HomeMy WebLinkAboutWOODBOURNE TRAILS LT 5AWoodbourne
Trails
Lot §A
#015-192-41
Permit Number:
Tax Code Number:
On-Site Wastewater Disposal System Permit
OSP141287
01519241000
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
Work Type: Septic Upgrade
Permit Effective Dates: August 13, 2014 to August 13, 2015
Design Engineer: SPURKLAND ENGINEERING
Subdivision: WOODBOURNE TRAILS
Site LegalAddress: WOODBOURNE TRAILS LT 5A G:2641
Owner/Address: JOHNSON NORMAN L & SANDRA L
11581 DOGGIE AVE ANCHORAGE AK 995076342
Site Mailing Address: 11581 DOGGIE AVE, Anchorage
Lot Size in Sq Ft: 28508
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.
Received By~
issued By:
Municipality of Anchorage
P.O. Box 196650 · 4700 Elmore Road
Anchoraqe, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997
http:l/www.m uni.orq/Onsite
Development Services Division
On-Site Water and Wastewater Proqram
**** VARIANCE/WAIVER REVIEW ****
WaiverS: 0SP14t288 COSA#: Permit~: OSPt41287
PID#: 015-192-41
Legal Description: Woodbourne Trails Lot 5A
Engineer: Spurkland Engineering
Applicant: Norm Johnson
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 15.0 feet.
This waiver approval applies to the proposed absorption field only. Any furore upgxade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
[] The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
[] Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
[] Adjacent properties are not affected by this waiver.
Waiver is Granted: X Waiver is not Granted:
Date: ~t/7//~,¢' Approved by: Iqame °f Reviewp¢'/
**** VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-192-41
Property owner(s) NORM JOHNSON
Mailing address 11581 DOGGIE AVE., ANCHORAGE, AK 99516
Day phone 346-1351
Site address SAME
Legal description (Sub'd., Block & Lot) WOODBOURNE TRAILS LOT 5A
Legal description (Township, Range & Section)
Lot Size .Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
([~ all that apply)
Absorption Field [] Initial [] Single Family (SF) []
(wtwo ADU)
Septic Tank [] Upgrade []
Duplex (D) []
Holding Tank [] Renewal []
Multiple Dwellings []
Privy [] /.~ U ~[~M~.E.rA, (SF and/or D,
Private Well []
Water Storage []
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
SLOPE Distance: 15'
I certify that the above information is correct. I further certify that this is in accordance with
appl)cabJe Municipal Codes.
(signaturepf property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
Receipt Number:
Permit No. O5¢1~ t~ Waiver No.
Permit App_9-1 ~ 12.doc
Environmental Consulting and Design
SEPTIC SYSTEM DESIGN
WOODBOURNE TRAILS LOT 5A
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 Elmore Road
Anchorage, Alaska 99519
July 29, 2014
Subject:
Septic System Installation Permit
11581 Doggie Ave.
Ladies and Gentlemen:
I am writing to request a septic system installation permit for the above referenced property. The
proposed system will serve a 4-bedroom single-family residence. Soil logs, design calculations,
a site plan, design drawings and construction specifications are enclosed for your review.
Design Calcs: No Groundwater observed to a depth of 17 feet below ground surface
(7/24/14).
Soil Rating. From Tes thole 7/17/14
53 mirdin - 0.45 gal per sq.ft/day
No. of Bedrooms 4
Required Area per Bedroom: 150/0.45 - 333 sq.ft.
Total area required: 333 x 4 - 1332 sq.ft.
System: We are proposing a 1250 gallon septic tank followed by two deep trench absorption
field. Each trench will be 50 feet long and 2 feet wide and contain 7 feet (1400 sq.ft, effective)
of sewer rock.
Soils: A test holes were excavated on July 17th, 2014. See the attached soil logs. Ground water
was not observed. Ground water monitoring will continue through construction of the septic
system.
Surface Water: No surface waters were observed within one hundred feet of the proposed
septic system upgrade.
Topography: The ground level slopes down towards the west at less than at approximately 10
% grade. There is a road bank of approximately 40% slope approximately 15 feet away from the
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
~~i~ Environmental Consulting and Design
lower trench (see slope profile sheet 4/4).
Waivers: Slope waiver- Absorption field to slope >25% 15 Feet.
The installation of this septic system will not prevent wells and septic systems from being
installed on the adjacent lots. The proposed septic system will not change the general slope of
the area. Ponding and/or concentration of surface runoff will not result from this installation.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely,
Lars Spu~kland, P.E.
Civil Engineer
203 West 15a Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
I_ot $
;o! 4
Lo! 5
EAST KLA1T RD
® I
II ®
II
Lot ,t
VACANT
~. i i i~I Lot ~A
VACANT
N
IiATE:I~15 IS NOT A SURVEYED PLAT. WELL & SEPTIC
TIONS TAKEN FROM ON-SITE tFATER AND WASTE WATER
EPARTMENT DOCUMENTATION, ALL LOC~4TIONS SNOWN ARE
PPROXINATE.
50 ]dO 150 £00 250
SCALE~ l' = lO0 FT,
SPUNK/AND ENGINEENING
203 iV 15TH, ~VENUE
ANCH, ~K, 99501
(907) 279-3916
I OODBOURNE TRAIZS LOT 5A
NORM JOHNSON
11581 DOGGIE AVE, ANCH£RAGEAK 99507
SEPTIC SYSTEM DESIGN
DATE~ JULY 24 2014
SHEET; 1/4 GRID~ SiV 2641
PERMIT # OSPIIlOXX PID # 015-192-41 iVOOflBOURNETRAILSLSASClOafliVGi
DIVERTER VALVE
{NSULATE UNDER DRIVEWAY
INSTALL ,50/.50 SPUTTER
DECO~WISSION EXISTIND I
SEPTIC TANK PER ~OA
CODE £EOUIREkCENTS
'~ " Lot 5A
INSTALL 4-BEDROOM SEPTIC SYSTEI~
NDe 1250 GALLON SEPTIC TAHK
INSTALL DIVERTER VALVE
TRENCH LENGTH 2 x $0 FEET
TRENCH WIDTH $ FEET
MAX EXCAVATION DEPTH 1! FEET
ROCK DEPTH 7,0 FEET
COVER 4 FEET
VACANT
NOT~' NO S[REA~S O~ SURFACE ~ATERS ~ITHIN ]
~00' OF PROPOSED SEPTIC LOCATION
J
NOTE: THIS IS NOT A SURVEYED PLAT. ~/ELL · SEPTIC
LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER
OEPART~ENT DOCUk~ENTATION, ALL LOCATIONS SNO~IN ARE
APPROXI~A TE.
25 0
25 50 75
SCALE~ I' = 50 FT,
125 150
II I
4' CONTOUR LINES
SPURKI. AND ENGINEERING
203 W 15TH. A VENUE
ANCH, ~K, 99S01
(907) 279-3916
WOODBOURNE TRAILS LOT 5A
N~RM J£HNSllN
DOGGIE AVE ANCH£RAGE AK 99507
SEPTIC SYSTEM DESIGN
DATE~ JULY 24 ~014
SHEET: 2/4 GRID~ 2641
PERMIT # OSPI41XXX PID # 015-192-41 W£ODSDURNETRAILSLSA,SCSO. DWG
/£lventer To Existin9 Field
/ Double Clean outs
Ne~ 1250 Ga/Ion
Stee~ Sept~ ~onk
ND SCALE
l'rench Elevdion
7,0 Pt o£ Septic Rock
7.0 St o£ Septic Rock
Double Clean outs
NEY 1250 GALLON
STEEL SEPTIC TANK
SPURKLAND ENGINEERING
£03 v 15TH AVENUE
ANCH AK, 9950!
(907) 279-3916
WOODBOURNE TRAIISLOT5A
NORM JOHNSON
11581 BOGGIE AVE, ANCHORAGE AK 99~7
SEPTIC SYSTEM SCHEMATIC
DATD JULY 25 2014
SHEET: 2/2 GRID~ 264l
PERMIT Il £SP141XXX PIB Il 015-19£-41 WBTLSAD3,DW6
DEPTH SOIL DESCRIPTION DATE:__7/jT/'f4_
I ORGANICS P/AS GROUNDP/ATER OBSERVED: No
IF YES, Al' P/HAT DEPTH:
2
$
4
$
6
7
8
10
11
12
15
14
I§
16
17
s~tr ~/ SO~E aRAVEt
(Ut, G~)
AFTER MONITORING PERIOD: , Dn/
DATE OBSERVED:_ ;~/24,/_~_4._
PERCOLATION TEST.,
FILL DATE GROSS TIME NET TIME DISTANCE DROP
5,815' 7/24/14 I:10 PI~ 0 min.
!5,188' 1:40 PI~ $0 min. 5. f88" 0.688'
4,688" 2:10 PI~ .TO min. 4,688' 0.500"
2:40 PI~ .TO min. 4,125"
PERCOLATION RATE: 55 minutes/inch
PERC HOLE DIAMETER: 6 inches
TEST RUN BETWEEN 6.5 Fr AND 7 Fi'
SITE PLAN:
N
SEE ATTACHED SITE PLAN
18
19
NOTES: PRE-SOAKED
2O
PERFORMED BY: Anson Moxness. I, Lars Spurklond P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE W/TH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
SPUNK/AND ENGINEERING
£03 PI 1Si'H, AVENUE
ARCH. AK, 99501
(907) 279-3916
~'OODBOtJRNK TRAILS LOT 5A
NERM JOHNSON
11581 DOGGIE AVE ANCHORAGE AK 99507
SOIL LOG PERCOLATION TEST
JULY £4 £014
GRID #, SW ,2631
PERMIT # PID# 015-19£-41
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVlRONF/~ENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE D~SPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL DESCRIPT (~N
LOCATION
~r Material.~,~ t
Liq. c DwellinglnSide length II Width
TPHONE ~NEW
[]UPGRADE
NO, OFBEDROOMS
CZ ,:? 0.7
Liquid depth
IF HOMEMADE:
Well PERMIT NO,
DISTANCE TO:
Manufacturer
Material
Foundation ~/....~ ! Nearest lot Jine z~..(~{
Total length of'line)~ -1/I Trench~wi~th (J,-1
~ ( I ,~3 --TQ~ches
Material beneath tile ~(~ inches
No.o,E,e, t. IL'ng'h°'each"n::'
Top of tfJe to finish grade
Width
Length
Depth
Type of crib Crib diameter Crib depth
Well Building foundation
DISTANCE TO:
Class Depth Driller
Sewer line
Building foundation
DISTANCE TO:
Liquid capacity in gallons
PE MIT NO~.,
IDistance between lines .~
Total effective bsorption rea
PERMIT NO.
TotaJ effective absorption area
:~t tts ZIs:Nearest lot line
Distance to lot line
PERMIT NO.
Absorption area(s)
OTHER
PIPE MATERIALS
APPROVED
DATE LEGAL
72-013 (Rev. 3/78)
LO¥ '5I
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264~4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
11
13 -
14-
16
17
18-
19-
2O
COMMENTS ~,~ ~'~
PERFORMED BY: ~f~
DATE PERFORMED:
SLOPE
SITE PLAN
WAS GROUND WATER .! S
O
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN .
~' ~ FT AND 7 FT
CERTIFI fid BY
72-008 (6/79)
I~ber 18, 1978
Mr. Dick Swain
Dynamic Realty, Inc.
501 W. Northern Lights Blvd.
Anchorage, Alaska 99503
Subject: Soils investigation for sanitary sewer system on: Lot 5t Block 6, Trails End
Subdivision, Anchorage, Alaska.
Dear Mr. Swain:
At your request of October 11, 1978, I conducted a soils investigation at the proposed
location of a sanitary sewer system on the subject lot.
This investigation, which was accomplished on October 13, ]978, consisted of the inspec-
tion of soils removed during drilling of a 6 inch diameter, 19.5 feet deep test hole,
using solid flight augersr powered by a Nodwell mounted CME 45 drill rlg.
After completion of drilling, the test hole was filled with water and a percolation
test performed. The results of this test are tabulated on an accompanying sheet.
The soils encountered are graphically shown on the accompanying test hole boring log.
the soils consisted of a layer of Organics, Peat, and some Organic Silt 2.5 feet thJck,
overlying a Silt with some Sand and Gravel 7.5 feet thick, underlain by a Sandy Gravel
with some Silt to a total depth of 19.5 feet.
The topography of the subject lot consists of a gentle slope in a westerly direction
of approximately 5 per cent grade.
Vegetation present on the subject lot consists of scattered stands of spruce, with
occasional lone spruce trees, to 40 feet tall, including an occasional birch to 25
feet tall, scattered groups of willows and alders to 8 feet tall, grasses to 3 feet
tall, and common mosses.
No water table was encountered.
An accompanying sketch shows the subject lot with the approximate location of the test
hole in relation to the property lines.
I appreciate the opportunity to be of service to you, Please contact me if you have
any questions regarding this soils investigation.
Very truly yours,
Michael B~Bergmann
Consulting Geologist
Box 191, Star Route A,
Anchorage, Alaska 99502
(907)344-9150
Attachments: Drawing of test hole boring log with location sketch and tabulation of
percolation test results.
xc: Department of Health and Environmental Protection
O~ober 18, 1978
Lot 5, Block 6, Trails End Subdivision,
Anchorage, Alaska.
Percolation test performed on October 13, 1978, on Test Hole No. 1, by filling the
6 inch diameter, 19.5 feet deep test hole (Test was performed on interval 0.25 feet
to 15.0 feet as test hole had caved at 15.0 feet) with water, and measuring the water
level drop periodically for one hour.
TABULATION OF PERCOLATION TEST RESULTS
TIME LEVEL(inches) DROP(inches) ET(min)
0928 2.25" start start start
0938 7.0" 4.75" 10 2.1
0948 11.25" 4.25" 10 2.4
0958 14.75" 3.5" 10 2.9
1008 17.25" 2.5" 10 4.0
1018 .9.5" 2.25" 10 4.4
1028 21.0" 1.5" 10 6.7
RATE(min per inch)
Average percolation rate for entire hour = 3.2 minutes per inch
Average percolation rate for last one half hour = 4.8 minutes per inch
Michael B. Bergmanm
Consulting Geologist
Box 191, Star Route A
Anchorage, Alaska 99502
(907)344-9150
Due North 119.89'
Utility Easement
10' Utility
3i' ,~
Due North 119.90~
-- D__oggie Avenue
Lot 5, Block 6, Trails End Subdivision,
Anchorage, Alaska.
NOT TO SCALE
Distances are approximate and have not
been measured By surveying methods as
to location of test hole.
Michael B. Bergmann
Consulting Geologist
Box 191, Star Route A,
Anchorage, Alaska 99502
(907)344-9150
T.H. No. 1
10-13-78
Organics, Peat, and some Org-
anic Silt: moist, loose, brn
to dk bm.
Si]t: w/some Sand and Gravel,
moist to sl moist at 7.0',
med dense, graybrn.
(GM-ML)
------10.0'
Sandy Gravel: w/some Silt,
sl moist to dry, med dense,
graybrn.
(GM)
19.5'TD
NO WATER TABLE ENCOUNTERED
Note: Test hole caved at 15.0' after
pulling augers.
Test Hole Boring Log represents soils
encountered on: Lot 5, Block 6, Trails
End Subdivision, Anchorage, Alaska.
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geologicol 8~ Geophysicol Surveys
Drilling Permit No.
LOCATION OF WELL (Please complele either la, lb or lc.) A.D.L. No.
--of--of--of--
lc IIDISTANCE AND DIRECTION .FROM ROAD INTERSECTIONS 3. OWNER OF WELL:
6. []C0bl$ tool []RolOry [] Driven ~DuG
~ Auger ~Jetted ~ Bored ~ Other=
~ Above or ~ Belo~ Io.d surfoce
MUNICIPALITY OF ANCHORAGE
DEPAP, T~EN'¥ OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
C~-:['R'f IFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date ~//~
GEHERAL IHFOR~.'iATIOH
(a)
Legal [)ascription (ir~clude lot, block, subdivision, section, township, range)
Locatioa (address or' directions)
(b) Applicant Name/'~ ~. "T~L.. _tl~e "T~ Telephone: Home -'~/~ ' ~J~'3 ~ Business
Applicant Address // '~'",1~ /* l~::>O ~1'~1/~'
(c) Applicant is (check one): Lending Institution []; Owner/builder [~; Buyer []; Other [] (explain);
(d) Lendin9 Institution ~,¢Al4~1,~4-~,,~[,*--'~'~''~4 ~'~'~, ~"
(e) Reat Estate Company and Agent
Telephone
Address
(f) Mail the HAA to the following address:
1YPE OF RESIDEf4L;E
Single-Family¢ Multi-Family []
Number of Bedrooms ___ '~
Other
WAif EFI SUP?LY
hldividual WoII)~I Community [] Public []
Note: It community well system, must have written confirmation from the State Department et Environmental Conservation
attesting 1o the legality and status.
SEWAGr: DISPOSAL
Onsite,: 1, Public [] Community [] Holdin~ Tank []
Note: ~ community well s~stem, must have written confirmation from the State Department et Environmental Ooeservation
aHesting to the legality aed status.
~¢HG!:,~ER!~4G Fli?..t PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of tile validation date shown below, I verify that my investigation of this Health
Authority Approval shows ~hat 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 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 disposa~ system is ie compliance with aU Municipal and State codes, ordinances, and regulations in effect on
Address
Approved for _~_-_~/~ bedrooms by ~,t, ~Date ~9~,~--~ y/~:~'
~:~lpl'r¥~V~c~_c~it~o n~/~App r ova~ is a p p r ove~/ Condition,l,J
CAUTION
Yhe 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 in the State of Alaska. 'The DHEP does this as a courtesy to purchasers of homes and their lending
institutioes in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before e certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
;2-o25 d u84)
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
Legal Description:
Well Classification ""~ -~
Well Log Present (Y/N) ~
Total Depth ~' Cased to
Static Water Level ~ D ~
Casing Height Aboye Ground l,~,. ~
Electrical Wiring in Conduit (Y/N) ~
Separation Distances from Well:
To Septic/Holding Tank on Lot I J ~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line ~,~ ~'~ J~
Cleanout/Manhole ~'~1~ t~. I~.
Water Sample Collected by
Water Sample Test Results
Comments
If A, B, C, D.E.C. Approved (Y/N)
Date Completed t~' °~ ~" ~"~"' Yield
Depth of Grouting NO
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
I ~, ; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on
B, SEPTIC/HOLDING TANK DATA
Date Installed O¢-,T',~ ~ Ii'&,
Standpipes (Y/N) '"r~¢
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ~
To Property Line ~
To Water Main/Service Line
Course
Size l~-.~O No. of Compartments
Air-tight Caps (Y/N) )/' Foundation Cleanout (Y/N)
Date Last Pumped
~/'A ;for ~1~1¢'//'~"
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72 026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
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
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
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
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify th~heck...e,~v?:i.e_d~ conformed to all ~¢~!~A guidelines in effect on the date of this inspection.
Signed ~_ _~¢~,~,,e~,~.~-~ Date
Company MOA No.
Receipt No.
Date of Payment ~L -- ~ J ,~(,0 ~'~.¢...'"" ~-- ' ~ ...~.~. ~'' ;"")" :2."~: '
,~ · ,% ~ -,f'.t
Amount: $ ~9 .~-O~..~_ "f*, 49~ ?*'~ , ;.~., ~ Engineer's Seal
Page 2 of 2 ~O~
TELEPHONE: (907} 279-3916
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOT 5, BLOCK 6, TRAIL END
LOCATION:
11581 DOGGIE
OWNER:
ALLAN TALCOTT
RESIDENCE:
SINGLE FAMILY, FOUR BEDROOMS
WATER SYSTEM:
ON SITE WELL
SEPTIC SYSTEM:
FROM MUNICIPAL RECORDS:
TANK: GREER STEEL,
ABSORPTION SYSTEM:
ABSORPTION AREA:
SOIL RATING: 191
INSTALLATION DATE:
TWO COMP.
TRENCH
855 SQ.FT.
1250 GAL.
OCTOBER 1982
DATE OF PUMPING: MARCH 19, 1986 ISAACS
DATE OF TEST:
MARCH 19, 1986
TEST PROCEDURE:
SYSTEM WAS INSPECTED AND MEASURED. TANK WAS
FOUND WITH 5 FEET OF COVER. 47 INCHES OF
CLEAN LIQUID. NO SLUDGE OR SCUM. STAND PIPE
AT END OF TRENCH COULD NOT BE LOCATED DUE TO
SNOW COVER. 1000 GALLONS OF WATER WAS ADDED
TO THE TANK AT A RATE OF 50 GALLONS PER
MINUTE. THE WATER LEVEL IN THE TANK DID NOT
RISE.
TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
' ' '. .'.:2 :~
03 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 9950~
TELEPHONE: {907) 279-3916
RESIDENTIAL WELL INSPECTION
LEGAL: LOT 5, BLOCK 6, TRAILS END
LOCATION:
11581 DOGGIE
OWNER:
ALLEN TALCOTT
TYPE OF WELL:
SINGLE FAMILY
WELL LOG AVAILABLE:
YES
INSTALLATION REQUIREMENTS MET: YES
WELL YIELD FROM WELL LOG:
1.5 GPM
PUMP TEST:
1.5 GPM
DATE OF INSPECTION: MARCH 19, 1986
TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE WHILE THE
DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS
PUMPED FOR TEN MINUTES. THE RECOVERY WAS THEN MONITORED FOR
ANOTHER TEN MINUTES.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
MARCH 19, 1986. TEST WAS NEGATIVE.
TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours. This well surpasses this requirement.
The assessment of the condition of this well applies only to the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from the
surface, and changes in land use and other factors that may
impact the conditions of the aquifer feeding the well.
A..U NT OUT O.'¥
Property t3wner /,/~p .~ ~./4.~ ~> ~ Phone
Mailing Addre~
Buyer
Address Zip Code
Lending institution Phone
Address /¢~/2- -) :~ 71 f~ ~ Zip Code
Realty CO. & A~nt Phone
Address Zip Code
Legal Description
Type~R(of esi~nce
~ngle Family
~ Multiple Family NO. of Bedroo~
~ Other
Water Supply
~dividual A~ACH WELL LOG. A wMI Icg is required for all wells drilled since June 1975,
~ Community For wells drilled prior to that date, give well depth (attach Icg if available),
~ Public Utility
~ndividual 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 Inspector
Field Notes: MUNICI?ALIT'{ OF ANCHORAGE
? ECEIV D
(~"~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) CONDITIONAL APPROVAL*
72-023