HomeMy WebLinkAboutTALUS WEST #1 BLK 5 LT 19Talus West #1
Block 5
Lot 19
#015-202-39
Permit Number:
Tax Code Number:
Work Type:
On-Site Wastewater Disposal System Permit
OSP141161
01520239000
Septic
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Upgrade
Permit Effective DateS: October 02, 2014 to October 02, 2015
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: TALUS WEST #1
Site Legal Address: TALUS WEST #1 BLK 5 LT 19 G:2736
Owner/Address: CHALK KENNETH H & YOKO K
4311 SUNSTONE CIRCLE ANCHORAGE AK 995162221
)artment
Site Mailing Address: 4311 SUNSTONE ClR, Anchorage
Lot Size in Sq Ft: 18000
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y SepticTank 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.
Special Provisions: A sieve gradation analysis shall be completed on the SW/GM soil layer found
in Test Hole 1 between 13 feet and 17 feet. If the analysis results require changes to the design,
the absorption field shall be completed in accordance with the approved required change order.
Analysis results shall be submitted with the final inspection report.
t '/
Municipality of Anchorage
P.O. Box 196650 · 4700 Elmore Road
Anchoraqe, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997
http:l/www.muni.orq/Onsite
Development Services Division
On-Site Water and Wastewater Proqram
**** VARIANCE/WAIVER REVIEW ****
Waive~: OSP141445 COSA#:__ Permit#: OSP141161.
PID#: 015-202-39
Legal Description: Talus West #1, Block 5, Lot 19
Engineer: PES
Applicant: Kenneth &Yoko Chalk
Your request to use the proposed wastewater code for designing the proposed absorption field
has been approved. Additionally, your request to waive the proposed wastewater code
requirement for additional test holes 20 and 40 feet down gradient from the absorption field has
been approved.
This waiver approval applies to the proposed absorption field only.
[] The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
[] Notarized letter(s) of non-objection 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:
( { /t/,¢ Nhme of Reviewer
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. 015-202-39
Property owner(s) KENNETH & YOKO CHALK Day phone
Mailing address 4311 SUNSTONE ClR, ANCHORAGE, AK,99516
Site address 4311 SUNSTONE CIR, ANCHORAGE, AK, 99516
Legal description (Sub'd., Block & Lot) TALUS WEST #1 BLK 5 LT 19
Legal description (Township, Range & Section)
Lot Size 18,000 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
([i;~ all that apply)
Absorption Field []
Septic Tank []
Holding Tank []
Privy []
Private Well []
Water Storage []
APPLICATION IS AN:
TYPE OF DWELLING:
Initial
Upgrade
Renewal
[] Single Family (SF)
(w/wo ADU)
Duplex (D)
JUN 0 ~ Z014
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: '~'~ --
Date of Payment:
Receipt Number: - ~"~
Permit No. 0~/~ I1~
Waiver Fees: $6:~/~
Date of Payment:
Receipt Number: C)~ ~¢~-C_.~
Waiver No. (.~P[/'Ttt/q ~/,~''
Pannone Engineering Services LLC
5teven R. Pannone, Principal
Registered Professional Engineer
E-maih steve(~panengak.com
September 30, 2014
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
P. O. Box 196650
Anchorage, Alaska 99519
Subject:
Talus West Addition No.l, Block 5 Lot 19
Septic System Permit Request
Ladies and Gentlemen:
I am writing to request a permit to install an upgrade to the existing septic system be issued for this
property. The proposed upgrade system will serve an existing four (4) bedroom house. Currently the
existing field is in groundwater. The proposed system will utilize a 1500g S.T.E.P tank, an Orenco AX20
treatment pod and an auxiliary lift station. We propose using and engineered fill beneath the
proposed drainfield to obtain separation to ground water and to convey the treated effluent to a soil
layer that can accept the effluent. This and the surrounding developed lots are served by private
wells. There are no wells on surrounding lots within 100 feet of this system.
1. Soils. We performed a single test hole on May 13, 2014. The soils from two to thirteen feet were
blue till gravelly silt that has a percolation rate of 1500 mpi, which is considered an impermeable soil.
The soil below thirteen feet (13') was silty sands and gravels with an apparent faster then i MPI
percolation rate. Ground water seepage was observed at a depth of 12 feet during the excavation of
this test pit. The groundwater was monitored on May 20, 2014 at a depth of six and a half feet {6.5')
below the ground level. It is my opinion, based on the results of the soils investigation and percolation
tests performed and overall soils appearance; an application rate of 6 gallons/day/square feet should
be used for a category III wastewater system.
2. Soil Absorption System Design.
a. See Sheet 2 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain
field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and
drainage ditches.
4. Topography: The existing topography slopes from the north to south at varying slopes from east to
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 2 of 3
west but at approximately 7-8% in the area of the proposed drain field. There are no steep slopes
within 50' of the proposed drain field.
5. Waiver Request for use of Engineered Receiving Soil (ERS). I am requesting a waiver to the 1992
Code to use the proposed Code Update Section of Engineered Receiving Soils (ERS). Below I will detail
my request justifying the use of ERS:
a. One test hole was excavated by PES in 2014. The soils log is attached. Seepage was noted at
a depth of 12 feet during the excavation of the test pit. Ground water was monitored for
seven days. Ground water stabilized at a depth of 6.5 feet below ground surface.
b. This design proposes to use MoA Type II classified fill. This interface will be approximately
nine feet (9') in depth and will be compacted to approximately 80 percent to allow free
flow of the effluent through it into the native soil using MoA Waste Water Code application
rates. The infiltration area of the interface between the ERS and the in-situ soil was based
on the I to 5 minute per inch percolation rate of the in-situ receiving soiI. Atwo foot thick
filter sand layer will be placed over the MoA Type II material to act as an interface between
the SAS and ERS.
c. The SAS is sized assuming a percolation rate of the ERS soil, assumed 1-5 MPI, which gives
an application rate of 6 GPDSF.
d. The system will protrude above the ground surface. The cover of the system will produce a
mound, which will have at a minimum, three to one side slopes and six inches of organically
rich soil to promote the growth of vegetatiom
e. Shallow Ground water was observed in the test hole. Steps need to be taken to protect this
shallow ground water from contamination with sewage effluent. These steps include the
use of advanced wastewater treatment system to ensure a high quality effluent and
maintaining at least four feet of vertical separation from the highest ground water and the
bottom of the drain field (our design is calling for 4.5 feet vertical separation.) Surrounding
well logs show well depths in the 50 to 70 feet range. Static water levels are measured in
the 30 foot depth below ground level range. This indicates that this shallow ground water is
not the same aquifer that supplies water to the local wells (if they were the same aquifer,
the static water levels would be similar and that there must be a confining layer between
the depth of 30 feet and 50 feet below ground level.) So breaking through the blue clay
layer at minus thirteen feet should not affect the drinking water aquifer.
f. Waiver request to requirement for two additional test holes down gradient: PES researched
existing soils information (record soil logs and well logs on file with the MoA) from three
lots down gradient of the proposed ERS system. PES found detailed soils logs and well logs
down gradient. The sand layer continues in varying thicknesses down gradient. See
attached well and soils logs.
g. PES requests that we perform a sieve analysis of the underlying material {the GM/SM
material at -13 feet at the time of construction.
6. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification
that the review is complete and that there are no further comments is received from MoA On-Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 3 of 3
The proposed installation will not affect the future development of the surrounding or existing lots.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-821~.
21
11
AREA MAP
SCALE 1" = 100'
t..=..,,i 'MUNICIPALITY OF ANCHORAt..j
DEpARTMENT'OF HEALTH AND ENVIRONMENTAL PROTECTION
SOILS LOG -- PERCOLATION TEST
PERCOLATION'
TEST
SLOPE .~ I'1" t~ PLAN
WAS GROUND WATER
1 1 ?J~ 5 '~; ¢- ENCOUNTERED?
~..~-f: (D; t,~f~,,~) ~.s'~'~;/~~''~:~'
DEPTH?
~3- ~. 4~ ~, - ~+ ~
~ Depth to Net
14 Reading ~ater Drop
20 ' ~ Iml r,u ~ o'.tin chi
~- .~ ! PERCOLATION RATE
.- TEST RUN "E"I~¥EEN ~"' FT AND 7 ,. FT P~r~ )~' J~ ~ J
PERFORMEO BY:_.
· CERTIFIED Ry;
DATE:
,. Well Log
~oo~t~o~ ....... ~.?.~.....~....,....~......c.......?....~.~.:.~.... :~ ...................
Size of casing .......... .~ .............................................................. .a.~.~-~ ....................
Dist~ee to water while pumping ........... :_...~,.~ ........................... at rate
of ................. : ...... ..'f}..~...O. ............ gallons per, hour.
Formation
from to
0 /1
DELTA DRILLING COMPANY
SRA SOX $94 B
ANCHORAGE. ALASKA 99507
DEPARTMENT OF HEALTH & HUMAN SERVICES '~,,~ ~-"R~/.,~,~ ,~. ~
SOILS LOG -- ~/ERCOLATION TEST I'i ~'~'"~" ......... '::'~-~ ~- /
~ / w sh~ ti n
SLOPE SITE PLAN
5-
6-
7'-- 57
8-
9-
10- WAS GROUND WATER
ENCOUNTERED?
11 --
IF YES. AT WHAT
14-
15-
16-
17-
18-
19-
20-
PERCOLATION RATE , ~' I (mmuleshnch) PERCHOLEC~AMETER
BETWEEN '~-- FTAND .~ FT
COMMENTS · -
CERTifY THAT THIS TEST WAS PERFORMED
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DAT~
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
925 L* Street, AnchoraBe. Alaska 99501 2644720
SOl LS LOG - PERCOLATION TEST
SO~LS LOG
PERCOLATION
TEST
11
5'
6-
7
13-
14
15
16-
17
18
lg
2O
COMMENTS'~
PERCOLATION RATE ~ J~/I t~r ,/~ (minutes/inch)
TEST"U..ET~EE. . ~ FT A"D ~- , PT
12-008 (6,r79)
CERTIFIED BY:
DATE:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONIV]ENTAL PROTECTION
825 b Street, A~chora§e, Alaska 9950~ 264-4720
SOILS LOG - PERCOLATION TEST
SOl LS LOG
[~ PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION;
1
2
3
4
5-
6 ·
7
8
9
10
13-
14-
15
16
17,
18-
20-
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
I F YES, AT WHAT
PERCOLATION RATE
TEST RUN BETWEEN
COMMENTS .,~J~-~,~ /' ~"¢~r
72-008
( ~ ~ / ~ ~ J ~ EXlqTIN0 DRAIN FIELD (E) TO BE
~/ELL ~E, , ~
~ / ~' ~~,,~ ABANDuNED AT TIME OF CONSTRUCTION
~ I ~ ~4~Y DE&N FELD (P) ',~ A~A~DO[ ED ~CONCR TE!
% I T H ATTACHED ~ Xl I ~ ~Fu JNDATiON CLEAN OUT
~ / 'x , 'q ,,, :
~ / ~ EXISTING 4 BEDROOM
/' I ,--i ,,, HOUSE (E) ~ % '
I~ LOT20 " / ¢ LOT,*,
i ,¢ : i
~ SUNSTONE OI'R ~ WELL (E) /
~TE:
~EXCAVATEWlTH CAUTION, UTILI~IN AREA OF D'AINFIELO
FOR CONSTRUCTION P.O. BOX 100217 ANOHORAOE, AK 99510~,~ .' ....,~ .:~,~'.
Scde
TALIJS WEST ~1 BLK 5 LT 19 x ~_~E~h.~oh¥6~.~ ~s-202-39
KENNETH ~ YOKO CHALK ~¢i~-. CE 8149 .'~ ~ERMIT NO
4511%UN%TONE ~ ........
PLAN ANCHORAGE, AK 99516
SPECIAL PROVISIONS TO SPECIFICATIONS
1 ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE blOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS.
.3. SCOPE OF WORK: INSTALL NEW 1500 GAL S,T.E,P TANK AND SOIL ABSORPTION SYSTEM.
4. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 6.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST
HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 6.5 FEET BELOW EXISTING
GRADE NOTIFY THE ENGINEER IblbIEDIATELY.
PRIMARY SYSTEM
~ z ~ ~ ~ , , / FLTERFABRC
1500 g S,T.E,P. ~ NO
DESIGN PARAMETERS
PRIMARY/ RESERME SEPTIC SYSTEM A~B~VhATIONS
NO. BEDROOM: & (600 gpd) CU COPPER
TANK SIZE: 1500g STEP LEGEND DIP DUCTILE IRON PIPE
PERC RATE = 1 MPI TH TEST HOLE
SOIL RATING: 6 GPD/SF (for eng fill) -W- WATER LINE/ FC FOUNDATION CLEAN OUT
AREA RQD: I OOSF WELL RADIUS
SOIL R~TINO: 5 GPD/SF (IN-SITU SOIL 6-15MPI) Tff TANK CLEAN OUT NO.
AREA RQD: 120 SF -- SS -- NEW SEPTIC C~ CLEAN OUT NO
SYS. TYPE: WIDE TRENCH 05' ED. Mff MONITOR TUBE NO.
MIN LENGTH: 20LF R I RIGID INSULATION
DCO DOUBLE CLEAN OUT
USE: DV DIMERTER VALVE
20 -' ' -'
LF X 3 Y¢IDE. 0 o ED. + 4.6' TD FS FLOW SPLITTER
ON TOP OF BFG BELOW FINISH GRADE
2' SAND LAYER THEN GO ORIGINAL GRADE
21 LF X 6' WIDE 9' MOA TYPE Il. FO FINISH GRADE
TOTAL AREA: 1OO SF (ENO FILL) ~ 126 SF (IN-SITU SOIL). TS~V TOPSOIL ~ VEGETATE
OT S: ENG LLC
~6 oF AL~i 9/29/2014
JFOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510~__~ %,, ........~ .,~,~.~ ~
PHONE (907)272-8218 FAX <907)272-8211 ~' ~..'~,,,
TALUS WEST ~1 BLK 5 LT lg . ~_:R_.pSk.¢6F,&.~mm
KENNETH A YOKO CHALK~% ~~.. CE 8149 .~ PERMIT NO
4311 SUNSTONE
DESIGN DETAILS ANCHORAGE, AK gg516'I~ ~OFESS,,O~~ Sheet
ADVANTEX DESIGN PRIMARY SYSTEM
ADVANTEX 24'* PASSIVE
4* JIM CApCX20 POD~ INSULATED AUXILIARY
~ ~ RISER PUMP X VE N~T%
/ L El ~ ,o ~ 64.
SLIDE SECTION ~ ~1
OVER THIS CONNECTION
TO PROVOE
SHEER PROTECTION 14'
EXTEND TO
BRIDGE EXCAVATION
WEIGHT CALCULATIONS TALUS WEST
Buoyon~ Eorce = Weight of Woter Disploced
.iANOUT ((Pix(5 3372/4)xlO)x62 4 PCF = 13,9¢0 # Up
~-8' ]~4 COUNTER WEIGHT
O' NATIVE MATERIAL Assume water @ 6 5' oil soil unsaturated
'~ , x ~;~ ~ / ' x ¥~ Assume tank has no weigh(
t: :::::-~ ~¢ -:: SEWER ROCK E(4'x5 33'x10')-~(4'x P1(2.3 z)/4)+(3 x 2.5 x
Tole[Weigh(on Tank = 18432 6 ~ OK~
SECTION
9/29/2014
PHONE (907) 272-8218 FAX (907) 272-8211 Scde
PID. NO
TALUS WEST ¢1 BLK 5 LT 19
KENNETH A YOKO CHALK ~'.
4311 SUNSTONE *l%'. '~ 0SP141161
SiTE SECTION ANCHORAGE, AK e95~6 ,!~<?~b~syE~ Sh~t
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
SLOPE ] ~¢ ~ SITE PLAN
MUGM GRAVELY SILT ~4 -~'-~%N~ ] ~ I ' I
~ 5/20/2014 ~ TH
~ ~NN,EL (E) SUNS*ONE~ LWELL (E) ~ .
WAS GROUND WATER SLOPE
14 ~ ENCOUNTERED? Y
15 ~ GRAVELY
SW/GM SAND WITH IF YES, AT WHAT TH
16 ~ SOME SILT DEPTH? 12.0'(Seepage) X
17 DEPTH TO WATER AFTER
BOH MONITORING? -6.5'-
18 I DATE: 5/20/2014
WATER I
19 READING DATE CLOCK NET TiME LEVEL NET DROP
TIME READING
20
I 5/13/14 11:43 --- 2.60 ---
2 12:13 30 MIN 2.65 0.05
DATE PERFORMED: 5/16/2014
3 12:07 --- 2.25 --.
4 12:17 30 MIN 2.27 0.02
PEROLATIO~ ~ATfi ~500 {min/inch) P~RC HO~E DIA~ETE~ g inches
TEST ~U~ B[TW~fi~ 3
COMMENTS: Test hole excavated by A+ HOME SERVICES.
PERFORMED BY: Steven R. P~none, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORD~CE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
FOR CONSTRUCTION p.o. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (~07) 272-8211 ~.,, ~..~ f~ Sco~e
WATER I
READING DATE CLOCK NET TIME LEVEL NET DROP
TIME READING
~ 5/13114 11;43 ... 2.60 ---
2 12:13 30 MIN 2.65 0.05
3 12:07 -. 2.25 --.
4 12:17 30 MIN 2.27 0.02
6
TALUS WEST #1 8LK b LT 19
KENNETH & YOKO CHALK
4511SUNSTONE
SOILS LOG ANCHORAGE, AK 99516
~"~..~.~.MUNICIPALITY OF ANCHORAGE '-,:[, ~,,' ~J
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Tdephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
¢ PHONE NEW
NAME
MAI LING ADDRESS
LEGAL DESCRIPTION
NO. OEBEDROO. /
DISTANCE TO: ]Well /0 (~ '~'- IAh'°rpt'°n Dw.,,,ng PER.,TNO . O
mufacturer ~,~, ~[~f~ No. of compartments
capacity in gallons IF HOMEMADE: 11~j~,~gth Width Liquid depth
DISTANCE TO:
Manufacturer
DISTANCE TO: ~'~O '(~
PERMIT NO.
Liquid capacity in gallons
No. of lines of each line Total length of lines
Top of tile to finish grade .~ Material beneath tile
Length Width Depth
Material
Nearest lot line ~ ~ /
Trench width ..1~
Distance betwee Ii es
Total effective ab,~grption area
PERMIT NO.
DISTANCE TO:
Well
DISTANCE TO:
Crib depth
foundation
let
Total effective absorption area
Nearest lot line
Distance to lot line
Septic tank /0~)
PERMIT NO. ~C C~ ~'
I Absorption area(~) [ 0~) !
OTHER
PiPE MAT ER IA ,L.~. ,
$~ff- TEST RATING
, N STA L~.~)
REMARKS ~ ~ /J
APPR ED ,
DATE
72-013 (Re¢fi/78J
LEGAL
,.- .EF FIE.'] rlENT ~.. EHLTH RND EN%,'IR-NHENrFR/ ~~
....... L "¢rREET.. FINCHuRR,SE, RK. s,S,5¢.,L~¢
PERMZ'T' NO.
L 0 C R T Z 0 N 1.4 Z L E:~~ . -- o -- -
LEGRL L$9 8.5 TRLIJ5 WEST ~(.IE: LOT %ZZE $,-,E~id~J '~ .......
, o ..... -,b.!OHRE FEE T
T'¢F'E OF SOZL HB_,ORE,] ZuN c ..... , q, ,
l" '"~' I
lh.',ZHJH NUMBER OF DEE:,RZOM'E; = ~ ~ '-~aZL R ~ .-~,~] FT, BR..=
L~ ,~.-,
THE REQUIRED SIZE OF THE SOI TIO~ S'~'~TEM t'q,
I'"-'- ............. rl uh. hi/ ta THE r)T,z~;]r.~- =,~m,- .f' -'"--'. ','.-,,-,'~,-ZCLd~.
........ u'¢ ........ ~-W~EN I HE 5URFRCE OF' THE
aRULIND RN[:, THE E,U~TUH OF THE E:qCR',,,'RTIOb/ ':lIN FEET).
THERE IS NO
-,ET WIDTH FOR TRENCHES.
THE GRR',/EL DEPTH I~; THE MINIMUM ~EPTFI OF G '~,'~
R .... BETNEEN THE .6~LiTF~:L: F'tPE
FINE:, ]"HE E:OT'FOM OF THE EXCRVRTION "IN FEET).
.................... F'-- .......
R PH-.KHGE PLFINT MR'¢ BE INSTRLLED RT THE F'ERMiT~c~..~
F'OLLOklINQ CON[:,ITIONS: '~ ~ OPTION SI IB.TEDT
EITHEr' R CLRqq *' -'~, · .... ,.- ,
RGREEF'ENT Iq''NFIT ~"~ .... :',.....,~]a~%b:Hbr.4~ IS, REI;¢IIF'ED" IF ¢~ r4~'~;~-~-..
_: .......... ;',:Fl I:11~ '~,JT g't-~ll ~a,-,~G ..-- :-- ' " ......
K_. ~'~ -"-'~'-'~'--~ ~L PRO5;ECUTION.
E, HUF..FILLI'.,U OF RNa' ~z,.,,z .,
-,r-,TEH WITHOUT FINRL IN-FECTION RND I~PF'ROVRL
E:'EPRRTHENT klILL BE '= ' * P 9- ~ '-
-,UBJEL. T TO RL ~EuUTI UN.
F1]:NZHuH DIB'rRNCE BETWEEN R WELL RN[:, RN'¢ ON-SITE SEWRGE DIZ;F'OBF:~t ...... r__,TE~,] I~;
ZEnD FEET FOR R PRIVRTE WELL OR 2RR FEET FOR R PUE:LIC ~'.IELL..
WELL L~Ua RRE REQUIRED RN[:, HLI'ST BE RETURNE[ TO THE DEF'FIRTMENT NITHIN ]~8 Cd-Irc,
OF THE NELL COMPLETION.' ' _ ,,-
OTHER - -, ....
RE~UIREHEh b MFI'¢ FIPF'L~.'. ~- :
-,FEL. IFIL. MFI~Nq FIN[:, 'F .,-" ·
-- - UJNz,]RLu[ IIJN D:[RGRRHs RRE
RVR[LRBLE TO INSURE F'RZ~F'ER ZNSTRLL. RTZON. ..
[- ~" ~ ~ % '~ ~ :=< P ~ ~: ~ '~; E> ~ ,2: ~ ~-"1 ~ ~ F~: ~: ~... . ,,_~ -~:.
%.2: ....
t CERTIF'N' 'FHRT
Z: I FIM FRHILIRR WITH I"HE RE~!UIREMENT$ Fn~, ON-$ITE 5E[,.tERq 'RN[:, WELL:5;
FORTH B'¢ THE HUNICIPRLIT,¢ OF RNE:4ORRGE.
2: I 14ILL INSTRLL THE ,=~,,-'-,
- -,r=,TEH IN RCCORDRNCE ~4ITH THE ~1ODER
$' I LINDERSTRND THRI' THE oN-$ITE %EWER '-'"- - -' -'
"- m~:,TEM fiR? RE:~I 'FRE EF,fLRRGEHENT IF THE
~ESIE:,ENC:E ].:, REMODELED ]'0 ~ ...........
IN_.LUDE I"~ORE THRh¢~ 5 E:EDROOM$.
;I GNED: ....................
RPF'[~ I L-:FINT ~4ILL IFIM S I EF'IENS .........
'~ '~ .... ~ ............ [:'R l" _ .........
M-W DR LLING IHC.
DRILLING LOG
S
Well Owner-
Location (address of: Township, Range, Section, if known; or distance main road
Lot 19 Block 5 Talus West
_Use of Well Dom,
Size of casing__ 6'::...Depth of Hole_.__'53_ .- feet_ .... Cased... to- 52.3 fe~t
Static water level 30 ft. (&h(/9~) (below) land surface. Finish of well (check one)
Screen ( ); Perforated ( )-
Describe screen or perforation-- N/A
Well pumping test at 20 .gallons per (hiibr)
-of drawdown from static level.
6/21/78
Date of completion
(minute) for ]
hours with- 1 007,
open end ( x~c
);
Depth in feet from
ground surface
WELl. LOG
Give details of formations penetrated,
size of materiai;'color and hardness _
~') ._TO 2
· _TO
5 TO.
TO~7
47
4! TO_
47 TO. 53
TO
_TO.
_TO .
.TO
Cas'inz .s tic..kt;o
_Or ~antc.s_
i~ou!c!er _ ._
Silty
,-,-_%¢~y ..
~!d~r
silty sand: gravelly -- --
S~ tv water ~raval
~.~,-~,,~ gravel
3--CONTRACTOR
,.,. 4649 BUSINESS PARK gI..VD,
P.O. BOX 4-1276 ANCHORAGE, ALASKA ~,o09
TELEPHONE
(g37) 2794014
B=inMn§ Wa~er Analysis Report for Total Co~form gacte6,a
TO BE CO~¢,PLEi'ED BY WATER SUPPLIER
I.D. NO.
Mo. Day Year
Code
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab'ref, no.
[] Speclal Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO,
1
2
3
4
5
LOCATION
I L
Time Collected
Collected By
TO BE COMPI.b~'ED BY I,~,~BOP~ ,TORY
LABORATORY:
CHEH & GEO LABS OF AK. , INC.
NAME
4649 BUSINESS PARK BLVD.
ADDRESS
~AGF .._ Al ASKA
CITY
Time Received '
Analytical Method:
~ Fermentatfon Tube
~Membrane Filter
Lab Ref. No. Result* Analyst
L J LII
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form No. 18-310(3-78)
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
113=]-%--78 Time Received] *45 L,b.~o. 8837-38
Broth 48 hoursJ
~.Oml Tubes Positive/Total ~.Oml portlonl
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
MUN C PALITY OF ANCHORAGE DEPT, OF
DEPARTMENT OF HEALTH & ENVl RONMENTAL PROTEC'Fc~CJ~,ONMEN'~AL pROTECTIO
825 L Street - Anchorage, Alaska 99501 0OT~) 1978
ENVIRONMENTAL ENGINEERING DIVISION
Te,epho.e 2..-.720 RECEIVED
DIRECTIONS; Complete air parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1, PROPERTY OWNER ~-/~ PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If-~i~fe~en't from above)
MAI ~zl N G ADDRESS --
3. LENDING INSTITUTION
MAILING ADDRESS
PHONE
~PHONE
PHONE
4. REALTOR/AGENT
TYPE OF RESIDENCE NUMBER OF BEDROOMS
'~' SINGLE FAMILY [] One ~ Four [] Other
[] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
7. WATER SUPPLY
~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
El COMMUNITY since June 1975, For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8, SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** ~*lf individual/on-site, give installation date ~'/~' ,
[] PUBLIC UTI LITY If system is over two (2) years old an adequa~y--test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
)ATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
--DATE ]ATE )ATE
INSPECTOR INSPECTOR ,NSPECTOR
DiRECTiONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[~ SINGLE FAMILY [] ONE [] THREE [] FIVE E~] OTHER
L~ MUI.TIPLE FAMILY [] TWO [] FOUR [] SIX
-- PERMIT NUMBER
2. WATER SUPPLY
[] . INDIVIDUAL DEPTR OF WELL
[] COMMUNITY DATE DRILLED
[] PUBLIC UTi LITY
Connection Verified__ LOG RECEIVED
PERMIT NUMBER
3. SEWAGE DISPOSAL SYSTEM
[]INDIVIDUAL/ON -SITE DATE INSTALLED ~ ~,~.~ (~
~PUBLIC UTI LITY
Connection Verified _ INSTALLER
[]Septic Tank or [~] Holding Tank
Size:_ If Tank is homemade SOIL8 RATING
give dimensions:
~OTAL AESORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Abso~rptlon Area Sewer Line I Nearest Lot Line
WELl-TO: -
Absorptio~ Area to nearest Lot Line
5, COMMENTS
VED FOR z~ BEDROOMS
[] CONDITIONAL APPROVAL (~etter must accompany certificate)
~]~ D~SAPPROVED
LEGAL DESCRIPTIO~
72-010 (Rev. 3/78)