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HomeMy WebLinkAboutPENNINGTON PARK BLK 4 LT 2APennington Park Block 4 Lot 2A #020 - 181 - 64 t5lAYAtAY Q.1. 2012 Municipality of Anchorage Community Development Department Page ( of On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: SW2-00'9 031-1 pZ3 PID Number: 'z o-- t 4s1 - G New qlJpgrade Name: , ABSORPTION FIELD ❑ Deep Trench 5Shallow Trench ❑ Bed ❑ Mound Address ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade �f Z GPD/SF i 62 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 210 Ft. Gravel depth beneath pipe 3,0 Ft. Block Lot Subdivision Perk,, P7 -h Per k,, 4 Fill added above original gr de 0 .t— Gravel length 0 n r► - 74 Township Range Section Ft. Ft. Gravel width 13', Beds: Number of Lines Distance between lines SEPARATION DISTANCES D Ft. -69- Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line � FC l Q Ft. Well /Ov (� I /00 / ' N /�J �J s v �� TANK Septic ElS.T.E.P. El Holding El Other vvrr Mannnu''fa,c_tu, r I 0.Wp ((` "C, Capacity I l2 SD Gal. Surface Water /oilf 11041r Material CU N r" l<L__1 Number of compartments Z Lot Line so �¢ 0'4 NA Foundations fv (� LIFT STATION Manufacturer Capacity Gal. Curtain Drain Remarksl�d�e. Pump on level at Pump off el at High water alarm at o t►oknotr rs� in. in. in. / 7Y Pump ma nd model Electrical Inspections performed by Installer J AYJ PIPE MATERIAL House to tanky �K Tank to 3 drainfield 3U Nll e , Drainfield CO/MT 3U 3 Inspector ��� kr n r4U� BENCH MARK (Assumed elevation) foo ft Inspection est A/aa� c� �d p dates: 5 th Location and description G? it GPi C?` % 1 ' 1 3� COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL 4 OF. AJ kj Conditional Approval: Date �'�C••• °.° 9Q 49TH' ... .. .. . • . • . • • O ... . . •..rY r.• ..�o.000 •o.a.. F% MICHAEL N. ANDERSON CE 9 Approved ,�,�� Date 1+ �- &J19 a `� �' ��® is Ncuwii nUYVI t_i-1-1L.uuc Permit No. SW2008034O�3 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 185650 Anchorage, A|oako 99519-8650 Telephone: 343-4744 [>n -Site Wastewater Disposal System and/or Well Inspection Report N Legal Description: PENN|NGTON PARK A[ 4, LOT 2A 100' WELL RADIUS ASBUILT . SEPTIC SECDO col 86 73 TC01 88 75 TC62 90 Z_9 CO 127 120 r -co 230 1216 ASBUILT . SEPTIC SECDO Michael N. Anderson, P.E. Civil/Structural Engineering cot Construction 4661 Natrona ,Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 Jan. 14, 2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Pennington Park Blk 4, Lot 2A, Inspection Report To Whom it may concern: This is my response to the structural comments concerning the concrete tank installed on the above referenced lot. I have done all of the structural calculations for this 1250 gallon concrete tank and I have inspected the tank at the manufacturing site. The tank was coated with a coating (petroleum based) and the baffles installed per the standard 1/3) and 2/3 volume design. The maximum soil load for the tank is over 5 feet of cover therefore the design as installed is acceptable. Over the past years I have observed the tank water lever to be very tight with no leaking or fluctuation. If you have any question please call me at 727-8864. SlnCel'ely ok Michael N. Anderson, P.E. Permit Number: SW2008034023 Tax Code Number: 02018164000 Work Type: Septic Permit Effective Dates: April 15, 2011 Design Engineer: Subdivision: 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 Renewal to April 14, 2012 ANDERSON CONSTRUCTION & ENG'G PENNINGTON PARK Ii) ~.~ 1. a r t m e n t Site LegalAddress: PENNINGTON PARK BLK 4 LT 2A G:3437 Owner/Address: DAVID WEED 17470 BETTIJEAN ANCHORAGE AK 99516 Site Mailing Address: 17420 BETTIJEAN ST, Anchorage Lot Size in Sq Ft: 105437 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: ven-a.q.d Close on the same day. ~ ered,"s~e~al~,and-heated topr-e~erit-free-z4nn ~ ~/ \ p 'al Provisions: If, during construction, a silty layer is found below the organic layer, The ~ Engineer needs to do an additional percolation test prior to the construction of the sep_t_ic_.fi,,e!d. "/ / Please submit stamped and signed results with the As-built Inspection Report. If the results [, require a design change, construction of the system will stop pend ng On-Site review and / Issued By: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www. muni.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Mailing address Site address Legal description (Sub'd., Block & Lot) Day phone Zip Code Zip Code Legal description (Township, Range & Section) Lot Size ~'~q~ t ~/~(~/ Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR ([~ all that apply): THIS APPLICATION IS AN: Absorption Field [] Initial [] Septic Tank [] Upgrade '~ Holding Tank [] Renewal Privy [] Private Well [] Water Storage [] 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. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: (Rev. 11/05) I Waiver Fees: Date of Payment: Receipt Number: Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 April 15,2011 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Pennington Park Blk 4, Lot 2A To Whom it may concern: This letter is in reference to the property for a new septic system for the garage addition. Previously KND Engineering installed to two test holes along the west property line, their design is in the file. Test hole #1 was excavated by myself to verify the soils and found to be slightly different then my soil log. Bedrock was found at 14 feet and the top layer didn't have any ML like the KND log. Water has been monitored for the past 2 years and found to be at 9 feet, throughout the seasonal high water period. The lot has a gentle slope from east to west at about 5% down to the west property line, where a small natural hill brings the slope back-up. After the hill the grade slopes to about 15 % to the west again. The land to the west is a large 100 plus acre lot which is vacant. There no public wells with 200 feet of the system an, d the creek on the south side is over 100 feet from the system. ~/~, ~ ~t f ~ ,¢ ~,,~ ~t r,- We do not expect that there will be any adverse effect on the adjacent lots by the development of this system. If you have any question please call me at 727-8864. Sinc~, Michael N. Anderson, P.E. DESIGN CRITERIA: I ~MOUND OVER (TH#2) (TH#l) -o /-- ~-.....%~ ~GRADE 4 BDRM X 150 = 600 GPD ORe .Z.f JORG ~' ~ / FiLTF~R FABRIC SOILS = 600/1.2 = 500 GPD o.5I e~,-II \5;/¢-. ~,,~pi~¢U~TION 500 GA/5 X .58 = 58' GM (1), TRENCH ~o %SEWER ROCK 4.0 DEEP 5.¢ 5.0' EFFECTIVE -~o ~J ML ~ ML 5.0' WIDE 58' LONG -14 ~d B.O.H. -1~ B.O.H. BEDROCK BEDROCK SEPTIC FIELD SECTION EXISTING ~R J ....... 100' CREEK~ OFFS~ Septic Design Prepared For DAVID WEED . Prepared By MICHAEL N. ANDERSON, P.E. ~..~.~...~ ............................... 4661 NATRONA AVENUE ~.~MICHAEL N. ANDERSON/~ (9o ) / FAX (90 ) / / / EXiSTiNG 150' WELL RADIUS // /Fl // I /--EX,ST, NO SEPT,C TANK W/ ADEC WA,VER I / / I r-EXISTING / I / SEPTIC / -- 1----"~¢'"...~ ~ F~ ~m / ~ I EXISTING / TRENCH ~ ~ .¢~1, ~ ~ I / ~ / 'L~ ~ x / -~-%--'- TH~2 VERIFIED BY MNA ~ xxx * 15% ~// IIii II MT x CO oo ~xx . nn t ;; II ~ SOLES PERC RATE TO / ~ ~ ! II IiiI, /~ BE VERIFIED DURING n~,,~ .... ~ ~ =~_ VACANT ~ ~ , ,/ / CONSTRUCSTION ........ ~ ~ N ~ II / ~ PROPOSED 1,250 I ~ ', ~PROPER~ LINE= XXN. It iII ~ ~ ~ .............. 20' UTILIW ~SEMENT Septic Design Prepared For DAVID WEED PENNINGTON PABK, BLOCK ~, LOT gA ~ Anchorage, Alaska ~/ MICHAEL N. ANDERSON, P.E. ~'~~"~: .................... ,'m'~ 4661 NATRONA AVENUE ~.~ MICHAEL N. ANDERSON~ (90?) 345-33?? / FAX (907) 345-1391 ........ SCALE: 1"=40' APRIL 14, ~011 Performed For: Legal Description: 5- 6- 7- 8- 9- 10- 12- 13- 15- 16- 17- 18- 19- 20- COMMENTS Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O, Box 196650 Anchorage, AK 99507 www.ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test 6 ~ Slope Township, Range, Section: IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: Reading Date Gross Time Net Time Depth to Water Net Drop .4,// PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BE~WEEN ~ FT AND '~ FT PERFORMED BY: ~ '/~,/¢-, I /~ /¢-"¢'.~a~'4.¢#d CERT[FYTHATTHISTEST~WAS/ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ANCHORAGE, AK 99501 Phone: (907) 269-7519 DEPT. oF ENVIRONMENTAL CONSERVATION / Fax: (907) 269-3487 DIVISION OF WATER t [ http://www.state.ak.us/dec/ WASTEWATER DISCHARGE ATHORIZATION PROGRAM ~ f January 25, 2011 Michael N. Anderson, P.E. 4661 Natrona Avenue Anchorage, Alaska 99516 Re: Pennington Park Subdivision, Block 4, Lot 2A-South Anchorage-Waiver of Separation Distances from a Class C Source Well to an Existing Wastewater Septic Tank-ADEC Plan Tracking Number 8468 Dear Mr. Anderson: On January 13, 2011 the Department received the request for a waiver between a Class C source well and the existing septic tank; a 1,000 gallon Greer steel tank that was found still serviceable. The waiver is justified based upon the engineer's recommendation, the well log's indicating 190 feet to the water table that is in use, and a proper seal about the well head. The drinking water sample results for nitrates as nitrogen that was found to be 0.134 mg/1 by laboratory analysis. (January 11,2011) The waiver is from the Class C source well on Lot 2A to the existing septic tank an existing system. This waiver establishes the reduction of the required separation distance from 150 feet to 115 feet per the Engineers field measurements of the existing conditions. The Department has reviewed the engineer's recommendations and reduces separation distances as listed above. If in the future this Class C source well shows signs of contamination, which can be traced back to this waiver, the waiver will become invalid. At that time it may be necessary to relocate the Class C well to a location that meets all required separation distances. In addition, if the septic tank system fails and needs to be replaced the tank must be moved to meet the required separation distance at that time. This approval does not imply the granting of additional authorizations nor obligate any state, federal or local regulatory body to grant required authorizations. Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC 15.195- 18 AAC 15.340 or an informal review by the Division Director in accordance with 18 AAC 15.185. Informal review requests must be delivered to the Division Director, 555 Cordova Street, Anchorage, Alaska 99501, within 15 days of receiving the decision. Guidance information on the informal review process may be found at http://www.dec, state.ak.us/commish/ReviewGuidance.htm. Adjudicatory hearings requests must be delivered to the Commissioner of the Department of Environmental Conservation, 410 Willoughby Avenue, Suite 303, P.O. Box 111800, Juneau, Alaska 99801, within 30 days of the decision. If a hearing is not requested within 30 days, the right to appeal is waived. Thank you for your cooperation. If you have any questions please do not hesitate to contact me at 269-7519. cc: William Smyth, WW Respectfully, William R. Rieth, P.E. Environmental Engineer Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 September 11, 1997 David W Weed 1029 West 3 Avenue Suite 510 Anchorage, Alaska 99501 Subject: Lot 3 Block 4 Pennington Park Subdivision Permit #SW960289, PID #020-181-22 The subject permit, issued September 11, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of September 11, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If yF~have any questions, please call this office at 343-4744. Jam~s uros$, P.E. Program Manager On-site Services enc: Copy of Permit cc: KND Engineering PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960289 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:WEED W DAVID OWNER ADDRESS:17420 BETTIJEAN ST. ANCHORAGE, AK. 99516 DATE ISSUED: 9/11/96 EXPIRATION DATE: 9/11/97 PARCEL ID:02018122 LEGAL DESCRIPTION: PENNINGTON PARK BLK 4 LT 3 LOT SIZE: 74668 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL 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 (18AACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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 BY: ISSUED BY: DATE: DATE: I[~N~ ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 August 27, 1996 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Lot 3, Block 4, Pennington Park S/D - New Sewer/Well Permit Gentlemen: On October 24, 1995 we excavated two testholes for the subject property. At the present time the owner anticipates construction of a four bedroom unit for this lot. The results of these tests and water monitoring are attached. The property has a gradual slope from east to west. At the west end of the property the slope gets shallower and shifts to the southwest. We propose to install very shallow 5' wide trenches; the flow will be evenly divided by connecting to the center of the trench. Additional fill will be placed over the system to provide a minimum of 3' of cover when complete. There are no public or private wells within 200' of our proposed system location. There is neither surface water within 100' nor any known curtain drains within 50'. We do not expect that there will 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, .!I~ I'q I~ Engineering Kenneth M. Duffus, P.E. attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test(2) WASTEWATF-R DISPFISAL SYSTEH DETAILS/SITF PLAN LOT 3~ BLOCK 4, PENNINGTBH PARK S/D NB EXISTING SEWER WITHIN 200 FEET OF PROPOSED WELL, NO EXISTING WELL WITHIN 200 FEET OF PROPOSED SEWER EXCEPT AS NOTED, VACANT LOT 2 0 PROPOSED WELL LOT 3 CO VACANT TF ]SED FIELD PROPOSED 1250 TANK LF1T 4 VACANT DESIGN CRITERIA 1, 4 ]}DRN X 150 GPO = 600 GPO WASTE FLOW, 2, 600/0~8 GPO PER SQ~ FT, = 750 SF 3, 750 SQ, FT/5'W X ,58 R,F, (3,0' GRAVEL)--87', 4, USE SINGLE TRENCH 87' LONG, 5 W, 3' GRAVEL, 5, TOTAL DEPTH NOT TD EXCEED 5', 6, USE 1250 GALLON SEPTIC TANK, 7, INSULATE DRAINFIELD aH HD FBAN IF <3' COVER, INSULATE TANK IF <4' COVER, 8, CONTRACTOR TB INSURE HAX 2% GRADE FROM HOUSE TD SEPTIC TANK, PREPARED FOR: DAVID WEED 17420 BETTIJEAN STREET ANCHORAGE, ALASKA 99516 KND ENGINEERING ~0441PTARNIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/F~x (907)696-8111 DATE~ 8/27/96 SCALE, 1' = 100' JDRAWlNG ~ 95043-§1 Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: [~),'~VI~::~ \,/~/~---~f','~ LEGAL DESCRIPTION: /~O7'-~ P~--./V/'//,4,//~ ¢',0,Iv/ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18 19 20 COMMENTS -~,-~" .." ~ ~ ~ Kenneth Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? Y~,~ L IF YES, AT WHAT / O DEPTH? /~ P .-.~0 ~ ~Y'/: vv'~ '//~f' Depth to Waler Alter ~/~/ Monitoring? Date: Gross Net Depth to Net Reading Date Time Time Water Drop Ye" - ~ I' I ,¥,,,~ I ,-,~,;~ 7 Ye" /" ~I ~ ,~,:~ / ~,~ ~ W" '/z" ~ 3 ~,~ / ~,~ ~ '~/~" ~z" ~ W~/~ ~/~ ~ ~Y¢" -- ~ ~ .~,~ I ~,~ ~" 'M ", ~ Z ~,, ~ ~,~ ~ '/~" Cz ' ~ ~ ~,a I ~,~.. . PERCOLATION RATE 2,~ (m~nutes/,nch) PERC HOLE DIAMETER TEST RUN BETWEEN -~ FT AND Y ET PERFORMED BY: /~//~z~¢/~.,¢/~/'//~/; ..~7/ ,.~-0 I ,,.~,~¢/?¢/'~ .Z.P~.f'?/~.5 CERTIFY THAT THIS TEST WAS PERFORMED IN d ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: 72-008 (Rev. 4/85) PERFORMED FOR: LEGAL DESCRIPTION: _~_ ~.,% T,,,:,_ ,,,,oo,,o. ,,,~,,,,~ .." ~- ~ ..' ~ DEPARTMENT OF HEALTH & HUMAN SEf~VICES ,°..i.~~.oRa...~....° SOILS LOG --PERCOLATION TEST ~ ~¢,~_". Kenneth lA. Duff~ ~-¢ ~'~/V/J/42d~'7"O,'t) Township, Range, Section: 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER ENCOUNTER ED? SLOPE $ L IF YES, AT WHAT 0 DEPTH? P E Depth to Water Alter Monil~ring? . Dale: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop ,o/z p5 - /t ~ ~,~ / ~, ~ ~ '/z ', '~/~ ,, /g ¢ m.~ / ~,e & ~/~" ~" PERCOLATION RATE TEST RUN BETWEEN _ (m,nuteS/~nch} PERC HOLE DIAMETER _ F T AND F 'f /, ACCOI~L)ANCE Wl3'IIALL S'~A'TE ANO MUNICIPAL GUIO[LIF~E.% It,/ 1~6(-I ON lJ~l'.) I)AIL o^T( /d)/b? ~/P?~;' Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15- 16 17 18 19 20 COMMENTS Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? Y.~ S L IF YES, AT WHAT O DEPTH? /Z' p E Depth lo Waler Alter /o/~1/¢ ~ Monitoring? -~r-~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop o o - ,, _ PERCOLATION RATE ,~// (m,nutes/~nch) PERC HOLE DIAMETER TEST RUN BETWEEN /' ~ FT AND . .2. ~"" FT PERFORMEDBY: /'''/v//--~ ~-/~/,''~/d /~-,'~-?~'//'~ //~['). .50 I ,~,.'?/~?~/~ /-,~)£¥]/~'F~U,~ CERTIFY THAT THIS TEST WASPERFORMEDIN 72-008 (Rev. 4/85) PERFORMED FOR: LEGAL DESCRIPTION: L.~"F ~ '-~.~ I&)(,..TCN (FEET) 1 2 3 4 5 6 7 8 9 10 '11 12 13 14 15 16 17 18 19 2O I ~5 t~' _%o.'*"*-'*, I _~',.? .o' & **.'"4- Municipalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES F,t,~ ~,".. '~J "°x-,. ~- . . ~ .~ ."'e,.;,, - ·-... .... .,,,, WAS GROUND WATER ENCOUNTERED? Township, Range, Section: S L IF YES, AT WHAT 0 DEPTH? p E Depth to Water After Monitoring? Date: SLOPE SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop ~ ~o1-,~ I~ o - ~ - ~ I 7 ~,~. ~ ~ PERCOLATION RATE TEST RUN BETWEEN Imlnutes/mch) PERC HOLE DIAMETER ~-~l/ _ FT AND ~ FT ACCORDANCE WI'i'H ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE 72-008(Rev 4/85~ CERTIFY THAT THIS TEST WAS PERFORMED IN DATE 3un 26 200? 12:44PM LR~ OFFICES p.1  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT IP"ONE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS DISTANCE TO: ~ Z Manufacturer Material No. of compartments  Liq. cap~city in gallons Inside length Width Liquid depth ~ O~ IF HOMEMADE: ~ ~ O ~ DISTANCE TO: Well Dwelling PERM IT NO. ~ ~ ~ Manufacturer Material Liquid capacity in g~llons ~ Well Foundation Nearest lot line PERMIT NO. ~ ~ ~ No. of lines Length of each line Total length of lines Tren~ width Distance between lines ~ ~ Top of tile to finish grade Material beneath tile Total effective absorption area Length Width Depth PERMIT NO, ~ w Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line m DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: SOIL TEST RATING INSTALLER REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE Health and Environmental L Street, Anchorage, AK. Department rotection 825 99501 264-4720 * * * HANDWRITTEN PERMIT * * * Permit #~D~I WELL AND,~rON-SITE SEWER PERMIT AppliCant: ~, ~U~'~) ~_~ Mailing Address: Location: ~3; ~ Phone Number: ~.$~--7~--~ Legal Description:' L-~7:~. &/~ ]~}~~A3'~t Size: ~/~ Type~of Soil Absorption System Is: T~ench: Drainfield: Seepage Bed: ~Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH ,~.~ · WIDTH LENGTH .~o~''! . GRAVEL DEPTH ~ '~ ! 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). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~ GALLONS * * 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. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee 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. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER ~1~ 1 g 8 3 * * * 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 codes. (3) sewer system may require enlargement if S igne~: I underst.~nd .~ha~he on-site t h,~ ~/n//~Temo d e 1 e d to SWP/024 (1/81) include more that 3 bedrooms. Issued by: ~ , .~~~ Date: ~/~l ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: -.--=1 3 4 5 6 7 8 9 DATE PERFORMED: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED7 s I 10 11 12 13 14 15 16 17 18 c.p.e~d, Jr, Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE PERF RMEDBY' ~ e~5 ~ J~ ~ ~ CERTIFIED BY: ,~,~,,.e~a-~ ,% ..' DATE. 7' J WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological ~ Seophysicel Surveys Drilling Permit No. LOCATION OF WELL (Please complete either la, lb or lc.) A,D.L. No. ,°,llBorough Subdivisio. Lot .,ack -~-~'1 'X4,f.e. Sec,ion No. Town.hlPNO Roage Ell Morldlan ,c. JJDISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 5. OWNER OF WELL: Address: Street Address end Area of Well Location 2. WELL LOG Feet Below 4. WELL DEPTH; (final) 5. DATE OF COMPLETION Surfaco F;'{:/~ '~ ~t ~.) ~ ~ ~ ~ 5--~ 9. FINISH OF WELL: Set befween ff. end ff. Bockfilling Gravel pack ~Abave or ~ Belaw Iond surfece Dele Equipmenf used: II. PUMPING LEVEL below lend surfoce end YIELD 1~47 ft. after t hr,. pumping I/l~ g.p.,. ft. after __hrs. pumping __ g.p.m. 12.~ROUTING Well Grouted: ~ Yes ~ No Material: ~ Neat Cement ~ Other: : 15. PUMP: (if available) HP Length of Drop Pipe ft. capacity g.p.m. ~ Subm. ~ dot ~ gentrifical ~ Other 14. REMARKS: 16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature ~o ~ F ~ C This well was drilled under my jurisdiction end this report is true lathe best of my knowledge and belief; Registered Business Name Conlract License Number A'u~horlzed Representative Farm 02-WWR (11/81) Copy Distribution; WHITE-State DGGS~ PINK-Driller, CANARY-Customer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY //J'~'~ -- 264-4720 GENERAL INFORMATION (a) (b) (c) Application Date Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name lJ;~J~,V'tC~ \.~. _¢~-~_~2> Telephone: Home ~.~- ~.."TzJ¢ ~ Business *Z"'It~-(x"~z~Z.-O Applicant Address 1'7~:::) ~-p~-'T'C,_']'~:;e.~ ~ -- ~tJC~. / ~lt2-. ~-"~G I~ Applicant is (check one): Lending Institution []; Owner/bi.der ~ Buyer []; Other [] (explain); (d) Lending Institution 'L~:~ Address ~'"j C, L...~. Telephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: S & S ENG!NEER'!NG SRB 196X EAGLE RIVER, Al( 99577 Number of Bedrooms Other 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. ' 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. Page 1 of 2 72-025 (11/84) 5o ENGINEERING FIRM PROVIDh,,G INSPECTIONS, TESTS, FILE SEARCH, D,-, £A 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 inspectio, i~.&~ Name of Firm $ ENGINEERING Telephone $~ i96x Address E/:t~LE Ei¥'ER, AK 99577 Date Approved for __~--/--~-~bedroomsby~'-'~./ /~- Conditional~ ate Approved / Disapp r~,,,~d Terms of Conditional Approval CAUTION ", The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered n the State of A aska. The DHEP does th~s as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) WELL DATA Well Classification Well Log Present~:~)N) Total Depth Static Water Level Casing Height Above Ground Electrical Wiring in ConduitON) Separation Distances from Well: To Septic/J;jel~l~Tank on Lot MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: ~ ~, ~. If A, B, C, D.E.C. Approved (Y/N) Date Completed ~"' I/'~" ~:~ Yield Cased to "~'"~ ff Depth of Grouting f,4~:;;;> r,~_~..z>O-r" ~.~ '~-"~',~' / Pump Set At ~ 'i~" Sanitary Seal on Casing(~;IN) Depression Around Wellhead (Y/~) ~, ~ 1,..~ ; On Adjoining Lots To Nearest Edge of Absorption Field on, Lot ~:~'~¢' ; On Adjoining Lots To Nearest Public Sewer Line , r-.,/.,~. To Nearest Public Sewer Cleanout/Manhole ~/~ To Nearest Sewer Service Line on Water Sample Collected by ~---~'~ '~_-i.~,~,,,,._~,~=~i).~t~--~., ; Date Water Sample Test Results ~r-1 ~, Comments ~/~,I,4.. ~/~--~:> ~ '~~ ~,.~_~-~_~? .-"~'~ , B. SEPTIC/.Id~EI~tG TANK DATA Date Installed Standpipes(~N) Air-tight Caps(~N) Depression over Tank (Y¢~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Size ~o~;~ No. of Compartments :~ .Foundation Cleanout (~N) Date Last Pumped ~.-.,~I¢..--~ --- ~5 ;for Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/l~e~i~-Tank: To Water-Supply Well To Property Line ~ Lr~ ~' TO Water Main/Service Line Course T© Building Foundation ~ ~ To Disposal Field "~7,.., ! To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) APPLI(' NT FILLS OUT UPPER HA! ONLY Property Owner ! '~ ,) \ t \/I ~, ~_-,~ i,i'~;\~ -~--i,, ~.,L~;~: E:'J,~' ~ Phone ~ ~ ~ ,, Buyer ~ Address Zip ,Code ' "' , ~.~ ~-L. ~'~ ~ Phone Realty Co. & Agent y?'~, ~5( J Phone Address Zip Code Street Locati~ Type of Resi~nce ~ Single Family ~ Multiple Family No. of Bedrooms ~ Other Water Supply ~ Individual ,-~ ~ ~ ATTACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~' Community ~ ~ ~ ~ For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspec?.~ Field Notes: ( ) CONDITION~ APPROVAL' Soils ~, ~ Date ~wer InstalledF_ ~[ ~ ~ ~ Well To Absorption Area /~ Well Log ReceiVedsize T Well to Tank / ~ ~ Septic T~k 72-023 (3182) Co f // .,d. 0 "~ Soils Rating in Absorption Strata ~ ~'l:l~t'''' ?/ Type of System DeSign ~;;;~"~ ~",~¢'""6'2'~ / Length of Field ,¢¥¢2' A/// Datewidthlnstalledof Field \ ¢-~ / Depth of Field "¢¢[ ~ O J//,. Gravel Bed Thickness ¢;~ °~ Square Feet of Absorption Area ~:24~ Standpipes Present ~N) Depression over Field (Y/~ Date of Last Adequacy Test Results of Last Adequacy Test ~ I ~'~¢~"~"/ F¢ ~' Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line To Existing or Abandoned System on · On Adjoining Lots To Cutbank (if present) Comments D, LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions Manhole/Access (Y/N) ~.~ //~ "Pump Off" Level at Vent (Y/N) /r` Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify tl~l~a~~l~d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection· Signed -- ,,"'-" Date //'~///X,/C;F' ~¢ Compan~GLE ~[V~, AI(~577 MOA No. ~ ~ ~ ReceiptNo. ~ ~0 J ~~ Date of Payment ~0 ~ / ~ ~ Amount: $ Z~ %~~ Page 2 of 2 72-026 (11/84)