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HomeMy WebLinkAboutHAMANN LT 13Hamann Lot 13 #050-621-12 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP121085 PID Number: 050-621-12 Dwelling: X Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New N Upgrade Name: Michael D & Laura A Bookout ABSORPTION FIELD ❑ Deep Trench MR Shallow Trench ❑ Bed ❑ Mound Address 24760 Eagle River Road ❑ other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 1.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe ]_ e.* sma 0.5 Ft. 0.5 Ft. Gti h Y1, Fill added above original grade Gravel length T15W6ship Range 3.0 Ft. 100.0 Ft. Gravel width 5.0 Ft. Beds: Number of Lines N/A Distance between lines I N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 500.0 Fe 2 14.6 Ft. Well 130.2 139.6 N/A N/A 61.2 TANK O Septic [:1S.T.E.P. ❑ Holding E] Other Manufacturer Anchorage Tank Capacity 1250 Gal. Surface Water 100+ 100+N/A NIA Material Steel Number of compartments 2 Lot Line 74.8 16.9 N/A N/ANA Foundation 68.3 83.3 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain N/A N/A N/A N/A Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPEMATERIAL HousetotankPVCTanktoPVC drainfield Installer JR's Septic Pumping Drainfield PVC CO/MT Inspector Pannone Engineering Services BENCHMARK (Assumed elevation)100 ft Inspdatesn 1d 6/8/12 6/8/12 Location and description 2w 306/9/12 4'" 6/9/12 Threshold of shed door COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date -�" -a 411 y � n 3annoRe' CE 8 49 ApprovedAfA PA LA Date_ �^1A pof Inspection Repo _-1-12.doc z z w 1\ Id Z < WELL 46 m ro WELL (E) 4BR HOUSE (E) SEPTIC AREA (E) 139.6 C' 1302 DROP CONNECT A B ABANDONED EXISTING W.. 'SEPTICTANKPER CODE 'TH 1 DRAINFIELD AND CRIB (E) C4 ABANDONED PER CODE M4 C2 6.9 TH2I Vv - M2 't- \ I ' 96, S DCO T2 T1 RESERVE 4BR DRAIN FIELD (P) M1 - -,- 20LFxO.5'EDx5'W, 2'TD SS -FS (BASED ON CAT 111) C3 C1 M 3NEW 1250g SEPTIC TANK WITH DCO & FS NEW 4BR DRAIN FIELD (2EA) 50LFxO.5'EDx5'w, 1 -TD WITH 0.5' SAND SEPTIC AREA (E) 13 b '-N NOTES:Date RECORD DRAWING PAMONE ENG SVC, Lw OF A/- 9/17/2012 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-821 Y Scale P.I.D. NO HAMANN, LOT 13 050-621-12 MICHAEL & LAURA BOOKOUT even nnome PERMIT NO. 24760 EAGLE RIVER ROAD CE OSPI21085 PLAN EAGLE RIVER, AK 99577 ........... Sheet 1 2 OF 4 A B C DROP CONNECT 75.0 69.3 T1 65.9 72.2 T2 57.0 75.4 DCO —67.6 76.5 FS 79.6 90.9 Ci 81.2 92.5 M' 76.1 87.4 62 44.0 62.0 M2 43.7 61.6 C3 70.6 88.0 M3 —771.4 89.0 C4 537 558 M4 56�7 59�1 z z w 1\ Id Z < WELL 46 m ro WELL (E) 4BR HOUSE (E) SEPTIC AREA (E) 139.6 C' 1302 DROP CONNECT A B ABANDONED EXISTING W.. 'SEPTICTANKPER CODE 'TH 1 DRAINFIELD AND CRIB (E) C4 ABANDONED PER CODE M4 C2 6.9 TH2I Vv - M2 't- \ I ' 96, S DCO T2 T1 RESERVE 4BR DRAIN FIELD (P) M1 - -,- 20LFxO.5'EDx5'W, 2'TD SS -FS (BASED ON CAT 111) C3 C1 M 3NEW 1250g SEPTIC TANK WITH DCO & FS NEW 4BR DRAIN FIELD (2EA) 50LFxO.5'EDx5'w, 1 -TD WITH 0.5' SAND SEPTIC AREA (E) 13 b '-N NOTES:Date RECORD DRAWING PAMONE ENG SVC, Lw OF A/- 9/17/2012 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-821 Y Scale P.I.D. NO HAMANN, LOT 13 050-621-12 MICHAEL & LAURA BOOKOUT even nnome PERMIT NO. 24760 EAGLE RIVER ROAD CE OSPI21085 PLAN EAGLE RIVER, AK 99577 ........... Sheet 1 2 OF 4 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALLED NEW SEPTIC TANK AND SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS MONITORED AT 5.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE, AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 5.0 FEET BELOW EXISTING GRADE. 6" TOPSOIL & VEGETATED 4' 0 DRAIN PIPE FILTER FABRIC DRAIN ROCK 6' ABOVE PIPE INV 95.8 -94.2 DRAIN ROCK 0 TH-2 _ 97.3 TH 1 "��� 92.8 (91.0 91.2 OR 90.7 -1.5 0.5 -90.2 GM �� �5.0--I--914.5 15 -..5.0--a�89REMOVED ORGANICS AND PLACED GM 6.0 SAND. t 0.5' -5.0 7.0 (92 .3) SECTION s-7.0 (84.0) e8.3 -9.0 BOH -10.0 BOH - 81.0 z 05 z aoo o V J VU V V WV N Q Z 0 m 00 a 'F FILTER FABRIC 5 0 z 0 97.7 ,3 z DRAIN ROCK 6` ABOVE PIPE INV 0 95.8 (N) 0 4" 0 DRAIN PIPE 95.8 (N) 4.0' MIN 94.2 (S) 94.2 (S) 10 10% MAX 92.8 (N) 92.8 (N) 93.1 NEW 1250g 91.2 (S) 91.2 (S) SEPTIC TANK 92.9 (N) 90.7 (S)-. ... ...... ._.._.. 907 TRENCH SEE DESIGN 91.8 (N) 91..8 (SN) )N) 90.2 (S) 90.2 (S) 91.3 � PROFIL,SBREVIATIONS 91.3(N) DESIGN PARAMETERS CU COPPER 89.6 (s) REPLACEMENT SEPTIC SYSTEM DIP DUCTILE IRON PIPE NO. BEDROOM: 4 (600 gpd) TH TEST HOLE TANK SIZE: 1250g LEGEND FC FOUNDATION CLEAN OUT PERC RATE = 2.5 MPI W WATER LINE/ T# TANK CLEAN OUT NO. SOIL RATING: 1.2 GPD/SF WELL RADIUS C# CLEAN OUT NO. AREA ROD: 500 SF M# MONITOR TUBE N0. SYS. TYPE: WIDE TRENCH 0.5' E.D. - MIN LENGTH: 100 LF SS NEW SEPTIC R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT USE: DV DIVERTER VALVE (2EA) 50 LF X 5' WIDE, 0.5' E.D., FS FLOW SPLITTER 1.0' TO WITH 0.5' SAND BFG BELOW FINISH GRADE TOTAL AREA: 500.0 SF OG ORIGINAL GRADE FG FINISH GRADE NOTES: PANNONE ENG SVC LLC �� Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 ,= (� OF A� 4sll� 2/19/2014 PHONE (907) 272-8218 FAX (907) 272-8211 /rGj�py�� Scale NTS .... .. ....... P.I.D. NO HAMANN, LOT 13 - / 050-621-12 MICHAEL & LAURA BOOKOUT Steven Panno e PERMIT N0. .', CE 8149 OSP121085 24760 EAGLE RIVER ROAD 1+4s., �r DESIGN DETAILS EAGLE RIVER, AK 99577 (IEDypNp� Sheet 3 OF 4 TEST HOLE 2 I 2 3 4 5SILTYGRAVEL 6 p GM SAND 7 617/12 8- 9- 10 BOH ll 12 13 14 15 16 17 18 DATE PERFORMED: 5012 SOILS LOG - PERCOLATION TEST SLOPE I ITE PLAIN 4BR HOUSE (E) FIC AREA (E) W TH2 WAS GROUNDWATER ENCOUNTERED? Y IF YES, AT WHAT DEPTH? -7.02 READING DATE CLOCK WATER TIME NETTIME LEVEL NET DROP READING NO PERC NTS 3 4 P.I.D. NO n Pa orae 0-621-12 CE 8149 PERMIT NO. OSPI21085 COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. NOTES: RECORD DRAWING SOILS LOG PAMONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 HAMANN, LOT 13 MICHAEL & LAURA BOOKOUT 24760 EAGLE RIVER ROAD EAGLE RIVER, AK 99577 yr 9/17/2012 Scole NTS . .. ....... P.I.D. NO n Pa orae 0-621-12 CE 8149 PERMIT NO. OSPI21085 ....... Sheet 4 OF 4— On -Site Wastewater Disposal System Permit 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 Permit Number: OSP121085 Tax Code Number: 05062112000 Work Type: Septic Upgrade Permit Effective Dates: May 22, 2012 to May 22, 2013 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: HAMANN Site Legal Address: HAMANN LT 13 G:0261 Owner/Address: BOOKOUT MICHAEL D & LAURA A 24760 EAGLE RIVER ROAD EAGLE RIVER AK 995779689 b /g/,Z 17— noo^ Site Mailing Address: 24760 EAGLE RIVER RD, Eagle River Lot Size in Sq Ft: 95832 Total Bedrooms: 4 This permit is for the construction of: Y 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. S' b t12 ,Snn-?rte_N1 Y!1 GPS /� SGL vtGw l tsf Gis (� d—� rti. J,� Received Issued By. MUNICIPALITY OF Community Development Department Development Services Division t On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 050 - (Z!- 1'Z Property owner(s) J&p)pKOJ7 Day phone Mailing address 2y7(,o 6A&Le J21vffZ 966P Site address 2y76o 6 -.&LL R1 bE Ro.9 � Legal description (Sub'd., Block & Lot) .Pm,4NAl,Alor 13 Legal description (Township, Range & Section) Lot Size 9C132- Sq. Ft. Number of Bedrooms q THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (N all that apply) Initial ❑ Absorption Field Septic Tank Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. owner or Permit/Rush Fees: 5W.40 Waiver Fees: `J" LI Date of Payment: t` H10a Date of Payment: Receipt Number: N 30 26 Receipt Number: Permit No. 6spt'oi16S Waiver No. G:\Building\On SiteTormsUlent FormsTermit App_010411.doc (Rev. 1/11) Pannone Engineering Services uc Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@paneneak.com May 15, 2012 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Hamann, Lot 13 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing house that is being expanded to 4 bedrooms. Currently the lot is developed. The existing septic tank and drain field will be abandoned per code. The new drain field will be built just to the south of the original system. The lot is served by a private well, that is located over 100' from this system. The surrounding lots are served by private wells located over 100 feet from this system. 1. Soils. A single test hole was excavated by Pannone Engineering Services in May of 2012, and the ground water monitored for seven days. Groundwater was monitored to a depth of 5.0 feet after the seven day monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used for a conventional waste water system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The topography in the area generally slopes to the south at approximately 18%-20% in the area of the proposed drain field. Mallln& P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82"' Ave, Cuite 136, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments -Soils Log -Septic System Design Mailing: P.O. Box 1003217, Anchorage, AK 99510-0217 Physical: 615 Fast 82°` Ave, Suite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 Z 1 64 V) SEPTIC AREA (E) \ L, wD < WELL 'rnn '5 WELL (E) 4BR HOUSE DROP CONNECT (P) -(E:) 110.0 xk120.8, / I'll Q I , \ 1, 12508 SEPTIC TANK r0 1p 0 WITH DCO & ABANDON EXISTING 1lwvv SEPTIC TANK PER CODE TH 1 DRAINFIELD AND CRIB (E) 45.6 '-ABANDON PER CODE W < RESERVE 4BR DRAIN FIELD (P) 20LFxO.5'EDx5'W, 2'TD (BASED ON CAT 111) NEW 4BR DRAIN FILD'(6 (2EA) 50LFxO.5 EDx5'W, l'TD',- WITH 0.5' SAND SEPTIC AREA (E) NOTES: PAMONE ENG SVC, LLC Date FOR CONSTRUCTION 5/22/2012 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211Scale W.. . .* 1::_50' .... . . ... . .... D. NO HAMANN, LOT 13... ........ 050-621-12 MICHAEL & LAURA BOOKOUT teven annone - PERMIT NO. CE 8149 24760 EAGLE RIVER ROAD 04 OSP121085 'k. sheet - Sl PLAN EAGLE RIVER, AK 99577 '% ........ 1 OF 4 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW SEPTIC TANK AND SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS MONITORED AT 5.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 5.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 1250g SEPTIC TANK (P) TRENCH SEE DESIGN PROFILE DESIGN PARAMETERS REPLACEMENT SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1250g PERC RATE = 2.5 MPI SOIL RATING: 1.2 GPD/SF AREA RQD: 500 SF SYS. TYPE: WIDE TRENCH 0.5' E.D MIN LENGTH: 100 LF USE: (2EA) 50 LF X 5' WIDE, 0.5' E.D., 1.0' TD WITH 0.5' SAND TOTAL AREA: 500.0 SF LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PAMONE ENG SVC, LLC CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 HAMANN, LOT 13 MICHAEL & LAURA BOOKOUT 24760 EAGLE RIVER ROAD DESIGN DETAILS EAGLE RIVER, AK 99577 sTmoomommews CU COPPER TH-1 DUCTILE IRON PIPE Sjo 6" TOPSOIL & VEGETATE 4" B DRAIN PIPE FILTER FABRIC DRAIN ROCK 6" ABOVE PIPE INV DRAIN ROCK FC FOUNDATION CLEAN OUT T# OR0.5' C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG 4.0 H=75•D—H REMOVE ORGANICS AND PIACE FINISH GRADE GM SAND. f 0.5' � -5.0 -7.0 ML SECTION BOH O Z2 U O WO q4 qz W W FILTER FABRIC � o oDRAIN ROCK 6" ABOVE PIPE INV o / r4" B DRAIN PIPE 4.0' MIN n n / n n 1250g SEPTIC TANK (P) TRENCH SEE DESIGN PROFILE DESIGN PARAMETERS REPLACEMENT SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1250g PERC RATE = 2.5 MPI SOIL RATING: 1.2 GPD/SF AREA RQD: 500 SF SYS. TYPE: WIDE TRENCH 0.5' E.D MIN LENGTH: 100 LF USE: (2EA) 50 LF X 5' WIDE, 0.5' E.D., 1.0' TD WITH 0.5' SAND TOTAL AREA: 500.0 SF LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PAMONE ENG SVC, LLC CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 HAMANN, LOT 13 MICHAEL & LAURA BOOKOUT 24760 EAGLE RIVER ROAD DESIGN DETAILS EAGLE RIVER, AK 99577 sTmoomommews CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE rGj . ` teven A:'Pai I�. CE 8149 Scale NTS J.D. NO 050-621-12 e j PERMIT NO. OSP121085 Sheet 2 OF TEST HOLE 1 OR ORGANICS 1 DATE CLOCK NET TIME 2 NET DROP 1 3 --- 3.60 4 GM SILTYGRAVEL 5 7.57 17 3 10:45 = 5115112 6 --- 4 7 10 MIN = 513112 4.12 8 10:55 CLAYEYSILT ML mix 9 BOH 10 11 12 13 14 15 16 17 18 DATE PERFORMED: 5/3!12 SOILS LOG - PERCOLATION TEST SLOPE _. ITE PLAN... M K J 4 \ BR HOUSE (E) 5 I I WAS GROUND WATER ENCOUNTERED? Y IF YES, AT WHAT DEPTH? -6.5-' DEPTH TO WATER AFTER MONITORING? -5.0'- DATE: 5/15/12 SLOPE TH x READING DATE CLOCK NET TIME WATERTIME LEVEL READING NET DROP 1 513112 10:35 --- 3.60 -- 2 10:45 10 MIN 7.57 3.97 3 10:45 --- 3.60 --- 4 10:55 10 MIN 7.72 4.12 5 10:55 -- 3.61 -- 11:05 10 MIN 7.61 4.01 PEROLATION RATE 2.5 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 2 FT AND 3 FT COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Prec hole was presoaked. Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL�TG7�UIDLLINNES IN EFFECT ONTHE DATE OF THIS TEST. NOTES: PAMONE ING SVC, LLC )h Ll Date 5/22/2012 FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 .'"� •qcS �� PHONE (907) 272-8218 FAX (907) 272-8211 /rg�Q �yf� Scale NTS • •• • •••• P.I.D. NO HAMANN, LOT 13050-621-12 ♦�. Pa MICHAEL &LAURA BOOKOUTteven nnone PERMIT NO O 9F:, �% 24760 EAGLE RIVER ROAD (� c CE 8149 OSPI21085 SOILS LOG EAGLE RIVER, AK 99577 '�l;'�FApi Essj=�' Sheet 3OF 4 4" JIM CAP, 4" PUMP—OUT SLIDE SECTION OF 6" PIPE OVER THIS CONNECTION TO PROVIDE SHEER PROTECTION— EXTEND TO BRIDGE EXCAVATION RESERVE SYSTEM DESIGN ADVANTEX 24„ PASSIVE AX20 POD\ INSULATED AUXILIARY AIR RISER, PUMP BASIN VENT. RESERVE SYSTEM DESIGN PARAMETERS REPLACEMENT SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. W/ AX20 POD PERC RATE = 2.5 MPI SOIL RATING: 6.0 GPD/SF AREA RQD: 100 SF SYS. TYPE: WIDE TRENCH 0.5' E.D. MIN LENGTH: 20 LF USE: 20 LF X 5' WIDE, 0.5' E.D., 1.0' TO WITH 0.5' SAND TOTAL AREA: 500.0 SF oi� 11�I1 '��� NOTES: Pt11\l\ONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 HAMANN, LOT 13 MICHAEL & LAURA BOOKOUT 24760 EAGLE RIVER ROAD SITE SECTION EAGLE RIVER, AK 99577 • NTS :L.NO • •• •• •. 050-0.621-12 • • Steven "R. Pannone % PERMIT NO. f. . CE 8149 OSP121085 mss' Sh R?0FE`-,=� 4 eOF 4 i0. f MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I Ir ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAMEPHONE ❑NEW tl�llelze Q .T / p L2 C PGRADE MAILING ADDRESS ^/Q/a,,,15 LEGAL DESCRIPTION s LOCATION . / J & NO. OF BEOR .OrO / l l Q C l�. DISTANCE TO: Well Absorption area Dwelling PERMIT NO. OY P W 24 Manufacturer C) X/ l Zi J� Material No. of compartments F- /' N Liq. it i allons IF HOMEMADE: Inside length Width Liquid depth d0Z DISTANCE TO: Well Dwelling PERMIT NO. _ Manufacturer Material Liquid capacity in gallons O W = DISTANCE TO: Well/ O Fountl. y.+ 7 Neas7{.{pt i cJ PERMIT NO. Z W No. of lines / Length dine Total I 9t of lines Trench d}!.i Distance en IjPgs CJ Inches /"'t ¢ I- Top of tily�p finis rade � � enal benea tyle e+ �t��.f , Total effective bsorption area O ✓ inches W Length Width Cepth I PERMIT NO. Q F- W 1 Type of crib i �tej C1 Crib depth Total effective absorption area to DISTANCE TO: Well Building foundation Nearest lot line j Class13 V DD It L Driller Distance to lot line PERMIT NO. i DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER \ F PIPE MATERIALS C Al, SOIL TEST RATING INSTALL REMARKS 0ot,J ai •.. . - r. Tom` �. r Rola.rte .f'.e Ho. 1457- (Z � _�paeeinslt.L�j� AP V DATEEf LEGAL •� a ., .cl ,I;,u 7 of (Rev. 3/78) , , 11 ir-a :L I F•FIL_ I TF= F tta�_ DEPARTMENT OF HEALTH AND ENS:+IRONMENTALOT ECT ION [' _ '25 - STREET, ANCHORAGE, AK. ^c64-1720 C�t•.I-�: I TE EEfJEF<: ILtF•Y��HCE F~EE:f•l I T PERMIT NO. i 820404 ) APPLICANT ARLENE FROST C. -'O SRS ENG LOCATION EP LEGAL LT. 13 HANMAN SSC' LOT SIZE 52000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRAINFIELD MA:'IMUM NUMSER OF BEDROOMS = 3 SOIL RATING C50 FT/E:F')= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: L�EF•TH= Z L_EtJhTH= r_.= GF?f=I%. EL C-EF•TH= THE LENGTH DIMEN=ION IS THE LENGTH CIN FEET) OF THE TRENCH OP, 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). THE TF:Et-4r_H lJ I LATH I c &3_ THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). PERMIT APPLICANT HAS THE RESPON_IBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE I -JELL WILL SERVE. --- TIJO { ;2 > AF:E F<:EC- i_I I FzEG- --- 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 OP 150 TO 200 FEET FROM A PUBLIC PJELL 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•EF -Al I T EXf=" I F:E'c = 1s 1S4 I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR: ON-SITE SEWER'S AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I I -JILL INSTALL THE 4 STEM IN ACCORDANCE WITH THE CODES. I UNDEF:ST 1D THAT !-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE _ T/*INCLUDE MORE THAN 3 BEDROOMS. SIGNED LIC ISSUED BY V4. 0 LEGAL DESCRIPTION: 4— /-7 Z6 �^' in e! (-I DEPTH SLOPE WELT) 4 ` ' 2 3 O�b 4- L/ G HT S'/L 7- 5 a S/G T11RIF / s 15b r [[[ 7 � 1 e 8 VC, 1 / 9 C 10 J/f �(/, WAS GROUND WATERn 11 /11%1 � / //✓ / ENCOUNTERED? 12 J ' IF YES, AT WHAT 13 DEPTH? 14 Date ❑ SOILS LOG Depth to Water Net Drop •.�or\4!\. 15- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L Street, Anchorage, Alaska 89501 264-4720 EMEN®■MI■■■ or 'a + .. 1 17 SOILS LOG — PERCOLATION TEST �' a :.. PERFORMED FOR: �l/��l to %� DATE PERFORMED: / z 19 !�A r'a: llic LEGAL DESCRIPTION: 4— /-7 Z6 �^' in e! (-I DEPTH SLOPE WELT) 4 ` ' 2 3 O�b 4- L/ G HT S'/L 7- 5 a S/G T11RIF / s 15b r [[[ 7 � 1 e 8 VC, 1 / 9 C 10 J/f �(/, WAS GROUND WATERn 11 /11%1 � / //✓ / ENCOUNTERED? 12 J ' IF YES, AT WHAT 13 DEPTH? 14 Date Gross Time Net Time Depth to Water Net Drop •.�or\4!\. 15- .WE■®■■■■■ CF A410 ( ry EMEN®■MI■■■ or 'a + .. 1 17 �' a :.. 18 CaeeH• hLAn' 0r 1�sxr- 19 !�A r'a: llic t 9Ji SS^ryy,�® I ■■■.■■INNN■ MIMME®MER►MIN Date Gross Time Net Time Depth to Water Net Drop .WE■®■■■■■ EMEN®■MI■■■ MOMEMENNIMIN ■!_RE.MENEM 5E 89■IINIMS■ MEN MENEM ■S ,t. ONION SWIM MIMMEMINEMMIN mmmmmmmzmm _moom■ommum Reading J Date Gross Time Net Time Depth to Water Net Drop 20 g-:at:•w �. PERCOLATION RATE ha (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: 2! 5,b=- A1C—f A) fE2 J/U[_. CERTIFIED 72008 (6/79) f \r \MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME Wap r PHONE togy P-77 IEW ❑UPGRADE MAILINGA/_�j�DRESS —r Y'J a / n LEGAL DESCRIPTION -Trac- I m rYrn rL 13 LOCATION - NO. OF BEDROOMS Uy DISTANCE TO: Well Absorption area r J Dwelling PERMIT NO. ICl J Q W � Manufacturer/+ _Qe �S� Materials+ee( a� No. of compartments rn Liq. caplacity in gallons IF HOMEMADE: Inside length Width __ Liquid depth_ Ij y JZZ DISTANCE TO: Well Dwelling PERMIT NO, =-F Manufacturer Material Liquid capacity ingallons OWell W= DISTANCE TO: I Q Foundation % 3 Nearest lot line (O'r PERMIT NQ.� L tea—s LL Z r ? W No. of lines Length of ea Ii Total length of line Trench widtly., .5 aches Distance between lined a¢ H o Top of tile to finish grade Material beneath tilen 0 d Inches Total effective >sor tion area 4i W U Length Width Depth PERMIT NO. Q l- c S W Type of crib Crib diameter i Crib depth �- Total effective absorption area yWj DISTANCE TO: Well Building foundation Nearest lot line J J CI Depth( eller Distance to lot line PERMIT NO. •� W DISTANCE TO: Building foundation Sewer line Septi n Absorptio (s) OTHER R Is e PIPEM TERIALS 5010 TEST RATING' INSTALLER REMARKS 'TCL 4 ¢_ s S -t � I -CID s ^ � �JY�` d /L�•e APPROVED DATE LEGAL % 1 /a % C"J 72-013 fRev. 3/78) `� r`+1 r'loll� t•1Ur4 I C I t HL I TY IDP HNC-HL#[rt'nG E .r DEPARTMENT OF HEALTH AND ENVIRONMIENTAL PROTECTION 225 'L' STREET, ANCHORAGE, RK. 59501 264-4720 is :30A R1 -7nn1-'79 dei. [7� i v6 Co C�td—=• I TE Et•-1EF? PEF?t•1 I T PERMIT NO. C 780295 APPLICANT HAMONN CON= FO BOX 617 EAGLE RIVET: 694 277E LOCATION EAGLE RIVER LEGAL TRACK 1 HANMION S/D Lof 13 LOT SIZE t{tt##tt# SQUARE FEET TYPE OF SOIL APSORE:TION SYSTEM IS: TRENCH h?RXIMlR9 NUMBER OF BEDROOMS = 3 SOIL RATING (SG! FT/ER)= 120 THE REOUIRED SIZE OF THE SOIL ABSORPTIn?L-SYSTEM IS: o � C•EF='TH= �� LEt�IiiTH= yz�= �CiPR'•.� EL C•EPTH= `1' THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OP. 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 CIN FEET). F 'EC�L� I PELF SEPTIC TFit••it=: l3t4LL7rt-4S PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS• DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUNDER OF RESIDENCES THAT THE WELL WILL SERVE. --- T1,10 C ^ ? I I Or -AE F:IF-E FRElnLt I PEP --- PAC:KFILLING OF ANY SYSTEM bIITHOUT 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 R PRIVATE WELL; OR 150 TO 200 FEET FROM R PUBLIC WELL DEFENDING UPON THE TYPE OF PUBLIC WELL. OTHER REOUIF.EMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F E� ty I T E:�:F-I PES C•ECEt7E EF_ y 1S�v r I CERTIFY THAT 1: I AM FAMILIAR WITH THE RE?UIPENENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. _: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. _: I UNDERSTAND THAT THE OH -SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED:e �Sr�/Gi/ F'LICAh1T���f etONtd CONST ISSUED BY__ _--------------- DATE-�t_8 r_T� __ V3. 2 (—Y.Oonibructlon 9cit ^4-4 _ -uns tdtt U vorth • thovund nFtni"r 1�1 2204 Cleveland Anchorage, Alaska 99503 % Performed For 'tom- - '��r�,tt�.:_,,.�.� Date Performed �kh? Leaal Ilescrintion: -Lot. B1 cY. i Subdivision This Form Renorts Soils Lon Percolation Test Depth Feet Soil Characteristics Z _ 4 Ilk 6- 10- 0- -12- 14- 16— is- -12- 14-16- 18- 20— 20— Was Was Ground Water Encountered? `q' I1 ves, At what Depth? 0 L Readinq Date Gross Time Net Time Depth to H2O Net Dron I— Fercoiation Kate ninute Proposed InstaTTat- n: Seenace Pit Drain Field Depth of Inlet Dect o ottom Of Pit Or Trench V"VENTS: —r 4 wi Lu< Test Performed B�__, 3. , %%-�'���-- �� �_ ��`_ ['ata Certified `By: -�— > ` Date: 1 /.V 7.� EomIMMEMN eM■iSol ■ 101010101 Imonsoon IMMEME-M iMISOMMEM ii L Readinq Date Gross Time Net Time Depth to H2O Net Dron I— Fercoiation Kate ninute Proposed InstaTTat- n: Seenace Pit Drain Field Depth of Inlet Dect o ottom Of Pit Or Trench V"VENTS: —r 4 wi Lu< Test Performed B�__, 3. , %%-�'���-- �� �_ ��`_ ['ata Certified `By: -�— > ` Date: 1 /.V 7.� S -In M -LL; Or-naft 2�4,, �� a� 4nrC mcr IPi�S� „ sIL�L- - .k, qks 3 6J4-rv�-, 4'r -I C.6 �V 0 "TW`l.Jli .�t/�� •J Q{.D T'wnst� 3a. �(oao I U KI -L Co11�<ec_1 GREAIEK ANCHORAGE Department of AREA BOR�vuH Environmental Quality 3330 C Street Anchorage, Alaska 99503 NAME F � ""ry REP ORT ON-SITE SEW LOCATION ,� MAILING ADDRESS p Am GE �ISPOSqI SYSTEM 11 goX G / SEPTIC a LEGAL DE �•iy/1erz PHONE TANK: I'S, 10 DISTANCE /� / T /3 /-19 - FROM WELL Fr.._tm tlJtZL, HN $ MANUFACTURER -/�� L 20 INSIDE LENGTH It" " 2�f INSIDE WIDTH MATERIAL _ $�T NUMBER OF SEEPAGE PIT: �LIOUID -COMPARTMENTS= olle 7- DEPTH NUMBER OF PITS WJE /,O -C / i �jlp -LIQUID CAPACITY l077� �• DIAMETER /,v X /6 0 x W�-t- -GALLONS. LINING MATERIALI•E6S ?At OR WIDTH" X z(,. IBLENGTHS BUILDING FOUNDATION 7p// SIZE: DIAMETER / DEPTH .DEPTH G ADD171pNq NEAREST LOT � DISTANCE F LINE: TOTAL EFFECTIVE FROM: WELL a pyo• L ABSORPTION ASSORP TION AREA (WALL AREA) d1jD -SQ. FT. MILL: �/y)k sT McZ.-7- �V /2C -p YPE No / c/ w 17jveAe 3o Ai t rv- &e_ /5. /1LDING CON57RUCTION A��S / / �4r1^ve IUNDATION- NEAREST2'e/«/NFj �n6 L07 LINE NEAREST DEPTH ;SPOOL �SEWER LINE- SEPTIC DISTANCE FROM: OTHER SOURCES TANK /� / SEEPAGE ROVED �SYSTEM /pz,Fi� DISAPPROVED -- REMARKS- ANCES: _ DIAGRAM OF SYSTEM LED BY: A APPROVED G.A.A.B. U 1n IAL: Cur-rcr,✓ w n � a •.`..:J a I pt�13' J+ E_ IQ 1 N �I DATE 7 APPROVED G.A.A.B. -» ,/ • GRE Jte-�"O�'ANCHORAGE AREA BOIH IR 7 /&- % f j'• 0 DEPARTMENT OF ENVIRONMENTAL QUALITY PERITNO. 3370 •'C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 ANO Gvt<L PLeHIr SEWAGE DISPOSAL SYSTEMA— APPLICATION AND PERMIT /��/1 J �3fl1/AR upoPHONE � NAME OF APPLICANT � ••e/Q�G k �nwµN �DS7� MAILING ADDRESS INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK SEEPAGE PIT >e `�1�/'DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED —5/�Q�N /'-y_—�� �AV FINANCED THROUGH r TO BE INSTALLED BY PT SOIL TEST RESULTSQ .Q L/0 l� J NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED �/� '1- 1�77S - -• 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 4W 54A! TYPE .__J�'iL`SA��^' SEEPAGE MINIMUM DISTANCES. REQUIREMENTS AP's FOUNDATION TO SEPTIC TANK S / / 1 FOUNDATION TO SEEPAGE PIT � .DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL 15 /1 SEPTIC TANK .5SEEPAGE PIT j . DRAIN FIELD AREA SIZE �� /• ""'TYPE / `^-/�• 4z,,,4e;gu lb 34 9' DIAGRAM OF SYSTEM TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK / D / SEEPAGE PIT -2LI / DRAIN FIELD 0, 0 SEPTIC TANK./av/ .SEEPAGE PIT � �dl 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 /�LL¢o �.L�fIA• li,��'s.' CONFORM TO BOROUGH REGULATIONS REGARDING IN STALLA G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I also Certify that this home will contain a maximum of three (3) bedrooms. I understand an upgra a would be necessary should more bedrooms be added. DATE ----y-4 TG APPLICANT'S SIGNATURE A_ FORMNO.EQ-0141 I I i I I I 1 -r t-i_rl II 1 I _ #--ji A I tIr 1 1 ! 1 j . 1 !I I 1 I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I also Certify that this home will contain a maximum of three (3) bedrooms. I understand an upgra a would be necessary should more bedrooms be added. DATE ----y-4 TG APPLICANT'S SIGNATURE A_ FORMNO.EQ-0141 0 Ef E GEOTECHNICAL & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 .694.2774 or 688-2280 Russe// Oyster 694.2774 Soils 6 Foundations SOIL LOG Performed for: Name:--F%l.4AtK /'IZOST Tel. No. Mailing Address: Legal Description: Lor /3 f/ANJANn/ SUBl�/d /s/oma/ Depth (feet) Soil Characteristics 0 1 ML — S/LT 7'cP SO/L 2 3 GP - SsJNOY GRAVA-4, G6'r-f/V 4 5 0 7 8 g (7P SRNDf� ��9UBG, %�PNG6 c�P to 11 ,112 a 14 Ground Water Encountered: Yes ✓ No If yest what depth /S-" Proposed Installation: Seepage Pit ✓ Drain Field Comments: Earl Ellis 6BB-2280 Land Development oZs'o d�a,,c. /7S110/9' ie Performed by: Date: Ud'(6/ /-J" //5F>S— Municipality of Anchorage -� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. -COI I - /1�1- 1. GENERAL INFORMATION COSA# 'fi�153 Expiration Date: - o % Complete legal description HA MA AJAJ LOT 13 Location (site address) .1 •7'7 (oO F-VLC ?Zi ✓u- R'd- Current Property owner(s) -Ha.wk-6'L1- Day phone -2&,'7- 3033 Mailing address Lending agency Mailing address ,247&0 Cetq(t- 1Zi✓4-r- Rd. F"i A -K 995-77 Day phone Real Estate Agent in n LinArS4y Day phone gol - 1(e 53 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. TYPE OF WASTEWATER DISPOSAL: 131� Individual On-site ❑ Individual Holding Tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional 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. 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 Eagle River Engineering Services Phone N 1 — Sr elieAi2:iVFW Rd., Suila 201 s Address EG Ie River. AK 99577 Engineer's Printed Name Qtr- !�rlo,jebrr A. /4jmd Date 5/Z 31 0-:�- 5. DSD SIGNATURE Approved for _3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following Attachments: COSA Checklist X Septic System Advisory _I)c Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: Jr' -.3 f (Rrv. 11)0% Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: PAP' AIJAJ 1-0-1- /3 Parcel ID: 0 _<n — G L/ Z A. WELL DATA Well typeawle 1 Date completed �15 Total depth I-1 Date of test Static water level Well production If A, B, or C provide PWSID # _ Sanitary seal C/N) Cased to t1}O ft. FROM WELL LOG WATER SAMPLE RESULTS: Well Log (YA@ J0 Wires properly protected &N) Yz2 Casing height (above ground) min. AT INSPECTION 7 1 10-7 ft. 13 ft. 9 p -m - Coliform _colonies/100 mL Nitrate •-4 4b mg/L Arsenic: _ZL ug/L date of sample: 4/1-7/0-7 B. SEPTIC/HOLDING TANK DATA Tank Type/Material 5c Ir%i c sf-e-r-P 9— p.m- Other bacteria 0 colonies/100 mL Collected by: Charts t Q2ltrini Date installed lel-79 Tank size (, 000 gal. Number of Compartments I Cleanouts BIN) a_ Foundation cleanout(Y/N) Depression over tank (Yo LL High water alarm (Yo _ Date of pumping Pumper TW 5 C. ABSORPTION FIELD DATA Date installed $7, Soil rating (g -p lditZbr f:21bdrm) 150 System type i.ui& dmLz6Ee (d Length (C3 ft. Width 5 ft. Gravel below pipe a ft. Total depth 5 ft. Eff. absorption area eft= Monitoring tube Y,` Depression over field &10 Date of adequacy test 4 J.;L I Ing Results (Pass Fail) 55 For 7_ bedrooms Fluid depth in absorption field before test ;L+ Water added gal. New depths in. Elapsed Time:1_ min. Final fluid depth rA L4 in. Absorption rate >= 4-50 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) 2-+eru r w,i If yes, give date tila_ D. LIFT STATION Date installed Size in gallons ` I Ma�ho10, Gess{�fl 'Pump on" level at _ in. 'Pump of ' t—= �' 1 Hig1h water alarm level at in. Datu Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot i 100 Absorption field on lot t I o o Public sewer main -t 100 Sewer/septic service tine -t ?.S' Animal containment areas t too On adjacent lots +100 On adjacent lots + 100 Public sewer manhole/cleanout ICO' Holding tank -r lS Manure/animal excrete storage areas t 100 SEPARATION DISTANCES FROM SEPTIC/HetOM TANK ON LOT TO: Building foundation + S Property line + S t Absorption field + 5 Water main + I o ' Water service line + 10 ' Surface water + I00' Wells on adjacent lots -t I (D SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line +-10 1 Building foundation + I n ' Water main Water Service line 4 I() ' Surface water -rl ho , Driveway, parking/vehicle storage a S Curtain drain +50 1 Wells on adjacent lots -i-100 F. COMMENTS G. C I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name C1f�Sr7J1°tf t!Z �• u 1ov� Date 5 / l 3 /0 7- COSA Fee $ ;;�o J Date of Payment 5-1 Receipt Number. (Rev. 11105) 10986k R. WOOD C€:10381 Waiver Fee $ 5Cr-- Date of Payment lP Receipt Number q5 -&(A) Municipality of Anchorage ,.. . • '� Development Services Department Building Safety Division • a• arr 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 Septic System Advisory Health Authority Approval # 070153 During a recent adequacy test on the septic system for Block , Lot 13 of Hamann subdivision, 23 inches of standing water was observed in the absorption field. This indicates that approximately 96% of the absorption area is inundated.— Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Health Authority Approval. q46�-c� to .0r otio 4 s�J sod JO G� C C� �- -------- - - - - -� ------------------------- \ �``------------------- .1 1 ' c � G R C� v� o V U �• , C1c i CM q46�-c� to .0r otio 4 s�J sod JO G� C C� �- -------- - - - - -� ------------------------- \ �``------------------- Yr A�°� �1 rA F°r PF I / 6 C \ Tk .., - I C\ �- - -------------`-'------------------------ \� - ------------------ 1 1 1 I 1 1 ' c I ]') , rri I C� 1 1 1\ v V G a _ r ' CC) (A I � 1 �aC3 i 1 \� I I 1 1 \ ' 1 < 1 \ 1 I I I I 1 1 1 1 I 1 i 1 Yr A�°� �1 rA F°r PF I / 6 C \ Tk .., - I C\ �- - -------------`-'------------------------ \� - ------------------ 1 , I \ "0••�0�,\ \ is rJ W11 A , rJ , , , , , 'i , $^ •-< "i r; , , , , 1 , 1 1 , , 1 I I , I I I I e ' I I I o 7 0 R , gyp. 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Q p Y O< •O ;7-- a O i• 0. .• � n w 'K j`�g p M •• M O N S•t /IA� s w ^ T5f B o n OW e 0 RR Vj r� ` � N O �• a e o C •-i o o^o■ a 4N/� :� AAA> IVY A n \ a u � o o n gno 3 >-v w o n ^ c M \ V < a < h M a O D ,• 0 0 0 A o CIRC -� <--f—_ �E \ \ ` J \ �h . \ \ 9 • •NI'g � 0.0: � o :ea�sas ?;aI�Pa_ooa �g�ee�� gg-s��aeo cR•8e: :$'�$ o.'S$o• ad ,d^—$fie =_pit ea g_Q 88 E O'o'�'e 4U, all RO e vja . Q p Y O< •O ;7-- a O i• 0. .• � n w p M •• M O S•t •C M1 M > s w ^ T5f B o n OW e n o � N O �• a e o C •-i o o^o■ a 4N/� :� AAA> IVY A n a c o n gno 3 >-v w o n ^ c M O o •� < a < M a O D ,• O vow a Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951 M650 www.cf.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: 5.256.07 Legal description: Hamann Lot 13 The attached paperwork has been reviewed and is being returned for the following reasons: 1. A waste water field is considered failed if the effluent prior to the test Is at or above the distribution line invert Name of reviewer: Jeff Date: May 25, 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Mayor Mark Begich AZunicipality of Anchorage t'O. Box 19()(:5) - Awhomgc. Alaska (X1i19-Wa) • TdgJione (!N)7) 31.3.8301 • rnx (WD 33.4 '00 47M nmpw Strccl • rindmmgc. Alaska 71107 ""v.munl.org I3ldlding Safety Mision June 20, 2007 Christopher Woods Eagle River Engineering Services P.O. Box 773294 Eagle River, AK 99577 Subject: Waiver Requcst for Ilamann Lot 13 Waiver Request WR#: 070032 Parcel ID # 050-621-12 IIA070153 Dear Christopher Woods: Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the private well has been approved. The approved separation distance is 95.0 feet. This waiver approval applies to the existing absorption field and septic tank to private well 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, J c 11 C vil n leer On 1te Water S: Wastewater Program Community, Security, Prosperity State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3, 1985) Waiver Request for: Hamann Lot 13 ParcelID#: 050-621-12 Waiver Request Number WR#: 070032 Waiver Requested: 95 foot horizontal separation from well on4ot to septic tank and absorption field. Engineer: Christopher Woods IIA070153 Septic Field & Tank Data The septic tank and absorption field was installed in 1982. The tank and absorption field has encroached the well for approximately 25 years. The nitrate levels sampled in the water well are with in municipal standards. Well Data The bottom of septic field is 5 feet deep and the static water level for the well on -lot during inspection was found to be 122 feet. For the purpose of calculating the state waiver points, there is 117 feet between the bottom of the septic field and the static water level. The topography slopes south at 15% away from the well casing. It would be safe to assume the water table gradient would be no less than 5% slope away from the well for state calculation points. The soil layers determined by the Sandhill Lot 2 shows there are many impermeable layers that would serve to inhibit any contamination to the encroaching well. Municipality of Anchorage Development Services Department Building Safety Division ` On -Site Water and Wastewater Program 4700 Bmgaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchomge.ak.us (907) 343-7904 Waiver Review Worksheet WR#:070032 PID#:050-621-12 HAlPermit# IIA070153 Date Received: June 20, 2007 Legal Description: Hamann Lot 13 Engineer: Christopher Woods Eagle River Engineering Services P.O. Box 773294 Eagle River, AK 99577 Applicant: Rebecca Hawkins Waiver Requested: 95 foot horizontal separation from well on -lot to septic tank and absorption field. Criteria: Geology Points: A. Water Table 7.09 B. Soil Sorption 3.78 C. Permeability 2.89 D. Water Table Gradient 4.50 E. Horizontal Separation 2.8 Total: _ 21.0571 .......................................................................... Waiver is Granted: X Waiver is not Granted: List Conditions or Reasons for above: Date: 6120107 By: Joe Goodall Name of Reviewer Rec#: 95840 Amount: $1150 Date Paid: 6/2012007 State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3, 1985) Waiver Request for: Hamann Lot 13 Parcel ID#: 050-621-12 Waiver Request Number WR#: 070032 Waiver Requested: 95 foot horizontal separation from well on -lot to septic tank and absorption field. Engineer: Christopher Woods IIA070153 Water Table Points ra Depth of well: 122 7.09 Depth of septic system: 5 117 Distance from the bottom of the system to the highest water table In feet Point Value 0 0 8 1 17 2 24 3 30 4 40 5 85 6 100 7 290 8 1000 9 10 ' Straight line Interpolation Is permitted between any two values Soil Sorbtion Points , m 3.78 13 3.5 + 1117, 32 f 6 + jI 65 2.5 * 7 6 Soft Type I Point Value Clean Gravel 0 117, l 117 117 Fractured Rock 1 Course Clean Sand 1.5 + I + f 1 + r 0 1 0 + x 0 1 0 Sand w/ Small Amt of Clay 2.5 l 117 l 117 J l 117) 117 J Silt 3.5 Clay and Sand Equal 4.5 0.4 + 1.6 + 1.4 + 0.4 Clay 6 0 + 0 + 0 + 0 'Use the predominant soil type but values can be averaged for a mixture Permeability Soil Type Point Vatue Clay(will channel) 0 Silt and Sandy Clay 2 Clayey Sand 3 Fine Sand 1.5 Sandy Gravel 1 Fractured Rock 0.9 Course Sand (30 grit) 0.4 Clean Gravel 0 Points „.. 2.89 f 13 1 7, 2+ 17, 3 +r 1-7 65 , 3+[ 117] 3 +(107) 1 +r 1-171 , + 1071 , + r'�71 , 0.22 + 0.82 + 1.67 + 0.18 0.00 + 0.00 + 0.00 + 0.00 *Use the predominant soil type but values can be averaged for a mixture Gradient 4.5 %Slope PointsVatue -60% 0 In Feet -30% 0.3 0 -20% 0.7 50 -10% 1.2 -5% 2 0% 2.93- .9}5% 5% 4.5 6 10% 6 60% 7 slopes toward well Oat slopes away from well •If the gradient Is unknown, assume the worst case Horizontal 0 Horizontal Point Separation Value In Feet 0 0 25 0.7 50 1 75 2 100 3 150 5 200 6 300 7 Points „.. 4.50 Points „.w 2.8 'Linear Interpolation between two point value Is acceptable. Horizontally means straight line distance to the well not the contaminate travel distance to water table which may be greater. Conclusion: Grant Waiver Total Polnts:1 21.0571 J Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW Road Suite 201 (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax June 7, 2007 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: lIamann Lot 13 Waiver Request from on-site well to septic tank and leachfield. Dear Mr. Roth: Eagle River Engineering Services (FRES) is applying for a waiver of separation distance to 95' (allowing for 2.5 feet from the standpipes to edge of the leachfield, and from standpipe to edge of tank) from the onsite well on the above referenced property to the edge of the leachfield and septic tank installed on this same property in 1982. It appears that during the time of installation, the location of the house and the slope of the lot hindered accurate measurement of the 100' separation distance. A current, accurate as -built survey brought the separation distance issue to light. The distances measured from on-site well to the tank cleanout standpipe, and the end-of- leachfield sump were determined to be 98.7 feet and 99.3 feet measured by accurate survey equipment. There is a current Certificate of On -Site Systems Approval on hold for this lot awaiting the result of this Waiver Request. We list the following factors and characteristics in support of this waiver: Soil Characteristics: The original inspection report indicated that the soil was sitly sandy gravel GM, with a rating of 150 square feet per bedroom to a depth of 11' below the ground surface. The shallow ground water table was measure to be 9 feet below the ground surface. The neighboring soil logs for Hamann Lot 12 and Sandhill Lot 2 show a silty, gravelly, fine sand SP/SM, and silty sandy gravel GM respectively. Well Characteristics: No well log was found in the MOA On -Site database or the DNR website for this property. The well log for Sandhill Lot 2 shows that the silt w/gravel to a depth of 18 feet. Beneath this layer is the following: 18-50 feet "hardpan", 50-115 feet "clay and gravel", 115-137 feet "hardpan", 137 feet and deeper various bedrock. The soil layers encountered from 18 feet and deeper would very effectively eliminate any chance of the shallow groundwater table and on-site wastewater from ever contaminating this water source. The well log from Hamann U003w7.024 W mvERLErrER Lot 12 is not legible except for the following: 1-35 feet "hardpan", 35 -deeper clay and gravel. The layers of clay and hardpan create an effective barrier and help isolate drinking water sources from shallow groundwater contamination. Our measured static water level was 122', with a total depth of deeper than 177', which is the depth of the installed pump. ERES measured the production rate of this well to be 1.75 gallons per minute. These factors are an indication that the aquifer providing the water to this well is very well isolated from any shallow groundwater or potential contamination. Surface Slope: Surface Slope is at 15% toward the South, away from the on-site well casing, so there is no chance of any on-site contamination from the property's septic system from ever reaching the well casing. Other Factors: There is a 25+ year history of continuing use of this well and septic system. Current water samples indicated no fecal coliform or other bacteria, and 0.246 mg/L nitrate, well below the allowable limit of 10 mg/L. All neighboring wells and septic systems are located on large lots and exceed the minimum separation distances from the well and septic system on this lot. Thank you for your timely consideration of this Waiver Request. We have attached the adjacent well log, water sample results, and soil logs. If we can provide any more information for you to expedite this waiver request, please call our office at 694-5195. Sincerely, EAGLE RIV ENG /-ERINNG SERVICES iristopher R. Wood, P.E. Principal \2003\07.024 W AI V ERLErfER Je, '/� / v 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.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. HAA # Expiration Date: 1. GENERAL INFORMATION Complete legal description wz HP/77 A Al Al Location (site address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Dayphone 69s�9e3� Day phone Day phone The Munidpality 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 we![ 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. TYPE OF WASTEWATER DISPOSAL: [] Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Munidpality 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 we![ 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 verity 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 verity 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 Oc ucGps �GJ�c}� Address 9iG o E'er✓.�Fi �/OG ��v�'E�C f/.� Engineer's Printed Name 5. DSD SIGNATURE L-f� Approved for bedrooms. Phonvf,o -J 7a6 -ie7y Date Y. //O .6Z .•i .• rs t.,. Disapproved. Conditional approval for bedrooms, with the following stipulations: a .- . .vu nrrr Additional Comments WATER AND M= Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other gy; /���/� / i Zr. r2/( Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division ` On -Site Water & Wastewater Program 4700 South Bragaw, SL P.O. Box 196650 Anchorage, AK 99519.8650 www.ci.anchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: G cs 'Jr /713 /1% A n(N Parcel ID: 0!�-0 A. WELL DATA Well type F'v.'dorms If A, B, or C provide PWSID # _ Weil Log (Y/N) N Date completed 197" Sanitary seal (Y/N) Wires property protected (Y/N) Y Total depth u: tt Cased to yo Y ft. Casing height (above ground) n. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform lg colonies/100 mi. Arsenic: = mg.A. B. SEPTICIHOLDING TANK DATA ft. g.p.m. Nitrate 0.3 pimg.n. Data of sample: ' -V oz. AT INSPECTION ft. Z.6 g.p.m. Other bacteria -&— oolonies/100 ml. Collected by: F,tco ea -..lc 6x Tank Type/Material . f -'`rE� 4 Date installed ?11 9z>S" Tank size ' -^,a gal. Number of Compartments xI Cleanouts (YIN) Foundation cleanout (YAV) Y Depression over tank (YIN) High water alarm (Y/N) Date of pumping %oz Pumper ✓�>y� +moi J C. ABSORPTION FIELD DATA Date installed 00/6x- Soil rating (g.p.d.tfe or ft?/bdrm) iso System type zd"7e— 6iJ�H Length 6 ft. Width -S ft. Gravel below pipe ft. Total depth ft. Eff. absorption area +:Ft ft Monitoring tube % Depression over field Date of adequacy test 0,/C, L Results (Pass/Fail) pors For -Z' bedrooms Fluid depth in absorption Held before test 20 in. Water added SP9gal. New depthin. Elapsed Time: /« min. Final fluid depth /Z in. Absorption rate, >= y -15V g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Al If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on" level at _ in. "Pump ofr level iC% +a-- 1 Iiglf meter alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic tank/1111 station on lot lee Ff On adjacent lots /Opm Absorption field on lot /m©Xf Public sewer main 'r'l1� Sewer /septic service line x SS On adjacent lots / o o AFf Public sewer manhola/cleanout Holding tank 'y/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation Property line /O '�f Absorption field Water main NVQ Water service line ZS��f Surface water /eg tf� Wells on adjacent lots /oB SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line fo ' Fi Building foundation ye �X/- Water main 4JZF Water Service line Z '`/r< Surface water /OD if Driveway parking/vehicle storage .Z 7'�� ,t/c Aid AC,vo"dAJ Curtain drain rb sw,.s -- Wells on adjacent kits F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through held inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effed on this data Engineer's Printed Name f�du« vv r T�.cyGd6y Date . ! v2 HAA Fee E_- Waiver Fee $ _ Date of Payment Date of Payment Receipt Number Av o i os n / RS "45 Receipt Number (Rev. 12/01) .I�NLEY;' CE 8178 ,: I ki. 100's MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL �) OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivisio section, township, range) �fA �� titi - Location (address or directions) (b) Property OwnergJC4a4d rrrc Mailing Address S/egy�C 2 (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address JAN tr' Telephone _5-6 2.' %657;7 SZ Home bf44- 3033 Business Telephone (e) Mail the HAA to the followina address: or. Check here ❑, if hold for pick up. List contact person and day phone number below. L'HV C 17034 F Tyle River Loop Read Ide. 2" Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family 3 Number of Bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Pagel of 2 72-025 IRw e1B61 From ka S. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm r; A 5 ENGINEERING Telephone Z4/-7 Addre 17034 Eagle River Loop Road No. 204 Date 6. DHHS APPROVAL Approved for Z&.& W bedrooms by Approved A= Disapproved Terms of Conditional Approval Conditional CAUTION Date 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 engineers work. Page 2 of 2 72-025 We, 61861 BMk ICIPALITY OF ANCHORAGE `\SI OF W 0'9EALTH AUTHORITY APPROVAL (HAAA) MSN\G7MNSILO CHECKLIST - FEBRUARY 1984 284-4720 Legal Descri?'on: A. WELL DATA R Well Classification Z If A. B. C. D.E.C. Approved (Y/N) Well Log Present (YAM Date Completed ('11 Yield ) •unite Total Depth —1-1 S rx Cased to �� } Depth of Grouting Static Water Level 1'u- Pump Set At t24:f n Casing Height Above Ground (2 Sanitary Seal on Casing<VN) Electrical Wiring in ConduitdVN) Depression Around Wellhead (Y/Q Separation Distances from Well: To Septic/UoWing Tank on Lot 100 ; On Adjoining Lots loo 14- To Nearest Edge of Absorption Field on Lot I � 1 ; On Adjoining Lots \ oo I -t To Nearest Public Sewer Line To Nearest Public Sewer I Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by �s� �� 0611�AAt:lrj : Date Water Sample Test Results`�J f i "?G� +^^ -e'r A -� 0 � Comments P. Ae kw==. a-1 z'[ oNhk:A> LIE- S.1- GfM B. SEPTIC/HOLDING TANK DATA Date Installed —1_4_%3—= Size I C� No. of Compartments ( Standpipes &N) Air -tight Caps mN) Foundation Cleanout (Y& Depression over Tank (Y/19 Date Last Pumped Pumping/Maintenance Contract on File (Y/N) —;for Holding Tank High -Water Alarm (Y/N) tlkTemporary Holding Tank Permit (Y/N) — Separation Distances from Septic/Nekding Tank: To Water -Supply Well 1 001 To Building Foundation 145 1� t To Property Line I� r -f- To Disposal Field 1-5- To -5To Water Main/Service Line 1 o fd To Stream, Pond, Lake, or Major Drainage Course I oo la - Comments Page 1 of 2 72-026(1 li84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata \50 411sit- Type of System Design Date Installed S-'� ^ 6rz— Length of Field U` / Width of Field - °S L.1 Depth of Field T- Gravel Bed Thickness Z . - Square Feet of Absorption Area q rd Standpipes Present(Y/N) Depression over Field (Y/6? Date of Last Adequacy Test `%-11 -8-7 Results of Last Adequacy Test y L�eflSJjre,21" Separation Distance from Absorption Field: r To Water -Supply Well cpc> To Property Line 4 - To Building Foundation A" To Existing or Abandoned System on Lot '2-prt i -o ; On Adjoining Lots '7 � 'E" To Water Main/Service Line rJ- To Cutbank (if present) /,tk To Stream/Pond/Lake/or Major Drainage Course A _� I-F� To Driveway, Parking Area, or Vehicle Storage Area )4 - Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments Check Permitted Bedroom Rating Against HAA Request •• Pumping Cycles during Adequacy Test. Meets MOA I certifythat I have checked. verified, orconformed toall MO andHAAguidelinesineffectonthedate olthis inspection. SignedsSIL KosdW fte Compa�9� L 91977 MOA No.G Oo3 Receipt No. /00 / 00116:1 / Date of Payment 912/�t-- Amount: $ /DUB Page 2 of 2 72-026 t11.64j