HomeMy WebLinkAboutMINDYER MANORS BLK 1 LT 3Ml*ndyer Manor
Block 1
Lot 3
#020-091-64
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Municipality of Anchorage Nov 1 x`095
Community Development Department Page 1 of 3
On -Site Water & Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.orglonsits • (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP 151327 PID Number: 020-091-64 ❑ New ■Upgrade
Name: DAVID GARDNER
ABSORPTION FIELD
■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address:
4751 VIRGO AVENUE *ANCHORAGE, AK
❑ Other
Phone: No. of Bedrooms:
Sail Rating:
Total Depth from original grade:
(907) 382-8373 3
2 GPD/5g. Ft.
10 Ft.
LEGAL DESCRIPTION
Dep&. to pipe Invert from original grade:
Gravel depth beneath pipe:
SEE DWG. Ft.
7.05 Ft.
Subdivision: Block: Lot:
MINDYER MANORS 1 3
Fill added above original grade:
Gravel length:
SEE DWG. Fa
20 Fc.
owns ip: _ onge: _ section: —
Gravel width:
Beds Number of lines:
Distance between linea:
2.5 FLI
Ft.
SEPARATION DISTANCES
Total absorption area:
282
Number of trenches:
1
Dist. between trenches:
—
Tor5'+
Absorption
Lift
Holding
Public/Private
From
Field
Station
Tank
Sewer Linos
50. R.
Ft
Well
*90'
100'+
—
25'+
TANK ❑ Septic ■ S.T.E.P. ❑Holdin ❑ Other
Manufacturer.
Capacity:
Surface water
*90'
100'+
—
GREER
1500
cal.
Lot Line
10'+
5'+
-
Material:
Number of compartments:
N/ASTEEL
2
Foundation
10'+
5'+
—
LIFT STATION
Curtain DrainNONE
KNOWN
Manufacturer: Capacity:
GREER/QUANICS 1500 cal.
Remarks: OLD TANK WAS DECOMMISSIONED PER UPC
Pump on' level at:
TIMER
Rump off' level at:
TIMER
High water olorm at:
46"
THIS IS A QUANICS AEROCELL SYSTEM
Pump Make & Model:
GOULDS PE51M
Electrical Inspections performed by:
MOA
*WR#OSV151131
PIPE MATERIAL
3 665
House to tank D3034 Tank to ASTM TM 3
34
drainfield
Installer
WILCO CONTRACTORS
MT D3034 Drainfield D3034 CO
CO/MT
GEG, Ltd.
BENCH MARK (Assumed elevation)
100.00 R.
Inspection
Location and Description:
Dates: 1st 10/9/2015 2nd 10/9/2015
3rd 10/12/2015 4th
SOUTH SIDE OF GARAGE SLAB
Community Development Department Approval
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Conditional Date:
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approval:
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Approved: wu �` !� Date: 2Z
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PERMIT NUMBER:
®SP151327
FINAL GRADE= 97.86-97.68
TOP OF TANK INLET= 93.35
2"
PARCEL ID NUMBER:
020-091-64
TOP
SIM/TEC 4" VISUAL PORT
2" DISCHARGE LINE
2X4 BUSHING
HIGH WATER
OVI
1500 GALLON S.T.E.P. TANK
MANUFACTURED BY GREER TANK
RATED FOR 10' BURIAL
ON/(
INVERT OF BUNG =92.70 30TTOM OF TANK.
TH#1 ORIGINAL GRADE @ F
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On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP151327
Tax Code Number: 02009164000
Work Type: Septic Upgrade
Permit Effective Dates: October 06, 2015 to October 05, 2016
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: MINDYER MANORS
Site Legal Address: MINDYER MANORS BLK 1 LT 3 G:3336
Owner/Address: GARDNER DAVID E & KATHLEEN L
4751 Virgo Ave. ANCHORAGE AK 995035789
Site Mailing Address: 4751 VIRGO AVE, Anchorage
This permit is for the construction of:
%his Z�z�
S °.od
2 P„v\
Lot Size in Sq Ft: 65140
Total Bedrooms: 3
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
�UBMIITTAL
SEP 2 12015
Gretchen NICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 020-091-64
Property owner(s) DAVID GARDNER Day phone 382-8373
Mailing address 4751 VIRGO AVENUE *ANCHORAGE, AK
Site address 4751 VIRGO AVENUE *ANCHORAGE, AK
Legal description (Sub'd, Block & Lot ) MINDYER MANORS; BLOCK 1, LOT
3
Legal description (Township, Section & Range)
Lot Size Sq.Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DEWELLING:
( Gall that apply) Initial ❑
Single Family (SF)
Absorption Field ®
Z
(w/wo ADU)
Upgrade
Septic Tank ®
Duplex (D)
❑
Renewal F]
Holding Tank ❑
Multiple Dwellings
❑
Privy ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
SEPTIC TANK AND DRAINFIELD TO WELL AND SURFACE WATER Distance: 90 FEET
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: sr •I� Waiver Fees:
Date of Payment: Rlaarls Date of Payment:
Receipt Number: GSA C% Receipt Number:
Permit No. (�JP%5al +� Waiver No.
(Rev. 01/11)
GARNESS ENGINEERING GROUP Ltd
CIVIL &ENVIRONMENTAL ENGINEERS 1—
September
September 29, 2015
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK -99507
Ref: Proposed Septic System Upgrade for Mindyer Manors; Block 1, Lot 3
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The existing drainfield is in a state of failure and needs
to be upgraded. We are proposing to install a new Quanics Aerocell (CAT II) treatment system (or another MOA approved CAT II
system), a 1500 gallon S.T.E.P. tank with Quanics Controls, and a deep trench type drainfield. One testhole was excavated on the
property and the drainfieldis_ designedaround the 30' radius of this testhole.. Commentsregarding. the design are summarized -as_.__ _ _...
follows:
1. SOILS: See the attached 2015 soil log which show the soil classifications, groundwater monitoring, and the percolation test
results.
2. DRAINFIELD DESIGN: See attached design dr,ving fcr. drainfield specifications.
„3URFAU- 'IJP IF a3There is a stream located approximately 90'south of the proposed drainrieid.
4. TOPOGRAPHY: Seethe attached design drawing regarding the topography. The average topography is 15-20% running NE to
SW.
5. WAIVER: We are requesting that your department issue a 90' waiver from the creek to the south. We are also requesting your
department issue a 90' waiver from the existing well on lot to the proposed drainfield and S.T.E.P. tank. Additionally we are
requesting a 10 foot waiver from the proposed drainfield to the existing drainfield. Justification for the requested waivers are as
follows:
• We are using a MOA approved CAT II advanced wastewater treatment system.
• We are only requesting a 10% variance for the creek and the well waiver
• The house is located in-between the well and proposed septic system. If effluent were to overflow, it would not travel
towards the well head. -
• The area between the drainfield and the creek is highly vegetated.
• The location of the drainfield is highly visible, if effluent were to overflow, it would be easily seen by the homeowner, or
AWTS service provider and corrected.
• We have 10' separation from drainfield to drainfield. When the testhole was excavated, there was no seepage from the
existing drainfield.
• A flow diverter will be installed after the tank. In short, only 1 drainfield will be operational at a time.
• Water samples were pulled on 9/9/2015 and the results are as follows:
-Nitrate: 0.327 mg/L
-Coliform: Negative
-
-Total Coliform: Negative
We are unawareI y adverse impacts this installation and waivers would have on adjacent wells or septic systems. If you have
anygtt@stions,/pl Aacontact us at 337-6179. Thank you for your assistance.
.E., M.S.
3701 East Tudor Road, Suite 101 *Anchorage. Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
OF BEDROOMS: 3
LETTER THAT PERTAINS TO THIS DESIGN.
NOTE: THE CONTRACTOR
PER DAY (GPD): 450
70 OBTAIN A COPY OF THE LETTER
CONTACT GEG. BY PROCEEDING FORWARD
SHALL HAVE THE 90' WELL
'ION RATE/S: 30 MIN/INCH'
WITH THIS INSTALLATION, THE ENGINEER,
RADIUS & 90' CREEK
D APPLICATION RATE: 2
WELL DRILLER, CONTRACTOR AND
SETBACK FLAGGED BY A
DRAINFIELD SQ.FT.: 225 FT'
PROPERTY OWNER AGREE THAT THEY
REGISTERED LAND SURVEYOR
HAVE READ THESE SPECIFICATIONS AND
PRIOR TO CONSTRUCTION.
IFI D nFCI(;NI-
AGREE TO ACCEPT THE TERMS AND
MAXIMUM DEPTH OF EXCAVATION: 10 FEET
WIDTH: 2.5 FEET
LENGTH: 20 FEET
EFFECTIVE: 7 FEET
ACTUAL SO.FT.: 280 FT'
EXISTING SEPTIC TANK TO BE
DECOMMISSIONED PER UPC
PROPOSED 1500 GALLON S.T.E.P. WITH-
- - - - - - QUANICS CONTROLS (OR OTHER MOA
APPROVED CAT II SYSTEM).
PROPOSED 650 QUANICS
----- AEROCELL POD(OR-
\ OTHER CAT II SYSTEM)
APPROXIMATE LOCATIO
'QF EXISTING GRAINFIELD
UNDOCUMENTED
SEPTIC PIPE \\F�OUND
IN FIELD; ORI61N _
UNKNOWN; TO
DISCONNECT
ORIGIN DU N
WOODRIDGE; BLOCK 2, LOT 9 /
� SC LE:
1 O' U t l l E s p) t 90' WELL RADIUS
i 1O ElecEsmt
---------------- __________----__-___---__----
/ X100' CREEK SETBACK
Cil � I
T.HH...# ll
I l
N
� 1
EXISTING 3
BEDROOM
HOUSE
MEASURED CREEK CENTERLINE
GARNESS ENGINEERING GROUP,
mmm�—' - CIVIL & ENVIRONMENTAL ENGINEERS
3701 E. TUDOR ROM, SUITE 101 • MC14DRME, AK 99507 • P1 NE (907) 337-6179 • Gx (907) 336-3]46 • WEBSITE: ww.go,rexe
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
DAVID GARDNER 382-8373 2 OF 2
LEGAL DESCRIPTION: DRAWN BY:
MINDYER MANOR; BLOCK 1, LOT 3 D.J.G.
TYPE OF WORK: DATE:
SEPTIC SYSTEM DESIGN UPGRADE 10/1/2
CREEK SETBACK
..........
I
0 J f y A. ness.
�1 . C .
CE 753 , �A
•�IRO`ESS\
SGS ReL#
1155201001
Client Name
Garness Engineering Group, Ltd
Project Name/#
Mindyer Manors B 1, Lot 3
Client Sample ID
Mindyer Manors B 1, Lot 3
Matrix
Drinking Water
Sample Remarks:
Pammctcr
Results
LOQ
Metals by ICP/MS
Received Date/Time
09/09/2015 13:26
Arsenic
ND
5.00
Waters Department
09/11/15
NEG
Total Nitrate/Nitrite-N
0.327
0.100
Microbiology Laboratory
E. Coli
Negative
1
Total Coliform
Negative
1
Printed Date/Time
09/21/2015 8:41
Collected Date/Time
09/09/2015 13:26
Received Date/Time
09/09/2015 13:26
Technical Director
Stephen C. Ede
Allowable Prep Analysis I
Units Method Container ID Limits Date Date Init
ug/L
EP200.8
C
(<10)
09/14/15 09/15/15
EAB
mg/L
SM214500NO3-F
B
(<10)
09/11/15
NEG
100mL SM219223B A
100mL SM219223B A
09/09/15 MEV
09/09/15 MEV
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS ^�
=��^-
3 l E TUDOR ROPO. SU I TE 101• MCHOR4 E. M99507' PHONE (N3378119'F (901 M3 M— WESSITE,vxxgemm¢,IAE==^o0-Com
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: MINDYER MANORS; BLOCK 1, LOT 3
PERFORMED FOR: DAVID GARDNER DATE: 6/21/2015
UL
(f,
ORG
GM
TEST HOLE #1
SOIL CLASSIFICATIONS
DEPTH TO
GROUNDWATER
DATE
DRY
8/21/2015
DRY
9/4/2015
111111111
-
1169!
-
%//%
2:04
%%
5"
MEN
3
RD
111111111
-
4
m
30
%O//.
1
11113!
2:37
E��
6"
C
6
3:07
DEPTH TO
GROUNDWATER
DATE
DRY
8/21/2015
DRY
9/4/2015
1:34
-
6"
-
481
,
o�
fiP
C:e N
SCALE:
1"=ma
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
9/4/2015 1
1:34
-
6"
-
2
2:04
30
5"
1
3
2:07
6"
-
4
2:37
30
5"
1
5
2:37
-
6"
-
6
3:07
1 30
5"
1
PERCOLATION RATE 30 (MIN./INCH) PERC. HOLE DIA.
TEST RUN BETWEEN 5 FT. AND 6 FT.
A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO
6 (INCHES)
SOILS LOGGED BY: DAVIDGARNESS PERCOLATION TEST PERFORMED BY: DAVID GARNESS
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFD IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 0 i �j
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
Day of 4> e-coySLL%_ of 20_Li, by and between spa �✓� �orio.y��r-
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as
(I ACL0t1 ` Ae r',C G i
located at (legal description).
2. Definitions.
Alteration. Any change to the design or function of an AW WTS that
includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design.
Certificate of On -Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with Anchorage
Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that
the systems are adequate for the homes that they support and meet the
codes that were in place at the time of system construction.
Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AW WTS that were included
in the original design which would allow the AW WTS to continue to
perform as designed.
Permit. An On -Site Wastewater Disposal Permit as required by AMC
15.65 to construct and operate an AW WTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on the
date of approval by the Municipality to operate the installed system or issuance of a
COSA, and shall continue while the AW WTS is in use of is operational or until the
property is sold or title is transferred by the owner and a new COSA is issued to the
new owner or transferee of the property.
4. Alterations. Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AW WTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AW WTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AW WTS. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement, and any renewals thereof, at the owners sole expense, to pay
for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement
costs, and (5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules
and orders for the AW WTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AW WTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AW WTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
H. Owner agrees that the AW WTS installation and maintenance requirements as
provided by the AW WTS vendor/installer and approved by the Municipality are
the governing guidelines for the construction, maintenance and repair of the
Owner's AW WTS.
6. Nonwaiver. The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof, or the right of such party thereafter to enforce each and
every provision hereof.
7. Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with
the same formality that this Maintenance and Repair Agreement was executed
with, and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement, the only authorized representatives of the parties
are:
a. Owner: `,4s k 0
b. Municipality: Director, Community Development or designated authority
C. Any attempt to amend, modify, or change this contract by either an unauthorized
representative or unauthorized means shall be void.
8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance
and Repair Agreement shall be brought in the Superior Court for the Third Judicial
District of the State of Alaska at Anchorage. The laws of the State of Alaska shall
govern the rights and obligations of the parties under this Maintenance and Repair
Agreement.
4. Severability. Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
OWNER:
By7.. (signature) Date:
(print name)
STATE OF ALASKA }
) ss.
THIRD JUDICIAL DISTRICT )
The foregoin instrument was qcknowledged before me this%day of
2015 , by 0,mJ C er ne
NOTARY PUBLIC FOR ALASKA
My Commission expires:
MUNICIPALITY:
By: (signature) Date:
(print name) Title:
LOCATION OF WELL
(Please complete either la, Ib or Ic.)
WATER WELL RECORD
-� STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological & Geophysical Surveys
Drilling Permit No.
A.D.L. No.
Ia. Borough
Sp ¢division
Lot
Block
Ib. 1/a gtrs.
Section No.
Township N
Range ❑
Meridian
of_of_ot—
S❑
W❑
Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS
3. OWNER OF WELL:
Adrirass' -
`� O
Street Address and Area of Well Location
1/�
2. WELL LOG Feet Below
- Surface
4. WELL DEPTH: (final) ��
5. DATE OF COMPLETION
Material T oom
Type Top Bottom
J'�
r1 o ft.
i
q t/�, l �7
6, l�„` Cable tool E] Rotary ❑ Driven ❑ Dug
❑ Auger ❑ Jet fed ❑ Bored ❑ Other:
l "•..' ( V .: ( lel ,� 0
i. j! �''(./ {,)
7. USE: Domestic Public Supply ❑ Industry
Irrigation Recharge El Commerical
Test Well ❑ Other:
8. CASING: ❑ Threaded Ef Welded � ,
diem. {.� in. to ft. Depth Weight —_Ibs./ft.
diem. in. to fl. Depth Stickup ft.
9. FINISH OF WELL:
TYpe I�',r%;, Diameter
Slot/Mesh Size: Length:
Set between ft. and _ ft.
Backfilling Gravel pock
10. STATIC WATER LEVEL: ft,
Above or p Below land surface Date
Equipment used:
OFANCHORAGE
I I . PUMPING LEVEL below land surface, and Y1ELD
z', i.;s �It�if
D PT. OF )'E,IT,I A
y ft. after hra. _pumping - .%_ g, p, m,
ft. after hrs. pumping g. p. m.
_ r I ,71 7 ,_ �-
12.GROUTING Well Grouted: Yes Ef No
Material: [] Neat Cement E] Other:
13. PUMP: (if available) HP
Length of Drop Pipe ft. capacity g. P.M.
❑ Subm. Jet E) Centrifica[ Other
14. REMARKS:
16. WATER WELL CONTRACTORS CERTIFICATION:
15. Water Temperature _° E] F C
This well was drilled under my )urisdiclion and this report is true to the best of my knowledge and belief;
x P'4
Registered Business's Nam /!,j :� Conlr/o,/y License Number
�f� e 7/-" Jl / /`'
Address: () itd/{ 1'l
Signed:/ f�`,,..e.--/i r�/.- ��, e, e''Date:_
�v
1Auf horlie8 Rdlpresenfive
JJ
/
Form 02-WWR (11/81) �'`Copy Distribution: WHITE - State DGGS, PINK -Driller, CANARY- Customer
MU`l
��� �� ���� ��� �� ���� �n P:3 E:
,
DEPARTMENT � ,/HEHLTH AND ENVIRONMENT8L\.,JJTECTION
825 'L/ STREET, ANCHORAGE, AK. 99501
~ 264-4720
F=� F= FZr-1 I~T-
PERMIT NO. ( 821194 )
APPLICANT DAVID MASON SRH BX 116-S
LOCATION
LEGAL LT.3 SLK1 MINDYER MANORS S/D LOT SIZE 99999 SQUARE FEET
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL OR 150 TO 208 FEET FROM 8 PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM A PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND
TO H COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
,
AVAILABLE TO INSURE PROPER INSTALLATION.
���M I -IF ���I F:P_"F= 2-1 .. ����
' I CERTIFY THAT
1� I HM 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 THE CODES.
SIGNED
WPLICANT
/
! ISSUED BY_Z_/~ZZ__A_Z-�_-`���
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
NAME
PHONE
EW
_ e�
t?4,/4Y 4/- 15&11
D UPGRADE
MAILING ADDRESS ��-
LEGAL DESCRIPTION
yer Lot-
LOCATION
N1
NO. OF BEDROOMS
J1
2x
DISTANCE TO:
Well ty
Absorption area /
Dwelling o
PERMIT NO. 6
i z
Manufacturer
Material
No. of compartments,
W
C-1 yF
®(
rn
Liq. c1666 Ions
IF HOMEMADE:
�_ Inside length ,
Width
.�—
Liquid depth
'1
DISTANCE TO:
Well
Dwelling
PERMIT NO.
SZ
Manufacturer
Material
Liquid capacity in gallons
W =
DISTANCE TO:
Well
Foundation
Nearest lot line
ge
PERMIT
,
J u. Z
No. of lines
Lent line
Total length of li s
Trench w' hF
Distance between lines
Z W
�
!
inches
Top of tile tb inish
Material beneath tile
Total
� F.
grade
effective a or tionye27/
a
inches
Length
Width -
Depth
PERMIT NO.
w
(7
Q i,-
Type of crib
Crib diameter
Crib depth
Total effective absorption area
W °:
Well
Building foundation
Nearest lot line
DISTANCE TO:
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
�
DISTANCE T0:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALSPV _
t
SOIL TEST RATING �!
INSTALLER ^
tTpL�
REMARKS
�(_
J
1�
I
G
T1
APPfTOVED DATE LEGAL
rrd-
iz-ut s IRev. s/ /b)
M U " I V-; 11 "-# n L_ I -F V F= F-1 r-4 0t-" -71 F7---" F1 13 E-=
DEPARTMENT,-,, HEALTH AND ENVIRONMENTAL�_-ROTECTICIV
825 `L' STREET., ANCHORAGE., AK 99501
264-4720
ID " -!-:; I TE S; F=
PERMIT NO. 820784
APPLICANT DAVID MASON SRA BOX 116-5 99502 344-7561
LOCATION
LEGAL L3 81 MINDYER MANORS LOT SIZE 999999 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FTZBR)= 200
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
LN F="F=" -IF " = -1 C21 L_ F:"" lc� _r " -4:9: 3F;;?F=lVF=L_ E}E-=F"-Y-"= 7p
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).
FREE (P U I FZ E-= C-4 _0=53 F= F=` -F I Z -F " " K � I = FE _ AC -71 1010 CL -i f =1 I I C-1 " fS-
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.
--- -FWID < f2 > I " S; F=' EEO -F I ID " _�- n FRZ E= FQ* E: P_ U I F;?- a: r-.-
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL 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.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F=" E: rC M I 7r FE X F=" I FZ E= E1F= 1::: F= M F_; E- FR ZEC:1- :JLS"
I CERTIFY THAT
1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. /b 1
SIGNED: — ----------------
APPLICANT DAVID MASON
ISSUED BY-
--------DATE__�
--- ---_-------------
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION:
.N1'
1' I ��Jj',x /" {d a'ai-v,
SOILS LOG
' PERCOLATION
TEST
DATE PERFORMED: 9' —3 —.9z
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
• T Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICESi
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. #
(1`1 - Ca ) — L�'-'S HAA # I\QSL '-U�
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 3; Btock 1; M.Lndye& Manan. Plat 78-294
Location (address or directions)
4751 Vj,%go D/ve
(b) Property owner Day.Ld I.& Kanen G.Ma!5an Telephone: (home)
345-5758 Business 659-5234
Mailing Address 4751 WLao anlve Aweharaage, AP.azka 99511
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
Telephone
(e) Mail the HAA to the following address: (or check here aif hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family NX Number of bedrooms 3
3. WATER SUPPLY
Individual Well 1XX Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site INx Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88) Page 1 of 2
TESTS, FILE SEARCH, DATA AND INFORMATION on of this
1 verify that my
ENGINEERING FIRM PROVIDING INSPECTIONS, I and/or wastewater disposal system is safe.
As certified by my seal affixed
val showsretthatthe fon-sitethe ) waater Supp gown below, investigation and
Health Authority Appro e number h bedrooms and type of structure indicated herein. I further verify that
alit of Anchorage files and from my al and
stem is in compliance with all Municipal
functional and adequate for
I and/or wastewater disposal this
inspection.
based on the information obtained from the Municipality
inspection, the on-site water
sk reguulations in effect on the date of this insp o 'er
State codes, ordinances, Telephone
Name of Firm ------- —.N ri„NG
S&i .loo Z
Address verf Alazka 99577 ��
Hanle Ri.
Date
A • a
P..J `.d
.E+fi i eer'
� •li
�Je: •Y_ell 3%
g. DHHS APPROVAL % - / _ pate
Approved for _t bedrooms by
/ Conditional]
!O Disapproved
Approved
roval
Terms of Conditional App
Health Authority Approval
issues
artment of Health and Human Services (DHa Sndependent professional
The Municipality of Anchorage Depresentations given in paragraph 5 above by inspections
u on the rep to purchasers of homes and their lending
cerificated based only p to ees of DHHS do not conduct insp
of e e not responsible for errors or omissions
registered in the Shot satisfy) certain federal and state this t of Anchorage Y
institutions in orderThe Municip Y
or analyze data before aineercertifs woe k issued.
in the professional engineer's Page 2 of 2
72-025 (Rev. 71M Back
MUNICIPALITY OF ANCHORAGE (MOA)
• �e Health Authority Approval (HAA)
o �4744
v\G�So�`S��N CHECKLIST - FEBRUARY 1984 1
� � V
Legal Description: X-o�6f 0C'k–-
01R % 1 d Z -41W uer A
A. WELL DATA �
Well Classification Biu ie FA M ( 114 If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) Date Completed % – Z z I – S Z Yield % Q O M
Total Depth Cased to Depth of Grouting — 442 – 2 0 –� oT
Static Water Level I +' Pump Set At 0 I:�'
Casing Height Above Ground I Z t f Sanitary Seal on Casing (Y/N) (I
Electrical Wiring in Conduit (Y/N) U Depression Around Wellhead (Y/N) K)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot ( OD,t ; On Adjoining Lots (00 rf
To Nearest Edge of Absorption Field on Lot / c0� / t ; On Adjoining Lots ( 0 C) t
To Nearest Public Sewer Line�A To Nearest Public Sewer Cleanout/Manhole AJ
To Nearest Sewer Service Line on Lot
Water Sample Collected by 6 4;=- Na ree4'I Nei ; Date (D – ! _ 1 O
Water Sample Test Results �r4 � i S f AC fo /_ l a C V- jV4 11J rfr2 vk _�e5
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed l7- SZ Size 1 0 Cgjittl No. of Compartments
Standpipes (Y/N) _Air -tight Caps (Y/N) _Foundation Cleanout (Y/N)_
Depression over Tank (Y/N) ti Date Last Pumped % – P>– 10
Pumping/Maintenance Contact on File (Y/N) [/(4 ; for 62�Y1
Holding Tank High -Water Alarm (Y/N)Temporary Holding Tank Permit (Y/N) Gu (4
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water -Supply Well ( OO It To Building Foundation �� 1
To Property Line l (D 'i -
To Disposal Field 4 I
r
To Water Main/Service Line ( (0 -f
To Stream, Pond, Lake or Major Drainage Course L-)r)t
Comments _::sePTrL PL)MtA(f�d OTD - E`60 7—'E
72-026 (Rev. 7/88) Front Page 1 of 2.
C. ABSORPTION FIELD DATA 7 ,
Soils Rating in Absorption Strata 00 B �\ Type of System Design ooepi C_
Date Installed 77= 8 Z Length of Field�� �� i 3 — 3 'To tP,
Width of Field Z 8 Depth of Field
Gravel Bed Thickness " I
Square Feet of Absortion Area (00? Statndpipes Present (Y/N)
Depression over Field (Y/N) Date of Last Adequacy Test 2 D —
Results of Last Adequacy Test < f �r tD(L — 3 dl � d r -00M
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well O O / fi To Property Line /0
To Building Foundation o f To Existing or Abandoned System on
Lot. N1 IA ; On Adjoining Lots 5U -r"
To Water Main/Service Line n + To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course
To Driveway,, Parking Area, or Vehicle Storage Area Z o
Comments s� �k��p(1 'tOrAlL)eV' � �ej, s�
D. LIFT STATION
Date Installed Dimensions
Size in Gallons Manhole/Access (Y/N)
"Pump On" Level at "Pump Off' Level at
High Water Alarm Level atVent (Y/N)
Tested for I ^ v Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes (Y/N)
Comments
"Check Permitted Bedroom Rating Against HAA Request"
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection. S & S ENGINEERING
Signed . 17034 Bayle River Loop toad No, 204
Eagle River, Alaska 99577
Company
irieer•.sSeal
Z
Date 6
MOA No G al,
07 v? Receipt No. `' v
Receipt No. p
Date of Payment — Waiver Fee: $
Amount: $ Z 2- U Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
f CP0 A
LABORATORIES
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343
FEDERAL TAX I.D. #92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order # 29433
Date Report Printed: OCT 22 90 @ 12:03
Client Sample ID:L3 B1 MINDYER MANOR
PWSID :UA
Collected OCT 17 90 @ 16:50 hrs.
Received OCT 18 90 @ 14:45 hrs.
Preserved with :AS REQUIRED
Analysis Completed :OCT 19 90
Laboratory Supervisor : TEP EN C. EDE
Released By
Special
Instruct:
Chemlab Ref #: 904364 Lab Smpl ID: 5
Parameter Tested
----------------------------
NITRATE-N
Sample ROUTINE SAMPLE.
Remarks: SAMPLE COLLECTED BY RD7.
Matrix: WATER
Result Units
------------------------------
ND(0.10) mg/l
Client Name S & S ENGINEERING
Client Acct SNSENGP
P.O.# NONE RECEIVED
Req #
Ordered By : R. SHAFER
Send Reports to:
1)S & S ENGINEERING
2)
Allowable
Method Limits
---------------------------------
EPA 353.2 10
1
Tests Performed
See
Special Instructions Above UA=Unavailable
ND=
None Detected
See
Sample Remarks Above
NA=
Not Analyzed
LT=Less
Than, GT=Greater Than
OF.100EDEHQEHj
O
V
v <
G
�. CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
— TELEPHONE (907) 562.2343 5633 B Street
4�y Anchorage, Alaska 99516
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY
❑ PUBLIC WATER SYSTEM I.D.11 I I I I I I 1 II
)\ PRIVATE WATER SYSTEM
Name Phone No.
S & S ENGINEERING
Mailing Address age rver OOP pa p,
Eagle River, Alaska 99577 f
City State Zip Code
SAMPLE DATE: b L[ 1 J I L(I b I
Mo. Day Year
SAMPLE TYPE:
1K/�
Routine
Check Sample (for routine sample
with lab ref. no. ) ❑ Treated Water
❑ Special Purpose ❑ Untreated Water
SAMPLE Time Collected
NO. LOCATION L Collected
1 �lcf3iBl/l� - .rL�erMn. iN�r7�44 lb50
I
2
3
4
5
Analysis shows this Water SAMPLE to be:
satisfactory
❑ Unsatisfactory
❑ Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received �90
Time Received
Analytical Method: Membrane Filter
" No. of colonies/100 ml.
Lab Ref. No. Result' Analyst
Ls�t� Mo
Lp A Q�
U m
U m
U C�
U m
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
Membrane Filter. Direct Count
0
BEFORE
verification: LTB
00K0
Coliform/100 ml
BGB
01%
COLLECTING SAMPLE
Final Membrane Filter Results
fr-\
Coliform/100 mi
Reported Bye!:-'
=`Date
Z-0—01�
��
Time:
a.m.
TNTC = Too Numberous To Count
T.
OB = Other Bacteria
PART ONE OF TWO
REMAINDER TO FOLLOW
Municipality ®f Anchorage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
November 27, 1990
Robert A. Shafer, P.E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 3 Block 1 Mindyer Manors
Subdivision, Waiver Request # WR900053, PID
#020-091-64, HAA #HA900455
Dear Mr. Shafer:
Your request for waiver of the required 100 foot separation of a
septic system to surface water has been approved. The approved
separation distance is 90 feet from the absorption field to
surface water.
This waiver applies to the existing septic system to surface
water separation only. Any future upgrade will require all
separation distances to be met or another approval from this
department. If at any time in the future the integrity of the
stream is jeopardized by contamination form the subject septic
system, this waiver will be immediately rescinded and the septic
system will be brought into compliance with municipal
regulations.
Sinc ely
Robert W. Robinson
Civil Engineer
On-site Services
RWR/ljm:299
Con r:
Jn Smit
ogram Manager
On-site Services
Kids Are Our Future
� '��.n9tn� � PNCNOOPv S pN
ot?e wN� pS�Rv\G�S ROBERT SHAFER, P.E.
ROGERSHAFER
\R CIVILENGINEERS
�l (907) 694.2979
NovembeeA 13, 1990 FAX 694-1211
MUNICIPALITY OF ANCHORAGE:
DEPT. OF HEALTH &
e4R<E RIVER, AVPSKP ENVIRONMENTAL PROTECTION
. 0
HEALTH AUTHORITY L, 1 Ip 910
APPROVALS
Muni.ci.paP,ixy as Anchanage RECEIVED
DEPARTMENT UE HEALTH AND HUMAN SERVICES
825 L Stxeet
P.U. Bax 196650
WATER
MAIN EX Anchona e
MAIN EXTENSIONS g , A las ka 99519-6650
REFERENCE: Lot 3; Btock 1; Mindye)t Manoh Py -at 78-294
4751 V.Cngo Dni-ve
SEWER & WATER
INSPECTION Request you issue the attached Heatth Autho&ity App)tovat and pant a
waivers gon the honizonta2 sepaiLation distance between the cheek .located
on the southside o6 the ae6eceneed paopeAty and the teaehg.ietd at a
distance og 90 gt.
ENGINEERING STUDIES
ANDREPORTS The teaeh6.ietd was .instatted August 18, 1982. The .enstattatcon was
inspected and appn.aved by a private eng.ineening gtnm. Thnough the
pnoeess o6 obtaining a Heatth Autho- i-ty Appn.oval we have measured and
detenm.ined at this time the .6epanati-on distance between .the teachg.ietd
WELLINSPECTION and the atneam toeated on the a.e6eneneed pnapeAty is 92 dt. We Leque6t
&FLOW TEST apptLovat og 90 gt. .in onden to attow gate pe4iod6 o6 high waters. The
uuon we 6ee.l the waivea should be panted .is Listed below:
The tot ztopez gently to the southwest side o6 the .lot. The slope o6
SITE PLANS .the tot between the seepage pit and the stream .is giteate,% whene the
.longer- distance (100' ptus) exist, than it is whene the shorten
distance exists. Thenegone, any e46utent sungaci-ng at the c/Lib would
peach the stream aeno66 the tonget distance be6ane .it eoutd peach
ROAD DESIGN the stream at the 6hanten distance.
It .is ours opinion the ho1rizontat 6epanati-on distance pnesen.ibed by
18AAC72.021 .is not %equifLed .in this case.
SOILTEST 16 you nequ.ine additional .ingonmation, ptease contact ours o66.ice.
rRTA.
PERCOLATION
TEST
APER, P.E.
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN 1 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
6
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
NOV 13 11993
RECEIVED
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