,/ /IL/M ILIRC I LY•In`/i u•'RasR u'gnr 1� KENNl171 D 4� J04 41 7118 Nk NORTUSTAR ELECTRIC COMPANY May 180 1994 Anderson Brothers Construction P. o. Boa 770129 Eagle River, AK 99577 Attn: Ken Dear Ken, Northstar Electric Company has Bono the electrical wiring to a newly installed sewage lift station and alarm at 22611 •Robinson (Lot 4. BlocX 1, Robindale Subdivision, Addition 1), Peters Creek, Alaska. The wiring has been done in accordance with the 1993 National Electrical Code. Alaska State Contractor License # AA 17485 Sincerely, Linda C. Boone LCB/ld ' , if PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE 1�M DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940125 DATE ISSUED: 5/13/94 DESIGN ENGINEER:KND ENGINEERING EXPIRATION DATE: 5/13/95 OWNER NAME:KOLEHMAINEN JOHN G & OWNER ADDRESS:22611 ROBINSON RD CHUGIAK, AK 99567 PARCEL ID:05105249 LEGAL DESCRIPTION: ROBINDALE #1 BLK 1 IT LOT SIZE: 48750 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: Y• DATE: S /3 �" -� DATE 1tOd V D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11 On -Site Services DHHS 825 L Street Anchorage, AK 99501 Dear Sin: REF: Lot 4, Blk 1, Robindale Subd. Addn #1 Attached is our request for an on-site sewer permit for the above lot. May 12,1994 This lot is serviced by both on-site water and sewer. During the process of certifying the systems it was determined that the septic system was in failure. We are therefore submitting a request for approval of a new on-site septic system. As shown on the site plan, there are no conflicts with existing on-site sewer systems or with potential reserve areas. This lot is relatively flat, as illustrated on the soils log. The natural slope will provide positive drainage away from the proposed absorption site. Due to the relatively flat slope, elevations illustrated on the soils logs and design details and the water encountered in one of the monitoring tubes it has been determined that a lift station will be required. There is no surface water within 150 feet of any portion of the proposed installation. The design is based upon testing and percolation data performed on May 5th. At that time, no water was encountered. Two monitoring tubes were installed and during field inspections of May 10th through May 12th water was observed at approximately 2'11" deep in test hole #1. Based on the water table encountered, the time of year and the relatively flat grade we have proposed a bed design in keeping with the requested 15' maximum width. Thank you for your consideration of this request. If there are any questions, please call me at 694-2359. Sincerely, Kenneth M. Duffus, E. KND Engineering Attachments: On -Site Sewer Application Wastewater Absorption System Details Site Plan Soils Log/Percolation Tests w a 0 J N N u >w 0. . o V S DESIGN DETAILS WASTEWATER ABSORPTION SYSTEM LOT 4'BLOCK I ROBINDALE SUB ADDN 01 1250 GAL LIFT STATION 75 InM 5' MIN In 69 LF 1 1/4' PVC WITH 3/16 In 1. HOLES @ 4.6' SPACING 2' PVC FROM TAiTv CAP ENDS OF PIPES TO FIELD 3 T 3 2' MANIFOLD ri PRESSURIZED DISTRIBUTION SYSTEM HOLE SPACING DESIGN 1. RESIDUAL HEAD = 5' 2. HOLE SIZE = 3/16' = 1.00 GAL PER HOLE @ 30 PSI 3. 30 GALS (PUMP DELIVERY) * 1.00 GALS/HOLE = 30 HOLES 4. 138 LF LATERAL � 30 HOLES = 4.60' PER HOLE SPACING e FINISHED GRADE TO BE A NINIHUN OE 2' ABOVE 2' HD INSULATION. GRADE TO PROVIDE POSITIVE .. r NT PVC IZSO GAL LITT STATION 15' MIN 4®w�\ ® `SOFA q® L s 1 v� �- 1 * 491I*\,1a �',( �*, �0 f` KENNETH DI FFL19 i eCE -911J 4v 0' CS310NAL s �OwaP ILTLT IAPIf Dvvp MwmC TML, O+IGDIAL GRADE '7 MEASURED GPWiD WATER DESIGN CRITERIA: 3 BEDROOMS x 150 GAL/DAY/BEDROOM = 450 GPD SOILS RATING: 22.8 MIN/INCH = 0.4GPD/SF (BED) 450 GPD - 0.4 GPD/SF = 1125 SF ABSORPTION AREA USING BED DESIGN, 1125 SF MINIMUM AREA 1125 SF � 15' W = 75' L DESIGN MINIMUM SIZE 15' W x 75' LONG BED 2' HD INSULATION REQUIRED OVER, FIELD SEPTIC TANK REQUIRES 2' HD INSULATION JOHN/KAROL KOLEHMAINEN 310 N HARRIETTE STREET WASILLA, AK, 99654-7627 KND ENGINEERING 22041 PTARMIGAN DR EAGLE RIVER, AK, 99577 Z-0501 WR SITE PLAN WASTEWATER ABSORPTION SYSTEM LOT 4 BLOCK 1 ROBINDALE SUB ADDN 41 C3 0 CC 4 I N' z w EC 5 SEPTIC L__ __J 2 SEPTIC , EXISTING VELI 3 EXISTII��! SEPTIC TANK TO BE PROPE Y ABANDONED. EXISTING I FP`jjff lON FIELDS TO BE ABANDONED P'N E EXISTING WELL . •� . • Q' TEST w GP.OUND SUR ACE EtrV d PP PO ED 15'W x 75'L x 3'D I SOP TION BED I250 1 PPESStPIZEO LIFT STATIm1 EMS TING "ELL 5 I 10 - - - - J - SEPTIC- - - I SEPTIC 0 OF ALA �� e /KENNMI DUFFVS CE -7118 <a' 1FESSIONA� AV 0®w'ew LOT SIZE: LESS: PERIMETER HOUSE FOOTPRINT TOTAL AREA AVAILABLE FOR ABSORPTION SYSTEM 'REPARED FOR: JOHN/KAROL KOLEHNAINEN 310 N HARRIETTE STREET WASILLA, AK, 99654-7627 48,750 SF 32,600 SF 16,150 SF KND ENGINEERING 22041 PTARMIGAN DR EAGLE RIVER, AK, 99577 694-2359 DATES 5-13-94 DPAWING N SCALE- 1' . 100• 194-S1-0501 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ��ti Ik2•o1 �jai2�N DATE PER " V1 LEGAL DESCRIPTION: L4 131 CJI rn a2k.— Township, Range, Section: N E'/4 5 3'1"I5N R1 W DEVTrI SLOPE SITE PLAN (FEET1 Org ��.u, 7P4 3Sil4y Sana, 5oer,a �-*ne 1�.1enS 4 (<.A,l Sana 5 Pett 13o L t [: 7 $ ML �Ha, �1pzr s 10 WAS GROUND WATER ENCOUNTERED? N•t ORI bINM� EyGIi�/.T0^1 S 11 �� IF YES, AT WHAT LO 12 DEPTH? P 7 jr E Ot11 toWer IUte ' 13 Monititwinp? DateS 294 14- 15- 16- 17- 18- 19- 20- COMMENTS 4151617181920COMMENTS Lo L" PERFORMED BY: ACCORDANCE WITH ALL STATE ANC 72-008 (Rev. 4185) F.1 ==mmm ��. PERCOLATION RATE —Z7-8 (minutevmcn) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND 4 FT S_I%^9A .,. Tex CERTIFY T T THIS T T WAS PERFORMED IN MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: S_��/,57 „lam' T ��. PERCOLATION RATE —Z7-8 (minutevmcn) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND 4 FT S_I%^9A .,. Tex CERTIFY T T THIS T T WAS PERFORMED IN MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: S_��/,57 „lam' T PERFC LEGAI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 TEST RUN BETWEEN 15 FT AND 4- FT COMMENTS PERFORMED BY: I I'l Is& CERTIFY THAT /THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / 72-008 (Rev. 4/85) I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 1 �� ENVIRONMENTAL ENGINEERING DIVISION - ' / 825 L Street -Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ONEW O _01 r CrN N F 471 1 1 VNUPGRADE MAILING ADDRESS Q Zo >f - E ! 1 �. LEGAL DESCRIPTION *1 -9 Po c. LOCATION NO. OF BEDROOMS r L DISTANCE TO: Well Absorption area Dwelling PEHMIT NO. VY . E Manufacturer Material No. of compartments w- V' Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth 6Y DISTANCE TO: Well Dwelli g PERMIT NO. _2 F Manufacturer Material Liquid capacity in gallons = DISTANCE TO: Well Y f Foundation / 135- Nearest lot line /� PERMIT NO 7� _ijZ No. of lines Length of ea c lin t Total length o lin Y+ Trench widtp, __ Distance betwe W inches yi H Top of tole to finish grade / Material beneath tile �� p Inch Total of festive a sorr'po area bb Length Width pth PERMIT NO. W t7 a H W d Type of crib Crib diameter 4foundation ri depth Total effective absorption area t" to DISTANCE TO: Well Wldiny Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J 3 DISTANCE TO: Building foun ,ion w r li Septic tank Absorption area(s) OTHER S S y r . la PIPE MATERIALS SOIL TEST RATI NG bk S x Y INSTALLER REMARKS U p y` OF a r � r • Ac 9 A. •ShaMr • tof•ert 137-E1v f_.a_No rej••.»...••�P�t`M�e 74 OFfSS�� �pRIT— U AP tOV DATE LEGAL 1w!y^ SRB Y96X / 0!264-0 £� TI ,C ,; PH927 2 13 (Rev. 3178) MU" I C I F --RL I TY OF f 74 " C FACQFZn0E � H DEPARTMENT ERLTH AND ENVIRONMENTAL ROTECTION 825 STREET, ANCHORAGE, AK. 9901 264-4720 Or -t -SITE SEWER PERMIT PERMIT NO. C 820834 > APPLICANT NORMAN STENNETT %S&S ENG SRS 196 99577 694-2979 LOCATION LEGAL L481 ROBINDALE #1 LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF.,BEDROOMS SOIL RATING (SO FT/BR)= '150 THE REQUIRED SIZE•`OF THE S2 ABSORPTION SYSTEM IS: E>EF}TH= S LENGTH-�? (3FznvEL C+EF}TH= 4 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE' GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). REQU I REE> SEPTIC TFiNK 'S IME= 1 (D 00 t3FiL_L-ONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. c. I rJSF}ECT I ONS 1=1RE REQU I RED> --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SE14ER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER, REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION._. F}ERM I T EXP' I RES OECEMESER M1. 1 +82 I CERTIFY THAT - 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY -THE MUNICIPALITY OF ANCHORAGE. -2: I !JILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON-SITE SE14ER SYSTEM MAY REQUIRE ENLARGEM T-IF"THE, RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. � r �, MUN I C: I F nL_ I TY C7F FiNl=HpFZn0E DEPARTMENT f^ HEALTH AND ENVIRONMENTAL OTECTION 825 'L STREET, ANCHORAGE, AK. 99bd1 264-4720 0r4—S I TE SEWER F}ERM I T PERMIT NO. C 820834 ) U APPLICANT NORMAN STENNETT/.S&S ENG SRB 196 99577 694-2979 LOCATION LEGAL L481 ROBINDALE N1 LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING <SO FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C+EF�*TH= 8 LEtJC3TH= 5'7 C3FZF=l VEL DEPTH= 4 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION <IN FEET). REGllJ I REO SEF=T I C -rn"K S I ZE= C3nL_LC}NS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TWCI <2 ] I fVSPEC3T I C}tVS FIRE FZaQU I REF? BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'ERt7I T EXF=* I RES CrEC3EMF3ER 31. 1982 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. r A f 1 SIGNED ISSUED L=_ 3E3' V4. 0 r� r MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG — PERCOLATION TEST y" SOILS LOG O PERCOLATION TEST PERFORMED FOR: ////,) rRze,-z J 7-101411e, DATE PERFORMED: L • i i� ;/18z. LEGAL DESCRIPTION: L j31 DEPTH Oh&..gw 1 r 0, REI) 311—Ty 54ftln 2 i S LJ 3 -tea Net Time Depth to Water Net Drop Ly 7 f! .2.8 bY _1D 9 d TrLy .l 10- 11 Or� 12 13- 3141516 14- 15- 16- or r 17 P4 18 1 19 20 6drAVF,L —5,ANb 1 L.IVPT siq 15-0 6113M WAS GROUND WATER ENCOUNTERED? 'PO'R')M L) HOLE'IF YES, AT WHAT DEPTH? i men ••t. .. r Ne Vr r go.. _ C+ ���a �F SSiC'•n���:" r fz _ PERFORMEDBY -I flus . 6: 72-008 (6/79) SLOPE SITE PLf N1 Is g MMINM!�J^MM■■IM■ .■■■■■■.■MENEM NOON. Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN FT I ED BY: DATE: GRE'"7ER ANCHORAGE AREA BO'"''UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME�/ ���� ��nlw MAILING ADDRESSPH0NE���'�'>'= fl ..t-c`ES.�✓i'..�LF/'a'd—C/.�/�.'✓117. crr' LOCATION LEGAL DESCRIPTION /-��� SEPTIC TANK: DISTANCE i NUMBER OF FROM WELL 2P MANUFACTURER ��/V/'%��'y MATERIAL COMPARTMENTSI''�� INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY L-_/ GALLONS. SEEPAGE PIT: T•Cc�C%l NUMBER OF PITS DIAMETER = LINING MATERIAL 7/il CRIB SIZE: OR WIDTH/ LENGTH_, DEPTH DIAMETER =DEPTH % DISTANCE FROM: WELL 12-' I TOTAL EFFECTIVE ����-'%r• BUILDING FOUNDATION, NEAREST LOT LINES . ABSORPTION AREA (WALL AREA) 7n�1 SQ. FT. ADDITIONAL ABSORPTION WELL - TYPE ELL: TYPEI�`Ol/`� CONSTRUCTION ���r`/�/✓/<<%'� DEPTH �-r�r DISTANCE FROM: BUILDING / 'f' NEAREST i �D NEAREST �`'�• �� `�� SEPTIC . SEEPAGE X00 i-- FOUNDATION LOT LINE SEWER LINE TANK SYSTEM CESSPOOL1✓&,-I J , OTHER SOURCES -��/�'1.e611101 0-11&/ . APPROVED DISAPPROVED REMARKS DISTANCES: If /o /1 r DIAGRAM OF SYSTEM INSTALLED BY: ,EkCA V/�17/•✓ — C/f< iiia,.. z PIPE MATERIAL: .4/ LOT SLOPE: REMARKS: DATE Fwm No. EQ -031 APPROVED G.A.A.B. GRE/0�'-R ANCHORAGE AREA BOI1�UGH 4 DEPARTMENT OF ENVIRONMENTAL QUALITY 5550 "C" STREET ANCHORAGE, ALASKA 99505 TELEPHONE 274.4561 ,w,...• J r SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT MAILING ADDRESS 't;%or PERMIT NO. Tw"L.J'd 976e PHONE 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 r1C--=!= I 1/ TYPE r(117t'E -'orf SEEPAGE AREA SIZE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT OL (I DRAIN FIELD �e J ' SEPTIC TANK TO SEEPAGE PIT WALL am• ' "�/� ete rX �~ e /- y 02 SEPTIC TANK SEEPAGE PIT `�" n DRAIN FIELD KI AQ, TO NEAREST LOT LINE. IL WELL TO SEPTIC TANK / LT _L SEEPAGE PIT DRAIN FIELD./ -=: ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD 1`n SEPTIC TANK. . SEEPAGE PIT DRAIN FIELD L 4:zi TO RIVER, LAKE, STREAM. +�L_1 CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION B FEET INTO UNDISTURBED SOIL. C 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. ,SC 're c- A-e�fiC 19v E I/ve f VAR -e GRAVEL BACKFILL J-�i, a �� CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. c OR LICENSED DESIGNER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE'/ APPLICANT'S SIGNATURE FORM NO. EO -014 TYPE DIAGRAM OF SYSTEM mom .■ N:O ■■■� .. ■MEN ■■ p- 22'12' EM1mmmmMSF u� MEMO oil INSTALLATION LOCATION nii im EMEME iiMEN o . ME X / y— EMINME..■ras ■■■■■■ C�::C:::::::: LEGAL DESCRIPTION < ..uEMMME ........si OTHER INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD TYPE AND SIZE OF FACILITY TO BE SERVED -- - / FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS "` 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 r1C--=!= I 1/ TYPE r(117t'E -'orf SEEPAGE AREA SIZE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT OL (I DRAIN FIELD �e J ' SEPTIC TANK TO SEEPAGE PIT WALL am• ' "�/� ete rX �~ e /- y 02 SEPTIC TANK SEEPAGE PIT `�" n DRAIN FIELD KI AQ, TO NEAREST LOT LINE. IL WELL TO SEPTIC TANK / LT _L SEEPAGE PIT DRAIN FIELD./ -=: ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD 1`n SEPTIC TANK. . SEEPAGE PIT DRAIN FIELD L 4:zi TO RIVER, LAKE, STREAM. +�L_1 CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION B FEET INTO UNDISTURBED SOIL. C 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. ,SC 're c- A-e�fiC 19v E I/ve f VAR -e GRAVEL BACKFILL J-�i, a �� CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. c OR LICENSED DESIGNER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE'/ APPLICANT'S SIGNATURE FORM NO. EO -014 TYPE DIAGRAM OF SYSTEM mom .■ N:O ■■■� .. ■MEN ■■ SEEN�mom EM1mmmmMSF u� MEMO oil �i nii im EMEME iiMEN o . ME EMINME..■ras ■■■■■■ C�::C:::::::: ..uEMMME ........si IUdH ORDINANCE NO. 28.60 AND THAT THE ABOVE Performed for l Legal Descript5i / y This form reports: Soils GREATER ANCHORAGE AREA BOROlV�Lk Department of Environmental Q% ity 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - PEROLATION TEST Depth Feet 2- 3- n- ` 6 7- s- 9- 10 - 11 - 12 - 13 - 14 - S10Ae on Was ground water encountered? _ If yes, at what depth? Date Performed G o?6 75 Reading Date Gross Time Net Time Depth to Water Net Drop Percolation rate minute. Proposed installation: Seepage Pit Drain Field Depth of Inlet _ Depth to bottom of pit or trench COMENTS: — -------------------- ---- —------------ Performed Dy:'t, J.oJeeeCcrtifled By L•'Q-040 (6/74) -Municipality of Anchorage Development Services Department • �' Building Safety Division Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onshe (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. COSA# nrni?� 1. GENERAL INFORMATION Expiration Date: (o 0 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ROBINDALE SUBDIVISION #1• LOT 4. BLOCK 1. 22611 ROBINSON ROAD • CHUGIAK. AK 99567 ' DEAN GOROSKI Day phone c/o AGENT 22611 ROBINSON ROAD • CHUGIAK. AK 99567 Day phone RANEY HARDMAN w/ REMAX PROPERTIES Dayphone 694-4235 16600 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER 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. 1 further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of Installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LfD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & 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 the operational requirements of the ADEC or MOA DSO. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or parry is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE VApproved for bedrooms. Disapproved. 337-6179 Date 3 Z ° /b? - Conditional approval for bedrooms, with the fllowing stipulations: ON-SITE WATER AND WASTEWATER PROGRAM Attachments: COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Reort Nitrate Advisory Other By. Original Certificate Date: 3-30-D7 (Rev. 11AS) Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water 6 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6M www.muni.orglonstte (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: ROBINDALE SUBDIVISION 1)1: LOT 4, BLOCK 1, Parcel lD: 0.3" 1 " 0 5' 2- yt? A. WELL DATA *BASED UPON SURROUNDING WELL LOGS. SEE ATTACHED LOGS. Well type PRIVATE If A, B, or C provide PWSiD# N A Well Log (YM) NO Date completed 1977 Sanitary seal (YIN) YES Wires properly protected (YM) YES Total depth 149+ ft. Cased to '40'+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 3/6/2007 Static water level ft. 149 ft. Well production g.p.m. 5.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 2.18 mgJL. Other bacteria 0 oolonies/100 mi. Arsenic: N_ ug./L. Date of sample: 3/6/2007 Collected by: GEG. Ltd B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/S.T.E.P. Date installed 5/14-16/1994 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cieanout (YM) YES Depression over tank (YM) NO High water alarm (YIN) YES Date of pumping 11/28/2006 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed 5/26-26/2001 Soil rating .p.d. or ft'/bdmr) 0_4 System type BED Length 75 ft. Width 15 ft. Gravel below pipe 0.5 ft. Total depth "5.9-4.3 ft. Eff. absorption area 1125 ft' Monitoring tube YES Depression over field NO Date of adequacy test 3/6/2007 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 669 gal. New depth 2_5 in. Elapsed Time: 180 min. Final fluid depth DRY in. Absorption rate >- 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - MONITORING TUBE AT EAST END OF 1994 PIPE NOT FOUND. D. LIFT STATION Date installed 5/14-16/94 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at 28 in. "Pump off" level at 22 in. High water alarm level at 34 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO *PER 1994 INSPECTION REPORT. Septic tankAl t station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line '16.5' Public sewer manhole/cleanout N/A Holding tank Animal containment areas 42, Manureianimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line t G'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION, 1 certify that I have determined through field kkVecdons and Vh r�Jy. review of Municipal records that the above systems are in .••••••• conformance with MOA COSA guidelines in effect on thisdate. ess: Engineer's Printed Name JEFFREY A. GARNESS 795 Date 3I2o/o9' ,..__. 0 COSA Fee S 1-12(). O Date of Payment cam%_ (07 Receipt Number L % 1 -7 (Rw. 11!05) Waiver Fee $ Date of Payment Receipt Number GARNESS ENGINEERING GROUP, Ltd. - CONSULTANTS B GENERAL CONTRACTORS March 30, 2007 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Waiver Request for Robindale Subdivision #1; Lot 4, Block 1, To whom it may concern: During our site visit in order to obtain a COSA from your department we noted that the sewer service line is approximately 16.5 feet from the well and that the well is approximately 42 feet from the nearest point of the horse corral. The separation distance from the well to the sewer service line was noted at 16.5 feet on the 1994 inspection report by Ken Duffas P.E. We also request a 42 foot waiver from the well to the horse corral. The lot is fairly flat in the area of the well and horse corral. Recent water sample results indicated nitrate levels of 2.18 mg./L and coliform bacteria results were undetected. These encroachments have existed for approximately 13 years with no adverse impacts to the referenced well. We are unaware of any adverse impacts these waivers would have on referenced well. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. WAIVERFEE: 3 3o p PAYMENT DATE: RECEIPT #: 9� D 3701 E. Tudor Road, Suite 101 ' Anchorage. AK 99507-1259 Ph: (907) 337-6179' Far: (907) 338-3246' Website: www.gamcsscngincering.com e 15-2007 17:20 From: 9076944214 70:9073383246 P.1�1 ■f we ■ IAT 4 BLACK 1 HAS 48,573 SQ.FT. OF AREA FOR: REMAX EAGLE RIVER"' 2-9-07 Iw = 50' ASM ILT Lot 4 ^ of " ICS Grid rrt,•«ner • JI..•-rv. me NW 1561 270028 ROBINDALE I ( I 9730 vaeuud Drire. Suit.: gds SUBDIVISION prawn Dy Y A,0% e, Alaska 99507 t9o�l 552-6050 DIID 228 S89.55'24'w 300.02 1 hereby certify thin the property described hereon IIaa been surveyed that the improvements situated lDereoh I'll Dy me, or at my direction, and or encroach on the ` ,` .�•,,, •.•s��, ,r •• . a _. _n. - �.,-.ter— a `-4 —.��._ n r _�_l,��[(►VT' .V • 00 *; !19 � •••/ .... ........ .... llac• of otDer ese•meats oD said properly CYCCpt as show . —.- w000 rtnc_ der, prior to conetructioa. It is the res onefbllit of file owucr or builder. to tint"h and utility ATM FEMCE to verify proposed building grade relative grade and to determine the existence of say easements. covenants. �•,� LS -7326 or restriction" which do not appear on the recorded subdivision plat. •� . : p`� Listed diatanees prevail over scaling. g Reproduction may cause distortion. �� Sime Frm:r e'CU cOYFRD A du.Fl �-- Ira - •. .•i (Ol EP'D w z 3 "re SnEL rME — 3 ti~ ,. _ c7NJfm — Strnc Lr) ' DECK !z p o'; n3. C 1- R Jf. •` VMCOYLIQU sFenc— 17Yf. SCiTG—.� ti tI.- f ri. —.' MOOD MCE P a• -TM TCC ��; r wualLtr;— S89'55'24 -W 300.02 � � I GRAPHIC SCAM F Nen . 30 /stef 1 I 2760 6 25 do 100 FOR: REMAX EAGLE RIVER"' 2-9-07 Iw = 50' ASM ILT Lot 4 Block I LanAfsa Grid rrt,•«ner • JI..•-rv. me NW 1561 270028 ROBINDALE 9730 vaeuud Drire. Suit.: gds SUBDIVISION prawn Dy Field Book A,0% e, Alaska 99507 t9o�l 552-6050 DIID 228 NO. 1 1 hereby certify thin the property described hereon IIaa been surveyed that the improvements situated lDereoh 'tee OF \11 ;q �,Q Dy me, or at my direction, and or encroach on the ` ,` .�•,,, •.•s��, oro within the property lines and do not overlap A �P'• property lying adjaeent thereto unless otherwise shown. That no thereto encroach on the r _�_l,��[(►VT' .V improvements on the property lying adjacent premises in question and that there are $10 roadways. transmission 00 *; !19 � •••/ .... ........ .... llac• of otDer ese•meats oD said properly CYCCpt as show . /••••• j der, prior to conetructioa. It is the res onefbllit of file owucr or builder. to tint"h and utility .. ............................. ,o , 00m �, CHARLES E. FORBES 6-00connection• to verify proposed building grade relative grade and to determine the existence of say easements. covenants. �•,� LS -7326 or restriction" which do not appear on the recorded subdivision plat. •� . : p`� Listed diatanees prevail over scaling. 0, °h ��Pta/�•�•�a\�°�� IrSi05 Reproduction may cause distortion. �� Municipality of Anchorage f10, Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051.052.49 HAA # y A O / Expiration Date: 1. GENERAL INFORMATION Complete legal descriptiori' Robindate #1. Block 1. Lot 4 Location (site address or directions) 22611 Robinson Rd., Chugiak. AK 99567 Current Property owner(s) Lisa Knghten Day phone 688-5419 Mailing address 22611 Robinson Rd., Chuglak, AK 99567 Lending agency Mailing address Day phone Real Estate Agent Bonnie Kinn Day phone 688-2276 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) 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) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. 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 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 Health Authority 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 Firm KND Engineering Phone -696-6111 Address 20441 Ptarmigan Blvd., E.R.. AK 99577 Engineer's Printed Name Kenneth M. Duffus Date 05/30101 5. DSD SIGNATURE -Z' Approved for bedrooms. Disapproved. 4GINEER STAMP Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineers Report Well Flow Advisory Other By: �• Original Certificate Date: S 3 1- '6 P (Rev. 12=) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchomge.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type Q.d40I4 If A, B, or C provide PWSID # Date completed prlor to 1975 Sanitary seal (YM) Yea Total depth probed to 1W+ ILCased to 143ft. FROM WELL LOG Date of test Static water level ft. Well production g.p.m WATER SAMPLE RESULTS: Coliform .Qcolonies/100mi. NltrateyaLmg.A. B. SEPTIC/HOLDING TANK DATA Parcel ID: 051-052.49 Well Log (YM) No Wires property protected (Y/N) Xu Casing height (above ground) 30• AT INSPECTION 150 ft. 9.33 9 - p.m - Other bacteria.L colonies1100ml Date installed1!9_ Tank size 1250 gal. Number of Compartrnents 2 Cleanouts Y_ Foundation deanout 1r Depression over tank t LHigh water alarm Y0 Date of pumping 05129101 Pumper JFrs C. ABSORPTION FIELD DATA Date Installed QM=1 Soil rating (g.p.dAtr or fe/bdrm) RA System type Bed Length 75 R Width 15 ft. Gravel below pipe 0.9 ft. Total depth 4M ft. Eff. absorption area 1125 ft Monitoring tube Y Depression over field (� uta sysr Date of adequacy test 1tesufls (Pass/Fa0) _ 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. Any rejuvenation treatment (past 12 moa (YM & type) If yes, give date D. LIFT STATION Date installed 5116194 Size in gallonsIMManhole/Access (YIN) yes 'Pump on' level at _& In. 'Pump ofr level at -ZL In.Hlgh water alarm level agh In. Datum t gMm of tank Cycles tested 3 Meets alarm & circvO requiremems? In E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAlft station on lot 1001+ Absorption field on lot 100'+ Public sewer main 751+ Sewer /septic service line 251+ On adjacent lots _ 1001+ On adjacent lots 1001+ Public sewer manhola/deanout 1001+ Holding tank 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property One ,. J + Absorption field 5'+ Water main 101+ Water service line 10'+ Surface water 1001+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One 101+ Building foundation f0'+ Water main 101+ Water Service One 104 Surface water 1004 Driveway, parking►veNde storage '+ Curtain drain 50'+ Wells on adjacent k)ts '+ F. COMMENTS 0. ENGINEER'S CERTIFICATION i certify that I have determined through field inspections and review of Municipal records that the above systems are In conformance with MOA HAA guldetines in effect on this date. Engineer's Printed Name Kenneth M. Duffus Date 05130101 HAA Fee $300 Date of Payment S• r.0 - 0/ Receipt Number (Rev. 11100) Walver Fee $ Date of Payment Receipt Number S 1%0"d MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES. Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLINGc� Parcel I.D. ri 05105249 HAA a _E�.LROIL_L()ay 1. GENERAL INFORMATION Complete legal description Rnhindala 91 Rlnrk 1 I nt A Location (site address or directions) 22611 Robinson Road, Chugiak. AK Property owner John L Karol Kclehmainen Day phone 688-2276(agent) Mailing address 310 tl Harriette Street, Wasilla. AK 99654-7627 Lending agency Day phone Mailing address Agent Bonnie King Day phone 688-2276 Address Pn Rny F71q?1 rhttgiak AK ggS1;7 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 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. . 72-025(Rfv.1/91) Front MOA121 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 KND Engineering Phone 694-2359 Address Engineer's signature 6. DHHS/SIGNATURE v Approved for bedrooms. Disapproved. Conditional approval for Additional Comments 6y7o Date 51]7/94 bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes 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. rumsCw.wq 8. k Mwm ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Robi ndal a N1, Bl k 1, Lt 4 Parcell.D. 05105249 A. Well Data Well type Ind. It A, B, or C. attach ADEC letter. ADEC water system number Logpreserd(Y/N) N (p rinr 7s) Date completed Driller Totaldepth Probe to 160' + Cased to 143' Casingheight 2 1/2' Sanitary seal (YM) v Wires properly protected (Y/N) y FROM WELL LOG AT INSPECTION Date of test N/A 4/4 iia Static water level 143' rn P"7 Well flow g•p.m. 4 87 g•p•nm cc Pump levetl unknown -< 0 p SEPARATION DISTANCES FROM WELL TO: o O <c O T SeptiCfiolding tank on lot i n9' ; On adjacent lots l,pp' 4. 7 Absorption field on lot 117' ; On adjacent lots 100+ Public sewer main NST Public sewer manhole/cleanoutn Sewer service line 16.5' Petroleum tank N/A WATER SAMPLE RESULTS: Coliform None Detected Nitrate tZ.20 mg/1 Other bacteria Date of sample: 5/3/94 Collected by: KMD B. SEPTIC/HOLDING TANK DATA Date installed 5/16/94 Tank size 1250 total Compartments none detected Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (YIN) N High water alarm (YM) v Alarm tested (YM)m_(.,�L) Date of pumping New Pumper N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1102 On adjacent lots 100+ Foundation 86' To property line 13' Absorption field 11' Water matn/service line 102' Surface water/drainage inn'+ 72 -Mer M'From CONTINUED ON BACK PAGE C. LIFT STATION Date Installed S 1rInA Manufacturer Orenco Systems, Inc. Size in gallons S n n ( 17E;0 Tnt a l ) Manhole/Access (Y/N) y Vent (Y/N) N 'Pump on" level at 28" . '*pump otr Level at 22" High water alar level 3 4" Cycles tested ATe1 r Meets MOA electrical codes (YM) Y ( see attached letter ) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot 102' On adjacent lots 100'+ Surface water 1001+ D. ABSORPTION FIELD DATA Date installed 5/16/94 Soil rating(GPD/FtZ) 0.4 System type Length 75t' Width 1FGravel thickness 1• Total depth g_6. Total absorption area 1,125 s f Cleanout present (Y/N) N — press .Depression over field (Y/M N Date of adequacy test NCw Results (pass/fail) pia for Bedrooms Water ievetinabsorption field before test none Attertest Peroxide treatment (past 12 months) (YM) N/A If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1171 On adjacent lots 1001+ Property line 11' To building foundation 112' To existing or abandoned system on lot 50' On adjacent lots 1 (10 t+ Cutbank N,LA Water main/service line 33:71 Surface water N/A — 1001+ Driveway, parking/vehicle storage area 1001+ Curtain drain 1 n n $ + E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and NAA guidelines in effect onLtlg dat� of this inspection. OF 41. 'hzo Signature 4Z�4 . _ /Y a_ Gn71) Engineer's Name Kennet ff. Duffus Date HAA Fee $ Date of Payment Waiver Fee $ _ Date of Payment Receipt Number d�?,?I Receipt Number 72-M r M)• Back C�S .2 57/C7-1 Kenneth K C CE 7116 -7 —, Time APPLP" ANT FILLS OUT'UPPER HAL70NLY " .- Time Propertyowner PJpman Stinnett Poona ' SR 2 Box 7145 Mailing AddressOQ zIp code688-2062 Buyer Kenneth J. Mearkle 5 LaVon Mearkle Inspector P.O. Box 814 zip code 99567 Address Field Notes: (lam (.t,J.(�11,i1t; �„vw �� C. C)• d.VA.4k Lending Institution s 99567 National Bank of Alaska 1 n c�aC%9... men S^^^ — T Poona Address 301 West Northern Lights zip code 99503 Realty Co. d Agent Anchoragot, 99-503 ERA Finis Realty 6 Development Co Poona Nancy Jo Stahly zipcode 99567 Address � BY: Legal Description Robindale 81, Block 1, Lot 4 Street Location Corner of Robinson and Darlene Well To Absorption Area Well to Tank Type of Residence Well Log Received Z) Single Family 3 �^ ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply t) Individual ' AT WELL LOG. A well log Is required for all wells drilled since June 1975. ❑ Community For wells trilled prior to that date, give well depth (attach log If available). ❑ Public Utility Sewer Disposal 1975 *1 Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Hol0ing Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date �� / Date Date Date Inspector Inspector Inspector Inspector Field Notes: (lam (.t,J.(�11,i1t; �„vw �� C. C)• d.VA.4k — 1 n c�aC%9... men S^^^ — T z jlf ns�d Avc(3-Ave- nd��o,,• (3APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROV - O ^— DATE BY: Soils Rating Date Sewer Installed G —?- Well To Absorption Area Well to Tank Well Log Received Septic Tank Size �^ 72M1 R