Loading...
HomeMy WebLinkAboutT12N R3W SEC 24 N2NE4SE4NE4NW4T12N R3W SEC 24 N2 NE4 SE4 NE4 NW4 #015-472-19 Municipality of Anchorage.ti `uuw i u Gc;a Community Development Department Page 1 of 3 DEC On-Site Water Wastewater Program 2 2 - .. and 4700 Elmore St. • P.O. Boz 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151230 PID Number: 015-472-19 ❑ New 2 Upgrade Name: Leland &Beverly Glenn ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 11000 Trails End Rd. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 - GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision - Block Lot N2NE4SE4NE4NW4 Fill added above original grade , Ft. Gravel length Ft. Township Range Section T1 2N R3W 24 Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES I To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ftp Ft. Well 71.5` N/A N/A N/A 63.1 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,250Ga1. Surface Water 100+ 100+ N/A N/A Material Steel Number of compartments 2 Lot Line 48.9 N/A N/A N/A NA' Foundation 8.7 N/A N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain N/A N/A N/A N/A - Pump on level at Pump off level at High water alarm at Remarks *Waiver on File WR86-035 in. in. in. Pump make and model Electrical Inspections performed by - PIPE MATERIAL House to tank 3034 raankto drainfield 3034 Installer Isaacs Excavating Services Draineeld 3034 CO/MT 3034 Inspector Pannone Engineering Services LLC. BENCH MARK (Assumed elevation) 100ft- Inspection1., 8/1 /2615 a Location and description dates : a Finished Floor 30 COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp `�,OF.....1 �l1110 Conditional Approval: Date •��even •rt..�annOtAe•/ AW /.% Approved ��{ A t a1X Date I l a Xo l l alt jgaPy` ,pgp Inspection Report_1-1-12.doc SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALLED NEW 1,250g SEPTIC TANK. 52.4- 1250 GAL TANK NEW w�u I L - ALLED 125og SEPTIC TANK DCO AND DV 4 BR HOUSE D s A B T1 9.70 11.70 ' T2 18.00 12.10 DC 20.60 13.40 DV 22-80 14.90 C 1 22-60 15,30 C2 26.00 I 16.00 4 BR HOUSE D s T12N R3W SEC24 N2 NE4 SE4 NE4 N DRAWN ENJC LELAND & BEVERLY GLENN 11000 TRAILS END ROAD PLAN ANCHORAGE, AN 99507 �n Pani CE 8149 1 12/22/2015 Scale P.LD. NO -_472-1_ ie j PERMIT N0. r/ OSP 151230 r Sheet 2 O 2 ABBREVIATIONS ,TH TEST HOLE (P) PROPOSED -� (E) EXISTING DESIGN PARAMETERS CO CLEAN OUT N0. . PRIMARY SEPTIC SYSTEM !MT MONITOR TUBE NO. NO. BEDROOM. 4 (600 gpd) r' TYP TYPICAL TANK SIZE. 1,250g NOTES: PANNONE ENG SVC, P.O. BOX 100217 ANCHORAGE, AK PHONE (907) 272-8218 FAX (907) LLC 99510 272-8211 RECORD DRAWING T12N R3W SEC24 N2 NE4 SE4 NE4 N DRAWN ENJC LELAND & BEVERLY GLENN 11000 TRAILS END ROAD PLAN ANCHORAGE, AN 99507 �n Pani CE 8149 1 12/22/2015 Scale P.LD. NO -_472-1_ ie j PERMIT N0. r/ OSP 151230 r Sheet 2 O 2 Development Services Department Property Owner Name & Address: troaiqKu 6, M 07 Building Safety Division On -Site Water & Wastewater Program a 4700 Elmore Road a P.O. Box 196650 Mark Begich Anchorage, AK 99507 s A > E TV Mayor www.munixrylonsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: _ Parcel Identification Number:: q-7 Z- Of Legal Description 5�k a � m Property Owner Name & Address: troaiqKu 6, M 07 Pump Installation Date: 73 _15_(G Pump Intake Depth Below Top of Well Casing: gofeet Pump, Manufacturer's Name: /� Ay _AA 14 Pump Model: Z 3 v5 0 V 3 L8 Pump Size i)2 hp Pitless Adapter Burial Depth: /0 feet Pitless Adapter Manufacturer's Name: IIIA Pitless Adapter Installer: Vy/G Well Disinfected Upon Completion? Yes ❑ No Method of Disinfection: Comments: Pump Installer Name: Y i/ h Ger w�CrP%el7 ANCHORAGE WELL & PUMP SERV. 330 EAST 76TM AVENUE - ANCHORAGE, AK 99518 - - AWPS.COM PHONE: 907-243-0740 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. On -Site Water and/or Wastewater 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: OSP151230 Tax Code Number: 01547219000 Work Type: SepticTank Upgrade Permit Effective Dates: July 17, 2015 to July 16, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: T12N R3W SEC 24 Site Legal Address: T12N R3W SEC 24 N2NE4SE4NE4NW4 G:2640 Owner/Address: GLENN LELAND & BEVERLY JOINT REVOCABLE TRUST GLENN L P & B R TR 11000 TRAILS END ROAD ANCHORAGE AK 99507001 Site Mailing Address: 11000 TRAIL'S END RD, Anchorage This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank All construction must be in accordance with: Lot Size in Sq Ft: 53375 Total Bedrooms: 4 N Privy N Private Well N Water Storage 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: mss_ The tank is to be placed as far from the well as possible but still maintain 100 wa from surface ter. Received Issued By: Date: —111-7 1201S Date: % 7�S it ' MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-472-19 Property owner(s) Leland & Beverly Glenn Day phone Mailing address 11000 Trails End Road, Anchorage, AK 99507 Site address 11000 Trails End Road, Anchorage, AK 99507 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T12N, R3W, SEC24 N2 NE4 SE4 NE4 NW4 Lot Size 53375 Sci. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) (w/wo ADU) Upgrade FADuplex (D) F-1Renewal ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Permit/Rush Fees: p� �`J Waiver Fees: Date of Payment: I') Date of Payment: Receipt Number: O tg sq(A Receipt Number: Permit No. 0-5150I S I230 Waiver No. Permit App_: :'.;c: Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@oaneneak.com 16 July 2015 Subject: T12N R3W SEC24 N2 NE4 SE4 NE4 NW4 EMERGENCY TANK REPLACEMENT Design Narrative Ladies and Gentlemen: I am writing to request a permit to install an upgrade septic system be issued for this property. The proposed system will serve an existing four (4) bedroom house. Currently the lot is developed. The existing tank is in failure and is backing up into the home. This lot is served by a private well. The surrounding lots are served by private wells. There are no wells within 100 feet of this system. 1. System Design. a. See Sheet 1 of the design package. 2. 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. 3. Topography: The existing topography slopes from west to east at approximately 10% in the area of the septic area thereafter increasing to an approximately 30% slope. 4. Waiver Request: No additional waivers are required. A separation distance waiver for the well to the existing tank and absorption field was approved by the MOA Onsite Services on 18 March 1986 (Waiver Request, WR86-035). The work relating to this request increases the distance from the tank to the well from the approved waived distance of 65' to 70'±. No work is being conducted on the existing absorption field. S. 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. The proposed installation will not affect the future development of the surrounding or existing lots. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALL NEW 1250g SEPTIC TANK. EXISTING FIELD AND CRIB INSI f' DV AND DCO AFTER NEW TANK ' 84 / ' - NO WELLS ON SURROUNDING LOTS W/I 100' 155.6 DESIGN PARAMETEI PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1250g NOTES: EMERGENCY TANK REPLACE DRAWN I JRL PLAN roc 9F m DV AFTER TANK 7-11 m _ REMOVE' ^� TANK E BACK W/ MOA 1`PE II iE P I 2P P 4 BR HOUSE O 4 104 DB r" /i6C3RCVIHI IVIVJ rc TH - TEST HOLE S VACANT (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. `�..---t----MT MONITOR TUBE NO. TYP TYPICAL r Date P o. eox�o E ANCHORAGE, AK 9ENC 9510 LC SOFA/-gslr,' m/,s/,5 PHONE (907) 272-8218 FAX (907) 272-8211 /�g�e �y►� Scale `...... . .... / P.I.D. NO T12N R3W SEC24 N2 NE4 SE4 NE4 NW ........... .. —t LELAND & BEVERLY GLENN Steven R. P one w PERMIT N0. �.. CE 8149 .•��� osPxxxxxx 11000 TRAILS END ROAD I+ ��s .. �.r ANCHORAGE, AK 99507 �tShteOF 1 ?-,MUNICIPALITY OF' ANCHORAGE, Her- 'h and Environmental Prote, ion Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME —�e`ah U" �I`Q-V\ h MAILING ADDRESS 51QA7 �o`,C 5 l0 PHONE LOCATION V(_akkS G:0D LEGAL DESCRIPTION, _C(�),fj )�3vJ 5a` -Y I-A"P,aB(9- SEPTIC TANK: DISTANCENUMBER OF FROM WELL c�C> I - MANUFACTURER rE�IC' —MATERIAL STe�'� COMPARTMENTS INSIDE LENGTH Ala WIDTH n -,a LIQUID DEPTHN LIQUID CAPACITY-. GALLONS. TILE DRAIN FIELD: TOTAL LENGTHq 1 DISTANCE FROM WELL FOUNDATION JOE% NEAREST LOT LINE-. 0 ' /—OF LINE I 4 # of Lines -� DISTANCE BETWEEN LINES 1�TRENCH WIDTH IS IN. TOTAL EFFECTIVE ABSORPTION AREA Co SQ. FT. LENGTH OF EACH LINEu t�C DEPTH OF FILTER /'(� DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE ' 0 IN. ABOVE TILE IN. SEEPAGE PIT: V Xl5TIh1(� GeSS�a� (— L-ttlky)bL" .I DIAMETEROR WIDTH_ LENGTH_, DEPTH Log Crib - Rings_ Crib Size: DIAMETER --DEPTH— DISTANCE FROM: WELL . -- TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. well ClassDepth: Up)VyA0 Well Distance TO: Lot Line 2.�! Bldg: lot- Sewer Line: rjp{- Pipe Materials: moi, t p12��ic. # of Bedrooms: c- GA c. Installer: t leu_)TC)" Remarks: DATE.3 - L APPROVED _'� � I I l ! _ -, I _ , Vit_ - T DATE.3 - L APPROVED _'� ` . TRENCH OR PIT IS THE DlSTHNCE BETWEEN THE SURFACE [.-'IF THE GRDUND AND THE BOTTOM OF ~ ^ DEPARTMENT OF ^ HEALH HND ENVIRONMENTHL PROTECTION 825 /L' STREET� HNCHORHGE/ HK� 99501 / IS THE 264-4720 DEPTH OF GRHVEL 8ETW1EEN ( C-�_���� OF THE E`�� � pl, J. 4 PERMIT NO. ( 78009] ) HPPLICHNT STR H BOX 56 LO:AT ION TRH!L� END LEGHL 1:12N R]N S24 PHR28R LOT SIZE 0 SQU9RE FEET TYPE QF SOIL HBSORBTION SYSTETRENCH MHXIMQM NUMBER OF BEDROOMS -- 4 SOIL RHTING (SQ FT/BR)� 100 THE REQUIRE) SIZE OF THE SOIL HBSORPTI0@ SYSTEM 1.S� �T,.. r.- L���K_ [HE LENIGTH DIMEN'SION IS THE LENQTH (IN FEL -T) OF THE TRENCH OR �RHJNFIELP THE DEPTH OF H TRENCH OR PIT IS THE DlSTHNCE BETWEEN THE SURFACE [.-'IF THE GRDUND AND THE BOTTOM OF THE FXCHVHTlON (IN FEET). WELL. DEPENDING THFRE IS NO SET WIDTM FOR TRE�CHES AND CONSTRUCTION DIHUNHMS FRE THE GRRVEL MEPTH IS THE MINIMUM DEPTH OF GRHVEL 8ETW1EEN THF OUTFALL PIPE HND THE BOTTOM OF THE EXCHVHTIDN (IN FEET). U I r�__, F-7 C� 3,���� PERMIT 'APPLICANT HAS THE RESPONSlBILITY TO INFORM THIS DEPHRTMENT DURING THE INSTHLLHTION INSPECTIOHS OF ANY WELLS HDJHCENT TO TH�S PROPERTY HND THE NUMBER OF RESIDENCES THHT THE WELL WILL SERVE �- .1 ­��������p�� �F L_ 0: Z��������� BHCKFILLING OF HNY SYSTEM WITHOUT FINHL YNSPEcTION AMU, APPROVAL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION MIN�MUM DISTHNCE BETWEEN H WELL HND HNY UN -SITE SEWHGE DI�POSHL SYSTEM IS �S0 FEET FOR H PRIVATE WELL/ OR 150 TO 200 F£ET FROM H PUBLIC': WELL. DEPENDING UPON THE TYPE OF PUBLIC WELL OTHER RFQy1REMENTS MHY HPPLY SPECIFICATIONS AND CONSTRUCTION DIHUNHMS FRE RVHILHBLE TO INSURF PROPER INST8LL9TION. �APE- ����v������� ����������� ���^ I CERTIFY THAT 1 I HM FHMI!'l8R WITH THE FOR ON-SITESEWE�S AND NELLS �S SET 'F0RTH 8Y THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN HCCORDHNCE WITH THE CODES. ]� I UNDERSTHND THAT THE ON-SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMF��T I� RESIDENCE lS REMODELED TO TNCLUDE MORE THHN 4 BEDROOM -S. APPLICANT LFLHwD GLENN lSSUED BY -__D8TE- _ e� SOILS LOG MUNICIPALITY OF ANCHORAGE ae DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG — PERCOLATION TEST q (7 PERFORMED FOR: Yy L']w TO (! �` yC, DATE PERFORMED: LEGAL DESCRIPTION: Cl (L'' VI I1 R!d n SLOPE _ DEPTH -- (FEET) ��-_� - 1 2 ) 3 i 5 6 -f 8 ED—i 10 11 WAS GROUND WATER V S ENCOUNTERED? O P 12 rc.7n`V� IF YES, AT WHAT E 1DEPTH? 13 LA) 5 � c ✓Yl Q 1 �G�rivzd `ir� 14- 15- 16- 17 4151617 18 19 ReadingDate Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) �S TEST RUN BETWEEN L" �V erg it COMMENTS C(/�Gl I 7 PFRFnRMFn Rv: ReadingDate Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) �S TEST RUN BETWEEN L" �V erg FT AND FT COMMENTS C(/�Gl I 7 PFRFnRMFn Rv: Z l(Slos� L'�I �. C E R T I FI ED BY: -y DATE: - 20 PERCOLATION RATE (minutes/inch) �S TEST RUN BETWEEN L" �V erg FT AND FT COMMENTS C(/�Gl I 7 PFRFnRMFn Rv: Z l(Slos� L'�I �. C E R T I FI ED BY: -y DATE: - 72-008 (7/76) V II CTION CHECK Field check list fo or or n -site installation inspections. First and second inspections. Well: Well drilled yet? Where and what distance. Neighboring wells in the area. Where and what classification e.g., semi-public. Sewer:t,,,Tank type and capacity. ,-Dank to well and neighboring wells. Tank inlet and outlet caulked? vStandpipe in place? Tank set level? Cast iron or approved plastic five(5) feet from tank. All pipe types noted and sloped within 2% to 6%. Trench to well distance including neighboring wells. Trench length. n� Trench depth below tank outlet. Trench depth. Trench sidewalls not smeared. �V Gravel quality okay. Type of perforated pipe. Cleanout between trench and tank vertical. Sump in place? Standpipe caps in place. Check soil test for possible permit issuance error. A to G¢ .- � 771 - a Le y. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 - Application Date -3 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) N Il N15- SE 77 NC � N '/' Sec 2Y� Trini Rau/ S,M i Pecrrel Z1 Location (address or directions) /�vvo T/tirCr En�L Ruad (b) Applicant Name Leland G/eo,7 Telephone: Home 3 `!6"ZO''2 Business Applicant Address if 000 T''VerJ E^4 Ra (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address' (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE 3. 4. lois cad wAeq Single -Family ® Multi -Family ❑ Other Number of Bedrooms Telephone WATER SUPPLY Individual Well 1 Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 - - n-026(11/84) 9 5. ENGINEERING FIRM PROVIDI. , INSPECTIONS, TESTS, FILE SEARCH, L"�A AND INFORMATION 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 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 F/uf/o� TeCAWLCV1 Slrvcco Telephone 3 YS'- /35'15 Address 1 s3o EcA., SA A -kr 99S'/6 Date (4 (,!/Cly-selokc Glrrissn�e w0111¢7e0e 4 Sar by bHEP 114 3/2-6/7g iF Me,eo2 wc, vrr .ior . We oai 93 Wa-.'.tri �ta.lrcQ to 6Sf S�/p �Sfe sM . Engineer's Seal 6. DHEP APPROVAL Approved for 76."e Approved ur � .��v4 -„ ,,.......°9s®® d ;.49TH p L .........................0 ® . THEODORE F. MOORE : o .• CE - 3589 0 61 0 bedrooms by Date 3—�F_�g�O Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Agchorage 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 institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2, 72-025 (11/84) "WFfUUIBMIUW( (OF A"XHORA I? CUMMUNICIPALITY OF ANCHORAGE (MOA) ftMm N NT(OP )� PROT & HEALTH AUTHORITY APPROVAL (HAA) PROs CilOry' CHECKLIST - FEBRUARY 1984 MAK 1 264-4720 p� r Legal Description: NV 44 C_ (ec 2K 7,12N, R 3w, s -rt, �Parce/ A� A. WELL DATA Well Classification QYrr+aFe If A, B, C, D.E.C. Approved (Y/N) N.A. Well Log Present (Y/N) —N Date Completed 1Y6 0 Yield Total Depth 63.* Cased to -7 S6 Depth of Grouting N'4 Static Water Level 2FJ' Pump Set At ,— Casing Casing Height Above Ground— 2 t Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) Separation Distances from Well: �✓�Y� r To Septic/Holding Tank on Lot 6s+ ; On Adjoining Lots > too' ,,sa%1w ' To Nearest Edge of Absorption Field on Lot 3' ; On Adjoining Lots I> tvo To Nearest Public Sewer Line N/A. To Nearest Public Sewer Cleanout/Manhole N, H• To Nearest Sewer Service Line on Lot IV4. Water Sample Collected by Date Water Sample Test Results Sec{-it.rscc Comments Wal 40 Pt aU %anrs cua 4t a eea A0 SV' Q� 3/ ZB ! T� Waiver low SO well /0 absorehog J-leW ceParaf*0a o i 93' B. SEPTIC/HOLDING TANK DATA Date Installed 17e 7 Sizel 2No. of Compartments Standpipes (Y/N) Y Air -tight Caps (Y/N) r Foundation Cleanout (Y/N) N Depression over Tank (Y/N) _N Date Last Pumped 3110186- Pumping/Maintenance !10!6!Pumping/Maintenance Contract on File (Y/N) Ah, ; for N.N. Holding Tank High -Water Alarm (Y/N) +`A Temporary Holding Tank Permit (Y/N) N'd• Separation Distances from Septic/Holding Tank: To Water -Supply Well 6sk To Building Foundation 31 To Property Line 7 30' To Disposal Field JV « To Water Main/Service Line N<A• To Stream, Pond, Lake, or Major Drainage Course ;;;0 (60' Comments Tan (c —A-- wet/ �ct�ergle cvarvGeeel % 1�` 6n 3/z8/7�r Page 1 of 2 72-026111/84) C. ABSORPTION FIELD DATA 85 a pe- I;y rvna�f Soils Rating in Absorption Strata IGo el- Awl Type of System Design P't Date Installed 1? ' 00 7 4F•e^C4 - '9 Length of Field 38' Width of Field Depth of Field 8 Gravel Bed Thickness 5� Square Feet of Absorption Area Standpipes Present(Y/N) Y Depression over Field (Y/N) N Date of Last Adequacy Test 3/ Results of Last Adequacy Test Sa�-4.%c41, Separation Distance from Absorption Field To Water -Supply Well 93� To Property Line > 30' To Building Foundation H/ To Existing or Abandoned System on Lot > 361 ; On Adjoining Lots > 30' To Water Main/Service Line N. A. To Cutbank (if present) N•'+ To Stream/Pond/Lake/or Major Drainage Course 7 Eou To Driveway, Parking Area, or Vehicle Storage Area 2' SO' Comments uWWe� geeJe�C roo well - abs ArenC4 ,yeo ®Ctrl o&'� 93 -7-v Ac,4 zlaoe i1 Se -7 eeX fog' .r liDas ed i r oefi�w/o SeetpaQG r' et:fo V/-;// Cbn9«Ae-e -46 D. LIFTSTATION N.A• Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for — Dimensions Manhole/Access (Y/N) "Pump Off' Level at - Vent(Y/N) 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. Signed 1 � 9ft&-'-t Date 31f01-06- Company 1f0166Company F&~AG MOA No. R.5-aS2 Receipt No. �%S4��+��� Date of Payment 3 -11 •,V(o @` OF• At �0® a �Giheer sn5e�•.0��® Amount: $ •of- �'a'• 49TH •'�*off �.....................:... Page 2 of 2 HEODORE F. MOORE t'� e. • CE - 3589 �bt A 72-026 (11/84) ®�Pr �••........ QoC� ®®o•®moo Municipality of Anchorage March 18, 1986 P.O. BOX 196650 ANCHORAGE, ALASKA 99519-6650 (907)264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Theodore F. Moore, P.E. Flattop Technical -Services 14530 Echo Street Anchorage, Alaska 99516 Subject: T12N R3W Section 24 Parcel 28A Waiver Request, WR86-035 Dear Mr. Moore: Your request for a waiver of the separation distances required between the septic system and well on the subject lot by 18 AAC 72.021 has been granted. The separation distance required between the well and septic tank and the well and absorption field have been waived to 65 feet and 93 feet respectively. These waivers are vaild for a four bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw CIVIL, & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. 1986 PH: (907) 345-1355 March 11, ANC 'KA 99516 ENV/ k$�Gr� - ase FAL M.O.A. Dept. of Health and Human Services pkQTECAjN P.O. Box 6-650 MAR 1 Anchorage, AK 99502 1If; Attn: Steve Morris EPE, q RE: Well-Absorption Trench Separation Waiver Parcel 28A, Sec T12N, R3W, S.M. Dear Mr. Morris: By means of this letter I am requesting a waiver of the well to absortion trench separation distance down to 93 feet for the subject property. Copies of relevant documents are enclosed for your review. The well and original wastewater disposal system were constructed in 1966, but no as -built records are available. In 1978 an upgrade permit was issued for a four bedroom system. The permit has a handwritten notation signed by "L.B." indicating that the tank -to -well separation was waived down to 50 feet, but it does stipulate a 100 foot separation between the well and absorption field. The as -built inspection report prepared by the Municipal inspector fails to indicate the actual well to absorption distance, which I measured to be 93 feet. The actual well to septic tank cleanout distance is 65 feet. The as -built indicates that the soils encountered during construction were better than those found in the test hole; thus the 456 square feet of absorption area is actually sufficient for a five bedroom residence. On March 10, 1986 the fluid level in the 6 foot deep gravel filled portion of the trench was less than a foot above the bottom, and it easily accepted water at an adequate rate for a four bedroom residence. The ground surface in the vicinity of the absorption trench is approximately 12 feet lower than at the well, and it slopes away from the well. The fluid level is 14 feet below the present ground surface which has been built up 4 feet since the time of construction. The soil log indicates tighter soils (fine sand with some layered silt) underlie the receiving strata; these will tend to slow the downward percolation, and at the same time the topography will direct the effluent away from the well. In the unlikely event that a failure should occur which results in effluent surfacing, from either the tank or the absorption field, this also will flow away from the well. The well itself is 65 feet deep and was drilled -in 1966 by Sunset Drilling. No log is available, but I measured the static water level to be at 28 feet, the yield to be 1.0 gpm, and the pump intake to be at 58 feet. A water sample taken 3/6/86 showed no bacterial contamination. It is my recommendation that in light of the abovementioned mitigating circumstances, and the good performance of the oversized soil absorption system, a waiver should be granted in this case. No discernable improvement to the public health would be accomplished by requiring that the well be relocated 7 feet further away. Please call me if you have any questions, and I shall look forward to receiving your response. Sincerely, I� /' 6- cc. Leland Glenn Ted Moore, P.E. CO LVa ,� $_W a, .............�./..�.y.).�.. THEODORE F. MOOP.E ; <'r_.' CE - 3589 _ 11 Time Time pie nn Date Date - Date 1 04 Inspector Inspect Inspector �LL Comme is Conditional Approval pFPT. OF HEALTH R r, s,, pe o wr� ,-ENVIR;NPP.._f`;'A-. —=�n`c 9 N��e-sbUa C oma^ �(� s� u� AUG 9 198 RECEIVE 11 P w Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner c rel 9 6V CUP/ F/9? "=:' Phone Mailing Address �. S� Sig lin 99W7 1 Buyer Address Lending Institution (•��� Phone Address Realty Co. & Agent Phone Address - - - Legal Descriptio _. - _ - _ C mac/ P ou-, a g Street Location Typo Residence /it Single Family 4j A.13+ ❑ Multiple Family No. of Bedrooms ❑ Other Wate upply __ ndividual ATTACH WELL LOG. A well log is required for all wells drilled since June ❑ Community 1975. For wellg d iped prior to that date, give well depth (attach log if El Public Utilityavailable. c7 b' SewDisposal - /�% Q/ 'age Individual Year Individual Installed: !�ti ❑ Public Utility When Connected to Public Utilit -- ❑ Holding Tank oo NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING JOVATEQ.f'r M -+ FAA! ECEIVED .- -- INSPECTION APPOINTMENTS - - TIME TIME - TIME ,�jt� % L DATE DATE - DATE One Four Other El1.�/ SINGLE FAMILY ❑ Two ❑ Five INSPECTOR INSPECTOR INSPECTOR in INDIVIDUAL* MUNICIPALITY OF ANCHORAGE - - DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 1// NOV 2 01979 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED ❑ PUBLIC UTILITY REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER - PHONE 'f e /a" MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE S 'amu 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITLITION PHONE MAILING ADDRESS 47 !/✓�. / "moi G-' � ✓ !%1 �Jn 4. REALTOR/AGENT PHONE MAILINGADDRESS - - 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS Z ❑ One Four Other El1.�/ SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER PPPLY in INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) C S- 8. SEWAGE DISPOSAL SYSTEM 1// ld INDIVIDUAL/ON-SITE** // YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY - 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER qq ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING CS-•�'`- TYPE OFTANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL c - .Vr ifJC.(L ).�..-,1/ .... ..i,...) �2a•��- iii 6 4. DISTANCESSeptic/Holding WELL TO: Tank Absorpti n Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS Cd,—APPROVEDFOR .�— BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79) MUNICIPALITY OF:ANCHORAGI\ DEPARTM.OF HEALTH AND ENVIRONMEh, L PROTECTION 825 _ L Street, AnchoraaP. Alaska 99501 264-4720 #1: Time 1:16 #2: / 1',) /1 u t Date �-9-�� (I S � InsP (1)'LUDa uuv1S 1 2 Date Received: February 24, 1978 Time ` ,� 1 #3: Time Date Date Insp „-AULA6. Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Mailing Address Phone: Property Owner: Leland P/Beverly R. Glenn Phone: 344-5120 Mailing Address: Star Route A Box 56 99507 3. Legal Description: T12N R3W Section 24 Parcel 28A 4: Single Family Residence: (x* Number of Bedrooms: Four Multiple Family Residence ( ) Number of Bedrooms: 5. Well System: Individual Well (x) Community/Public System ( ) C 7 Permit # Construction Depth of Well Well Log on File ( ) Bacterial Analysis Sewage Disposal System: On-site System (x3� Public Utility ( ) Permit # Septic Tank Size Absorption Area Installed 1967 Installer Manufacturer Soils Rate Distances: Well to Septic Tank to Sewer Line Nearest Lot line to Nearest Lot Line Material to Absorption Area Absorption Area Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: T12N R3W Section 24 Parcel 28A Comments( \A �Q \ Ess t flnti��� �+} 1 h 't$ �iH4Clk Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date: Disapproved: VQpyC/ Date: l� ! Department Worksheet: 20 Mfle q MFl, VC—D l2YC� r C2?� �� rncrl \Q� sovfw ' I65.0' a W L25 At.o �! c ' 7 4 -1 POYL( lf. O (3•4- Moo POUNO• e I uooSi� , —� Dlbrkl>JAr E P(kfTBn N 1sTonq N01 FOUND, uvusE- � Sc�Tic r„E si iQ z, ° ~ h NE t TIF�Drd} 1/ R RALT / Sir CNV06(v 2A„rfWKt VlSl r �IL11., SubD, SDR• W'r I 2 STDa11 Analrlo�l _ _ �v- . No1+�tN Ib5.0'# o a sr :T� 1.• I,NEGF�, ",: I hereby certify that I have surveyed the JAMES L. SCHEFFEL, Registered Surveyor N 1/2 NE 1/4 SE 1/4 NE 1/4 NW 1/4 of Section 24, Township 12 North, Range 3 -1 -ria 1” 50' 3 West, Seward Meridian, and that the im- provements situated thereon are within the AS -BUILT SURVEY property lines and do not overlap or encroac 1,N 172 NE 1/4 SE 1/4 NE of on the property lying adjacent thereto and Section 24, Township 12 North, Range 3 Vest that no improvements on property lying ad- Seward Meridian. jacent thereto encroach on the premises in q estion. Anchorage Recording District