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HERITAGE PARK BLK 2 LT 10
6/19/19 E_-Pcb-� MUNICIPALITY OF ANCHORAGE A Development Services Department -343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-211-70 Property owner(s) PAUL & DENISE GLEASON Day phone 9078913229 Mailing address 10546 TRADITION AVE., EAGLE RIVER, AK 99577 Site address 10546 TRADITION AVE., EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) HERITAGE PARK BLOCK 2, LOT 10 Legal description (Township, Range & Section) Lot Size 25,015 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Q Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank Upgrade ED Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ ' (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: 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: JWaiver Fees: _ Date of Payment: l l l) j r!� Date of Payment: Receipt Number: OL? S30 1) Receipt Number: Permit No. ©S 121 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 / Fax 345 -1391 Support Services Brent M. Western 907-440-4601 June 12, 2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: HERITAGE PARK BLOCK 2, LOT 10 The septic field has failed and the owner has requested a septic permit to upgrade the system on the above referenced lot. The design is based on a recently conducted test hole on June 4, 2019. We proposed to install a new 1000-gallon septic tank and a 57 long deep trench with 5 effective depth 7 from existing grade. The slopes are generally flat 0-5% at the proposed trench location. The lot and area is served by public water and the design will not impact any of the neighboring properties. Please contact Brent M. Western or me if you have any questions. Sincerely, Michael N. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191224, Rebecca Carroll, 06/19/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191224, Rebecca Carroll, 06/19/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191224, Rebecca Carroll, 06/19/19 Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 Fax 345 -1391 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: HERITAGE PARK B2, L10 PERFORMED BY: FWCS / MNA - I MIKE N. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6/12/19 DEPTH FEET OG SOILS 1 2 ORG/OL 3 4 5 6 7 8 GM/sm-sw 9 10 11 12 13 14 15 BOH 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 6/5/19 30 min 6 5 1/16 6 5 1/16 6 5 2/16 PERCOLATION RATE 6 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16 TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: 12 DATE: 6/11/19 TESTHOLE # 19-1 DATE PERFORMED: 6/4/2019 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: PAUL GLEASON 6/12/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191224, Rebecca Carroll, 06/19/19 , 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 I [~NEW MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS II Absorption area Dwelling Material ~ No. of compartments ~<~Z Manufacturer ~~ ~ ~ ~ Liq. capacity in gallons Inside length Width ~ Liquid d~th /2~ IF HOME'DE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons O~ DISTANCE TO: ~ ~ ~ Foundation3~%~/ Nearest lot line~ ~ PERMITNO. ~ ~ Z No. of I~es L~ng~of each~ne Total length of lines Trench width Distance between lines ~ Q~= Top of tile to finish~ ~[grade Material ~eneath tile ~ ( i~s Total effect~a~o~on~ area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: m ~' -' - O~ ~uildino foundation Se~er line Septic tank ABsorption area{s) ~ DISTANCE T . OTHER E MATERIALS SOIL TEST RATING I~AELER REMARKS APPROVED DATE LEGAL £~'-.I .... S I T~~- PERMIT NO. ( 820828 ) APPLICANT LOCATION LEGAL JHME_ '¢ WOODLE% JR. L10 B2 HERITAGE PARK t-ILH'-.! I C I f --~1 I T"-f C~F RI~,ICH~ RAGE DEPARTMENT C~HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE., AK. 9950~ 264-4720 SEP~ER F"ERt-1 I T 26~¢1 GOODPRSTER CIR., E~GLE RIV 752:,-02_?.8 LOT .~I-,E 99.9999 _-,QLIHRE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENC:H MAXIMUM NUMBER OF BEDROOMS =--~ SOIL RATING (SO FT?BR)= 282 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [:,EF"TH: ::LB I.....Er,tilTH= 51t EiR R'..-' E L [:,E F' TH: 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAV8TION (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 EXCAV8TION (IN FEET). I:;;:EC4. IJ I RFC, SFF"T I C: 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. T~-JC~ ( 2 ~) I 1'4SPECT I C~I'-,IS RI~:E REL---!LI I 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 t00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM 8 PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET 8ND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERt'I I T F;~:P I I;:ES DEC:Er-IBER 2_<1.. :1_982 I CERTIFY THAT 1: I RM 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. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. SIGNED: APPLICANT JAMES V. WOODLEY, JR. ISSUED ~ ~ ~ ~ ~-- E: '..r' ~~ -~-~ -r-'~%-'- ~-- ........ D A T E _ _~_~_~_/zi¢~_ ,,~.,.,.. V4. 0 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 lO 11 12 13 14 15 :16 17 18 19 20 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVI RONIVIENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST L. iO [] SOILS LOG PERCOLATION TEST ~c~n A, Sh~ No. 1457~E SLOPE 'l SITE PLAN COMMENTS WAS GRO~.= WA*ER J~ 0 S~ ENCOUNTERED? O '. E IF YES~ AT WHAT ' , ' DEPTH? PERFORMED BY: 72-008 (6/79) J Gross Net Depth t~- - Net Reading Date Time Time Water Drop '! &l -gz 7'.so PERCOLATION RATE ) ~ (minutes/inch) TEST R~N .ETWEEN </ FT AND S~_ FT CERTIFIED B DATE: 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. # 0~--C)¥,~I/- ?~ 1. GENERAL INFORMATION Complete legal description ~-~- HAA# HA Location (site address or directions) Property owner ~'~ ~,~-~ ~ ~,~r ~ Day phone Mailing address Lending agency. Day phone Mailing address Agent .~'~..//~,~ "-' ~-~'~'~ Address (,'~,~.~,y~j /-~2~ ~ Unless otherwise requested, HAA will be held for pickup. / NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well- Community well NOTE: Day phone NOTE: TYPE OF WASTEWATER DISPOSAL: 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. 72-025(Rev. 1/91) Front MOA#21 Public water "~ If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. 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 Address Engineer's signature David R. Dayton P.E. Chuglak, Alaska 99567 Phone Date 7/~~'h~ II I DHHS SIGNATURE _//'~ Approved for Disapproved. Conditional approval for bedrooms. 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. 72-0'25 (Rev. 1./91) Back MOA ~t Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~e'r- /~) //~U/d~ ~. Parcel I.D. O~'~::)- c~?? A, Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed , Driller Cased to Casing height Total depth Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line Wires properly protected (Y/N) g.p.m. AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~'/~j~ z._ Tank size I Z-~-z~ Compartments ~- Cleanouts (Y/N) Y Foundation cleanout (Y/N) ~ Depression (Y/N) /v///a7- Alarm tested ~(TM) i i/,..////~ High water alarm (Y/N) / ......... ~ Date of pumping ~,--~o/ ,~,'~z/~/~'/~ Pumper ~-,~' ~ ~'~,~r~-r~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /f///~- On adjacent lots To property line ~c~ Absorption field Foundation ~2~ ~ Water main/service line /'~ ~- Surface water/drainage 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Date installed ~/'~z ~/2 Length ~-'~'~ Width Total absorption area Manufacturer Manhole/Access (Y/N) "Pump off" Level at .Cycles tested On adjacent lots Sudace water Soil rating (GPD/FF) ¢.2~Z. ~,~..~z. System type ,~_ / Gravel thickness ~ / Total depth Cleanout present (Y/N) y Depression over field (Y/N) /t./ /'~,~ for _~7 Bedrooms After test ~,¢7" If yes, give date Date of adequacy test ,?//z_/~/~¢ Results (pass/fail) Water level in absorption field before test ~, ,~ Peroxide treatment (past 12 months) (Y/N) ,~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots ,4//(~ '~J' Property line ?.~ .~_5" To existing or abandoned system on lot Cutbank .,t/,/,~ Water main/service line / Driveway, parking/vehicle storage area ,/~ r~ Well on lot 4./ To building foundation On adjacent lots Surface water 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. David R. Dayton P.E. 20210 Donalar St. Signature :.~. ,,_., ....... Chug...., Engineer's Name Date ,~///~ ~//~/ HAA Fee $ Date of Payment Receipt Number 72-026 (3~93)' Back Waiver Fee $ Date of Payment Receipt Number SEPTIC SYSTEM ADVISORY HEALTH AUTHORITY APPROVAL NO. /~//~ ~?~3 ~/ Prior to a recent adequacy test on the septic system for this lot, ~ inches of standiung water was observed in the absorption field. This indicates that approximately g%~ % of the absorption area is inundated. However, this system did meet the minimum absorption requirements for a ,~f bedroom residence. This advisory must be attached to all copies of the subject Health Authority Approval. - LOT BLOCK SUBD. . ~O. BEDROOMS SYSTEM : TYPE SOILS. RATING ~- NOT S..__E_:' .- 'Z /¢' ~'-"' ..... ~ ~,- ; ' · - -~., '-~/,; /' '.". TIME MI~ WATER DEPT~ .~ -'" : WATER FLOW GALLONS" ',: " ~ . ',,- .,, ~.. .,. -.?';..:, ,-~... ,..... . . ] · ' , t " -"--'~''" .... ~ '' _ - ..... ::, .- . .. .. ,, _,.. 'i