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HomeMy WebLinkAboutMANN BLK 3 LT 3AMann Block 3 Lot 3A #020 - 041 - 02 Nov_23.2022 02:49 PM Anchorage Well & Pump Service Inc 9072430742 #3632 P 1/ 1 w MUNICIPALITY of ANCHORAGE Development Services Department # � Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log W01 Drilling Permit Number: _ Date of Issue. �- Parcel Identification Number: 020 041 02 11 Legal Description i1TIraw►i Bloc73tA Pump Installation Date.—" - 22 - 2022 Pump Intake Depth Below Top of Well Casing: Pump 111anufaeturer's Name: XYLEM PUMP Model: 500311 851 Pump Size: .50 hp Pitless Adapter Burial Depth: 10 11 Pitless Adapter Manufacturer's Name: 95 Property Owner Name & Address; RUSSELL CLAUDIA D 95301 GOLDEN VIEW DRIVE ANCHORAGE, AK 99516 4929 feet feet MARTINON P tless Adapter Installer: Well Disinfected Upon Completion? XYes ❑ No Method of Disinfection: PELLETS Comments: Pump Installer Name: ANCHORAGE WELL & PUMP SERVICE Company: 7640 KING STREET ANCHORAGE, AK 995.8 Mailing Address: 907-243-0740 City: Mate: zip. .Attention: The pump installer shall provide a pump installation log to On-site within 30 days of primp installation. Municipality of Anchorage Page J of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SN910210 PID Number: 02004102 Name: Wastewater System: [] New E~ Upgrade Cheryl Robinson Address: 16301 Goldenview Drive Anch ABSORPTION F~ELD qqs16 Phone: 562-1500 IN°' °f Bedr°°ms: 5 [~ Deep Trench [] Shallow Trench [] Bed [] Mound [] Other LEGAL DESCRIPTION soil Rating: Total Depth from original grads: ]_ · 2 GPD/Sq. Ft. 10 ' Lot: Block: Subdivision: 3epth to pipe botlom from original grade: Gravel depth beneath pipe 3A 3 Mann 3 · 5 Ft, 7 Ft. Township: Range: Section: Fill added above original grade: Gravel length: · ,~ Ft. 45 Ft. WELL: .... [] New [] Upgrade Grave]depth: Number of lines: Dis[ance between lines: AX1 S'clnq 7 Ft. i N/A Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. ~/,'~ O SQ. Ft. A,gTH 3034 Driller: Date Drilled: StaticWater Level: Installer: Date installed: Ft, Acreaqe Systems 8/3/91 Yield'. GPM Pump Set at: FI. Casing Height Above Ground'.Ft.TAN K SEPARATION DISTANCES ~: Septic [] Holding [] S,T.E.P. To Septic Absorption Lift Holding ~ublic/PrivateManufacturer: Capacity in gallons: From Tank Field Station Tank SewerLines Anchoraqe Tank 1 , 500 Material: Number of Compartments: Well 105' 112' None None 85' Sur,aee LIFT STAT I O N Water NQDP.- =====::===== :===== ===== Lot Size in gallons:I Manufacturer: Line 20 ' 25 ' None None 20 ' Foundation 1 8 ' 5 0 ' Non e Non e 3 5 ' "Pump on" level at: "Pump off" level et: High water alarm at: Curtain Pump Make & Model Electrical Inspections performed by: Drain None =====::==----=,:========== Remarks: BENCH MARK Location and Description: Ditch on west property line has ~_rlodi~ flow. Horlzont. al seDarati¢~ Assumed Elevation: distance from ST=145' , from DF=90' FI~. ENd, AL of: [¢', _ , ...... Department of Healtl~md l~tuman Ser~ti~.~s approval Reviewed and approved by: .._ ~. Date: 72-013 (1/91)MOA 25 Permit No. ~wc) 1 ~ 2 1 ~ Page 2 of ,~'-~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription: Mann Subdivision, Lot 3A, Block 3 PIDNo' 02004102 72-013 A (2/91) MOA 25 Permit No. ~o[ t p~l'O Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ~J'~"~-v~w ~-'-'-'-'-'-'-'-'-~/P ) ~ ~ ~ ~ ~- % PID No.: 0~0~(~ 72-013 A (2/91) MOA25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910210 DESIGN ENGINEER:MOUNTAIN ENGINEERING OWNER NAME:ROBINSON CHERYL J OWNER ADDRESS:16301 GOLDEN VIEW DR ANCHORAGE, ALASKA 99516 DATE ISSUED: 7/24/91 EXPIRATION DATE: 7/24/92 PARCEL ID:02004102 LEGAL DESCRIPTION: MANN BLK 3 LT 3A LOT SIZE: 44961 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 2. MAXIMUM DE PT~M?OF ADDITIONAL gin TEST/1 ~>'/ // VERIFY NO BEDROCK 6.0' BELOW SYSTEM DURING INSTALLATION. EXCEED 10.0' WITHOUT DATE: DATE: ~0 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION 'rEST LEGAL DESCRIPTION: ~ 3~1"I 6looE- Township, Range, Section: SLOPE 1 SITE PLAN 10 11 12 13 ~4 15 16 17 18 19 20 WASGROUND WATER ~,~ ENCOUNTERED? C) S L IF YES, AT WHAT O DEPTH? p ~onitoring? ~ Dale: Reading Date Gross Net Depth to Net Time Time Water Drop  0;%o ~,~" '~,~" ~'_~ o ~o ~', S~' '~, PERCOLATION RATE (,..,.~,~ ~ ~"~-~'~¢/~':'~'~ ''~r]''~ '~,O (minutes/inch) PERC HOLE DIAMETER PERFORMED BY: I ~ ~-¢~ CERTIFY TRAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~/Z~]~ I 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~J/~i~¢¢[~ JC~JZ-~-.-~] J~c'ln~'~ Township, Range, Section: SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15- 16= 17 18 19- 20- WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT li-Y o DEPTH? p E Monitoring? I"~ [}ate: SFf'E PLAN '-Fl;:)--=-t6,OZ Reading Date Gross Net Depth to Net Time Time Water Drop ©: IO o; ~v 'B,~'~ F mA o PERCOLATION RATE I (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ' -~ FT AND -~"" FT PERFORMED BY: ~~ ~'~~ I ~ ~/¢~' CE.TIFY THAT/,THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF AN¢FIORAGF DEPARI'IV1ENT OF HEAl_TH & ENVIRONMEN'-rAI. PP, O'FEC"£1ON ENVIRONMENI'AI.. ENGINEF. I-UNG DIVISION 825 l. Street- Anchorage, Alaska 99501 Telephone 264-47r~0 ON-SITE SEWAGE DIgPOSA!_ gY,$"FEIVI AND/OR WEI.I. ~NSPECTION REPORT Absorption area I nside length Dwelling NO. OF BEDROOMS I~__ Material Total lengtl;I.°fBlines 1'~ erich wi(~:~t h inches Material beneath tiie ~ NEW [] DPGRADE Depth PERMIT NO. No. of compartments Liquid depth PERMIT NO. [_iquid capacity in gallons Nearest lot line PERMIT NO, inches Oista~etween lines Total effective absorption area ~ 7-3 PERMIT NO. MAILING ADDRESS LEGAL DESCRIPTION LOCATION / I DISTANCE TO: I ~ ~ ~ '- /~ Z / Manufacturer /~ [~city in gallons ~~ ~ ~) ~). ~., I F HOMEMA DE::. ~ISTANCE TO' Well ,~ t ~ I~ufacture,' ~1 ! We~ ~ ~ I DISTANCE TO: I i~ {5 D ~ ~ I N~ o* ,n. I Length of each hne ~ ~of crib ~~ j IC,~ Depth Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) OTHFR PIPE MATERIALS PV(~, SOIL TEST RATING INSTALLER REMARKS ,9 .Lt] '. '~ ' 2100 - E 0CT. 24, 1970 '/ APPROVED DATE LEGAL 72-013 (Rev. 3/78) PERMIT NO. DEPFtRTMENT E. HEAl_TH AN[:, ENVIRONMENTAL. F .YT'ECTION 825 "L" STREET., ANCHORAGE., AK. S¢950i 264-4720 l,-.ff EE b. L_ ~:~ ~-,~ E) KZ:, ~q ..... ~ Z 1"" E: S~: ~% ~.....ff E~ ~: II~ ~2 F~: f"~ :[ T' ( 80052~5 ) FIPF'I_ICAHT CARY RE:ESE STAR ROUTE A BOX 1508-R 99507 2:44-0227 LOCATION GOL.[:,EN VIEN DRIVE LEGFIL - ' ~ ~ ~1 ~' ~ - ' ...... L:~:::E':~:MANN -JBDI~ I5ION I-OT .::,.[~zE ,4'7AF~¢ S:;) AF'E:' FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIl.. RATING (SQ FT,,'BR)= 85 ]'HE REQUIRED SIZE OF THE SOIL. FtBSORPTION SYSTEM IS: THE L.ENGTH .DIMENSION IS THE LENGTFI (IN FEET) OF THE TRENCH OR [:,RFIINFIEL[:,. THE [:,EPTH OF' R TRENCH OR PIT IS THE DISTANCE 8ETHEEN THE SURFBE:E OF THE GROUND RN[:, THE BOTTOM OF THE EXCAVATION <IN FEET). ]'HERE IS NO SET 1.4IDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETI,.IEEN THE OUTFFILL F'IF'E AND THE BOTTOM OF THE EXCR',,,'BTION (IN FEET). PERMIT APPLICANT HAS ]'HIE RESPONSIBILITY TO INFORM THIS I]:,EPARTMENT DURING THE INST'taLL. IRTION INSPECTIONS OF ANY WELLS R[:,..IBC:ENT TO TI-lIS PROPERTY BN[.', THE NUMBER OF RESIDENCES THFtT THE WELt.. WIL. L SERVE. BACKFILLING OF ANY SYSTEM 14ITHOUT FINFqL INSPECTION AND RPPROYRL. BY THIS DEPARTMENT 1.4II_L BE: SUBJECT TO PRI]SECLITION. MINIMUM DISTANCE BETWEEN A HELL AND ANY ON-SI'T'E SEWAGE [:,ISF:'OSFIL SYSTEM IS Z00 FEET FOR A PRIVATE 1.4ELL.. OR t50 TEl 200 FEET FROM R PUBLIC I.,.IELL DEPENDING UPON THE TYPE OF PUBLIC': HEL. L. MINIMIJM DISTANCE FROM A PRIVATE HELL. TO R F'RIVATE SENER L. INE IS 2.5 FEET RN[:, TO FI COMMUNITY SEI4ER LINE IS 75 FEET. NELL LOGS ARE REQUIRED AND MUST BE R. ETURNE[:, TO THE [:,EF'Fff~:TMENT HITHIN Z.':D [:,AYS OF THE I,JEL. L. COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICBTIONS AND CONSTRUCTION DIAGRAMS FIRE'". FIVRILABLE ]"0 INSURE PROPER INSTALLATION. I CERTIFY THRT :1..: IRM FAMIL..IRR HITH TNE REQUIREMENTS FOR ON-SITE SEI.4ERS AND NELLS RS SET FORTH BY TNE MUNI. CIF'ALITY OF ANCHORAGE. 2: I HILL INSTALL THE SYSTEM IN ACCOR[:,ANCE HITH ]'HE CODES. ]:: I LINI)ERSTRND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENL.RRGEMENT IF TPIE RESIDENCE IS REMODELED TO INCLtJDE MOF.'.E THAN ]-': BE[.',ROOMS. S I GNE[:,: ................................................................................ RPPL. I CANT C:ARY REESE LOT SIZE L~'~a~o SQUARE FEET ~?.If'lUft NUMEE~i OF BEDROOMS SOIL RATING ,'q ~-S~'~ ,_Q FT,"BR > = tE REOUIRED SIZE OF THE SOIL .RBSORPTION SYSTEM IS: ,EPTH='? ' L E I'-.il]T Ft: /_~z.~ ' G R R'...'E L IZ)E P TPt:= -.?t THE LENGTfl DIMENSIOH IS THE LENGTH (IN FEET> OF THE TRENCH OR DRBINFIELD. THE DEPTH OF 8 TRENCH OR PIT IS TH~ DI~NCE BETWEEN THE ~URF~CE OF THE GROUHD AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO ~ET WIDTH FOR TRENCHED THE GRAVEL DEPTH IS THE MINI~4UM DEPTH OF GRAVEL BETWEEN THE OUTFBLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET) :~U :RMIT APPLICANT H85 THE RESPOWSIBILITY TO INFOR~I THIS DEPARTMENT DURINO THE 4STRLLRTION INSPECTIONS OF RN'Y WELLS ADJACENT TO THIS PROPERTY AND THE .IMBER OF RESIDENCES THAT THE HELL HILL SERVE. TL.~O (2) II~ISPECTIONS lIRE REQUIRED tCKFILLING OF ANY SYSTEM HITHOUT FINAL INSPECTION /~ND 8PPROVAL BY THIS .'PARTMENT WILL BE SUBJECT TO PROSECUTION. ]NIMUM DISTANCE BETWEEN 8 WELL 8ND FfN¥ ON-SITE SEWAGE DISPOSI~L SYSTEM IS )0 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM Fi PUBLIC HELL DEPENDING :'ON THE TYPE OF PUBLIC WELL. NIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET 8ND '~ R COMMUNITY SEWER LINE IS 75 FEET. TLL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DA~S ' THE HELL COMPLETION. 'HER REQUIREI4ENTS M~Y APPLY. SPECIFICATIONS 8ND CONSTRUCTION DIAGRAMS ARE ~8ILRBLE TO INSURE PROPER INSTFtLLRTION. PERr'I I T E~:P I RES DECEI'IlDER 3::L. i98~'3 CERTIFY THRT I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE $EWER5 AND WELLS AS SET ~RTH BM THE MUNICIPALITY OF ANOHORBGE. I WILL INSTALL THE SYSTEM IN ~CCOROBNCE WITH TH~ ~0~. I UHDERSTRND THAT THE ON-SITE SEWER SYSTEM MAY REQUI~[ ~NLBRGEMENT IF THE :SIDEWCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. ..... ........... PPL I E:RNT ~t ;SUED B?_~7~ ............. DRTE./~ /~'~ V4.0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222~ SOILS LOG - PERCOLATION TEST ~ SOILS LOG [] PERCOLATION TEST 1 2 3- 4- 5- 6- 7 8 9 suJ SLOPE SITE PLAN I 1 10 11 12 13- 14- 15- 16- 17 18 19 20 WASGROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS 72-008 (7/76) DATE: >- ~ Z MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A S N LE FAMILY DWELUN 02004102 GENERAL INFORMATION Complete legal description Markn Subdivision, Lot, 3A, Block 3 Location (site address or directions) 16301Goldenview Drive Anchorage, AK 99516 Property owner C~er¥1 Robinson Day phone 349-7241 Mailing address 16301 Goldenview Drive, A~chorage, AK 99503 Lending agency Mailing address GMAC Mortgage Company 460 West Tudor, Anchorage, Day phone 562-218i 99503 Agent Mary Dee Beauchman Day phone Address 2600 Cordova Street, Anchorage, AK 99503 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 276-2761 X If community welt system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4, TYPE OF WASTEWATER DISPOSAL: X Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72-025 (Rev. 1/gl) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 Mountain Engineering Phone 562-1500 Address 3868 ~Anchorage,_ ____AK 99508 Engineer's signature~~ ~ ~ Date 8/14/91 DHHS SIGNATURE ~ Approved for __ Disapproved. bedrooms. Condit(onal approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 02004102 HAA # 1. GENERALINFORMATION Complete legal description ~... Rnhd~ v~ ~i nn., T,eh '~A . B1 ook- ~ Location (site address or directions) Property owner Mailing address Lending agency Mailing address Anchorage, AK 99516 16301 GO! denvie~*? Day phone Anchorage, AK Day phone Agent Mary Dee Beauschmann Address 2600 Cordova Street, Anchoraqe, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 5 TYPE OF WATER SUPPLY: Individual well ¥ Community well Public water NOTE: Day phone 276-2761 99503 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: x If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 M~l]nt~ i n Address 3R6R Engineer's signature Phone 562-15oo AK 99508 Date 8/5/9] DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for ,~_)-,-~-~ (',,~-,'~ bedrooms, with the following stipulations: / Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 724325 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: Mann S/D, Lot 3A, Block 3 ParcelI.D. 02004102 A. WELL DATA Well type ResidentiaE A, B, or C, attach ADEC letter. Log present (Y/N) Total depth 100 ' Sanitary seal (Y/N) ¥ ADEC water system number Y Date completed 11/13/80 Driller Syren Bros. Cased to 85 ' Casing height 18" Wires properly protected (Y/N) Y FROM WELL LOG AT INSPECTION z Date of test 11/15/80 8/1/91 ~~ _o Static water level Well flow 1 1 g.p.m. 1.4 g.p.r~ O Pump level - SEPARATION DISTANCES FROM WELL TO: O <r z zo Septic/holding tank on lot 1 0 5 ' ; On adjacent lots 1 2 0 ' Absorption field on lot 112 ' ; On adjacent lots 120 ' Public sewer main Non~ Public sewer manhole/cleanout None Public sewer service line Petroleum tank None WATER SAMPLE RESULTS: Coliform (~ Date of sample: '7 [ ;~ [ (~-~l Nitrate I ~ {~"~ ~ / ~._/ n Other bacteria Collected by: Brent Eato~ Mountain Enqineerinc B. SEPTIC/HOLDING TANK DATA Date installed 8/2/91 Cleanouts (Y/N) ¥ High water alarm (Y/N) N/A Date of pumping Tank size i ~ 500 Compartments 2 Foundation cleanout (Y/N) ¥ Depression (Y/N) Alarm tested (Y/N) N/A New Installation 8/2/91 - Permit ~SW910210 N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 105 To property line 20' Surface water/drainage Onadjacentlots G? 200' Foundation 18' Absorption field 25 ' Watermain/serviceline 65' 145' To ditch on West Prop Line with intermittentflow 72-026 (Rev. 3/91 Front MOA 31 CONTINUED ON BACK PAGE C. LIFT STATION Date installed ~nn~ Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed R./3./c) 1 Length zJ.5 ' Width ~ ' Total absorption area 630 SF Depression over field (Y/N) N Results (pass/fail) New System Peroxide treatment (past 12 months) (Y/N) N Soil rating 1.2 GPD/SF Gravel thickness 7 ' Surface water System type Trench Total depth 10 ' Cleanouts present (Y/N) ¥ Date of adequacy test New-Installed for 5 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots GT 200' Wellon lot 112' To building foundation ,50 ' On adjacent lots c.m 1 C~, If yes, give date Property line 45' To existing or abandoned system on lot 15 ' Cutbank No~e Water main/service line None 90' to ditch on west PL Surface water ~,H ~*h p~ r ~ ~,c3 ~ ~, ~= 1 ow Driveway. parking/vehicle storage area 20 ' Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 8/3/91 bedrooms Signature Engineer's Name Date 8/5/91 HAA Fee $ /'~0, dO Date of Payment ,,~';"~/ Receipt Number ,,22¢~ 72-026 (Rev, 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO, 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX:(907) 561-5301 ANALYSIS REPORT BY SAMPLE for WORKordar~ 36799 Date Report Printed: AUG 5 91 @ 12:25 Client Sample I9:LBA B3 MANN SUBDIVISION PWSID :UA Collected JUL 31 91 @ 21:30 hrs. Received AUG 1 91 @ 10:00 hrs. Preserved with :AS REQUIRED Client Name :MOUNTAIN ENGINEERING Client Acct :MTNENGN BPO ~ PO # NONE RECEIVED Req ~ Ordered By :MARK PEARSON Analysis Completed :AUG 2 91 Send Repasts to: Laboratory Supervisor :STEPHZ.~C. EDE 1)MOUNTAIN ENGINEERING 2) Released By : If y~/"~,l %. Allowable Pa~amete~ Tested Result Onit8 Method ............................................................................................................... NITBATZ-N 0.13 ~/1 EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: BRENT EATON. Remarks: 1 Tests Performed * See Special Instructions Above UA-Unavailable ND= None Detected '" See Sample Remarks Above MA~ Not Analyzed LT~Less Than, GT~Greater Than ~ SGS Member of the SGS Group (Soci~t¢ G~n~rale de Surveillance) Tom Fink, Mayor ] unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 14, 1991 Mark Pearson Mountain Engineering 3868 Shannon Circle Anchorage, Alaska 99508 Subject: Waiver Request for Lot 3A Block 3 Mann Subdivision Waiver Request #WR910036, PID ~020-041-02, HA910339 Dear Mr. Pearson: Your request for a waiver of the required 100 foot horizontal separation of a septic system to the surface water has been approved. The approved separation distance is 78 feet betwwen the absorption field and the surface water. This waiver approval applies to the existing septic system to surface water separation only. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. Should the operation of the subject wastewater disposal'system cause any contamination or degradation of the subject surface water, this waiver will become void. ~o~th~S.i~ugere ly, Civil Engineer On-site Services Concur: ~ // On-site Services ljm:#5 Mountain Engineering 3868 Shannon Circle Anchorage, AK 99508 August 9, 1991 Mr. John Smith, P.E. On-Site Services Section Municipality of Anchorage P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED AUG 1 2 1991 Municipality of Anchorage Dept. Health & Human Services Dear John: Re: Mann Subdivision, Lot 3A, Block 3 Waiver of Horizontal Separation Distance to Ditch Dear John: This letter is to request a waiver of the absorption field to surface water separation distance requirements for the above referenced lot. We are requesting that the separation distance be waived to 78 FT. We recently completed an on-site system installation for the lot. Although the design drawing showed the location of the ditch, after the installation, the On-Site Services Section indicated that the ditch would be classified as a stream. Because appealing this classification would take longer than requesting a waiver, and to avoid any ambiguity in the future, we are applying for a waiver. The attached as-built drawing presents a site plan of the area, and includes spot elevations assuming an elevation of 100' for the top of the well casing. We feel that any surface waters that flow in the ditch will not be adversely affected by the location of the absorption field for the following reasons: 1) Water flow within the ditch is periodic, and not continuous. During a preliminary design field investigation last summer, no water was observed to be flowing in the ditch. The homeowner and neighbors indicate that the ditch does not flow year-round. Additionally, Susan Oswalt of On-Site Services has indicated that she has seen the ditch when it has been dry. 2) During a site visit yesterday, the small "trickle" of water that was flowing in the ditch disappeared back into the ground within one block down-gradient of the subject tot. This would indicate that the water probably does not contribute to any other significant body of surface water without at least .MtlNICIPAI.,TYOF^NrJ~o~g additional treatment by filtering through the soils. ENVIRONMENTAL SERVICES DIVISION AUG 2 1991 RECEIVED 3) Soils conditions in the vicinity of the new drainfield are excellent. The materials are well graded, and of adequate percolation capacity to allow water to travel vertically downward instead of laterally. Attached for your reference are the soils logs and percolation tests used during the system design. 4) During test hole excavations on the lot to depths of 17 FT, neither bedrock nor groundwater was encountered. The absence of both reduces the possibility of horizontal transport of the drainfield liquids. 5) The entire septic system is completely new, and unlike older, of unknown status, the septic system leachate will have good clear water output. 6) The apparent reason for any significant flow within the ditch is that the drainage course several blocks to the south of the subject ~ot was recently re- routed by the Municipality of Anchorage to flow parallel to Goldenview. If the ditch is then considered a stream, the act of re-routing the drainage course leaves many homes along Goldenview with no feasible septic system replacement options that meet the separation requirements. Most of the homes have water wells on the east (upper) sides of the lots and septic systems on the west sides of the lots. In re-routing the drainage, the MOA has potentially compromised the regulatory acceptability of many existing systems, along with the only potential replacement areas on the most of the lots. In summary, we feel that the new septic system will not adversely affect the waters that flow in or around the ditch. The homeowner and l also wish to thank you and your staff for your time and patience in discussing this matter. I will be unavailable to answer any questions that you might have until Tuesday, August 13. In the meantime, please leave a message for me on our recorder at 562- 1500. Sincerely, Mark Pearson, P.E. < II Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL OESCR,PT~ON: UC+ ~1 6loeb ~i M~_.~ Township, Range, Section: SLOPE 1 2 3 4 5- 6 7 8 9 10- 11 13 SITE PLAN 14 15 16- 17- 18- 19 WASGROUNDWATER ENCOUNTERED? S IF YES, AT WHAT ~L DEPTH? p E Depth to Water Alter~ Reading Date Gross Net Depth to Net Time Time Water Drop (? ~h~t iq:oo ~;o~ ~o~ 0 20 ~ 0-6~/e4~ -Fo'2 Gil PERCOLATION RATE (mlnutes/~nch) PERC HOLE DIAMETER -- TEST RUN BETWEEN '~ FTAND 4 FT PERFORMED BY: ~ I ~J~ ~¢~ CERTIFY THAT THIS TEST WAS PERFORMED AOCORDANCEWITHALLSTATEANDMUNICIPALGUIDELINESINEFFEOTONTHISDATE, DATE: ~/;~/~' 72-008 (Rev. 4/85) cio 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 Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT [ L..~: 0L DEPTH? p E 13- 14 15 16 17 18 19- 20- Moniloria~? ~ Dale' PERCOLATION RATE --J ~ tmmutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ['- FT AND ~- FT Reading Date Gross Net Depth to Net Time Time Water Drop -iI i :oo .ERFORMEOBY: ~lV~'2J~*~ ~i"V~/q'~- I ~V~t,,/'b ~ CERTIFYTHATTHISTESTWASPERFORMEDIN J ~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Mountain Engineering 3868 Shannon Circle Anchorage, AK 99508 August 9, 1991 On-Site Services Section Municipality of Anchorage P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED AUG 9 lgg! MUniCipality of Anchorage Dept. Health & HUman Services Dear Johe: DRAFT Re: Mann Subdivision, Lot 3A, BI0ck 3 Replacement System Design/Surface Water Set-Back Requirements Mountain Engineering recently submitted an on-site wastewater disposal system permit application for the above referenced lot and received the permit on 7/24/91. This property is located along the east side of Goldenview Drive near East 162nd Avenue. The on-site system upgrade was necessary because the existing system failed adequacy tests and was sized for only 3 bedrooms, while the house actually has 5bedrooms. Construction of the new system took place on 8/2/91 and 8/3/91. We submitted the inspection report/as-buitts earlier this week along with Health Authority paperwork. Yesterday I was informed by Mr. Dan Bo~vJes of your office that the ditch located on the west property line (along Goldenview) is considered a stream and as such will require a waiver of the 100' horizontal separation distance requirement. I would like to make the following points regarding this matter: I re-visited the site yesterday to track the drainage routing in the area. It appears that a drainage course several blocks south of the subject property, along Goldenview, has been diverted from its natural downhill path to flow parallel and on the east side of Goldenview Drive. The ditching becomes buried for a portion of the route (according to Dan, it is perforated CMP in the buried sections), daylights again near the Lot 3A, and continues along the east side of Goldenview. Last night there was a clear-water flow in the ditch several blocks south of Lot 3A. This flow was approximately 2-inches deep in the ditch. After the flow emerges from the buried section, it is only about 25% of the original flow, and this flow completely disappears from the ditch within one block of Lot 3A. Letter to MOA, On-Site Services Regarding Goldenview Ditch Page 2 Before the system was originally designed last year, I walked a 200' radius around the system and found no surface water. Additionally, I believe that Susan Oswalt has seen the area when the ditch was not flowing. The homeowner and neighbors also indicate that the ditch does not flow continuously, and have volunteered to supply letters of verification if necessary. If the ditch was really a cataloged stream, it seems that it would be more appropriate to point this OUt to engineers before a permit is issued. If the department has some insight as to which ditches within the MOA are really "streams", it would be to all of our advantage if the information was shared. I know that there was some discussion in your office regarding this stream/ditch matter before the permit was issued. I think we would all be more comfortable debating this question prior to the installation of the system. Although I understand the difficulty in resolving certain ambiguous issues, the homeowner and realtor are less understanding when, on one hand, the department issues a permit, however after the system is installed the department requires an expensive and time-consuming waiver. The proposed design clearly showed the ditch, and it was my intent to keep the system as far away from the ditch as possible. However I would have investigated other options if we had known the ditch would be considered a stream. I understand the importance of maintaining separation distances to surface and ground waters. I also understand the difficurty in enforcing regulations that are not always entirely clear. I can not believe, however, that it was the regulatory intent of the Anchorage Assembly or the State Legislature to treat the ditching along Goldenview with the same separation criteria as Cook Inlet or Rabbit Creek. I will telephone you or Dan this morning to discuss this issue. The sale of the house was delayed by the installation of the new system, and now by the stream/ditch matter. I therefore must resolve the issue as soon as possible. Thank you for your consideration. Ican be reached today at 562-2514. Sincerely, : DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE DEPT, ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~  ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND sEwER FACILItiES 2, BUYER 5. LEGAL DESCRIPTION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS r~ SINGLE FAMILY [] One [] Four [] Other [] Two [] Five MULTIPLE FAMILY ~ Three [] Six 7, WATER UPPLY ~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for aH wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** ~"~ {~ .YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER F-IINDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY / ( Connection Verified INSTALLER r-qSeptic Tank or [] Holding Tank Size: ] OO0 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: I Absorption Area to nearest Lot Line 5. COMMENTS ~APPROVED FOR ..~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompan,.y,.cer~ficate) o DISAPPROVED DATE BY ~./~ 72-010 (Rev. 6/79) ,t\ N C H O R A G E, , \ LA o x A .q 9 :~t')'l (9!-}?) 204 4.11'1 GEOFIGi:: M. ,qUI_L[VAN, Oi;P,.\i';IB,1ENY,'.iF i',:/d '[!i AN [ NVIIIONb)ENt'A~ PSOY[{CFION ]..:...').[. I]a i. ), :Iii ,, ] 0 Cary [},ecsc Anchorage ~ A].aska 99!]07 Subject: Lot 3A BJ.ock 3 Mann Subd:iv:i.s:i.cm App.rova].. :For your individual sewer and waiter facJ. litiq~s c~!~}lot: be gF2~nke~. ~l].hJ.]. ~.he fo'L]owJ.ng items have "]' '~ L oat)] el'~d (1) A well log subm:i, tt:ed to h}t:i.s depar-tment for our r ovJ. (2) TI'? waLer analysis repot'I: ~eeds [:.o be deliverr~d this office from khe Chem ]l,ab, 5G33 }3 Si:tee'h, for our review, If d~e].(: are a. riy fur-kher, queskJ, ons please ca].], this SJ nc erely, RC ]?/it. j w CJ C: