HomeMy WebLinkAboutWOODBOURNE BLK 2 LT 4Woodbourne
Block 2
Lot 4
#015-351-24
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP151352 PID Number: 015-351-24
Dwelling: N Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New Upgrade
Name:
James W. Dvornikoff
ABSORPTION FIELD
❑ Deep erich ■ Shallow Trench ❑ Bed ❑ Mound
Address
P.O. Box 111511 Anchorage, AK 99511
Phone
Number of Bedrooms
n
Soil�y
Total depth from original grade
441-6700
Four
D F 1
3 Ft.
LEGAL DESCRIPTION
Depth t nve t gradeGravel
1 Ft.
depth beneath pipe
2 Ft.
Subdivision Block Lot
Woodbourne 2 4
Fill added above original gradeGravel
1-2 Ft.
length
88 Ft.
Township Range Section
Gravel width
5 Ft.
I Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
TO
Septic
AbsorptionLift
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Station
Tank
Line
628.6 Ftp
TWO
>10 Ft.
Well
>100'
>100'
>100'
>75'
>25'
TANK ❑ Septic N S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Existing
Capacity
1,500 Gal.
Surface Water
>100'
>100'
NA
NA
Material -
Steel
Number of compartments
Three
Lot Line
>5'
>10'
NA
NA
NA
Foundation
>5'
>10'
NA
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
None
Noted
RemarksAbsorption System Only Replaced
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Under this Permit.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank D3034 drainTankto field
eld D3034
Installer
G&R Excavating
Drainfield F810 CO/Mr
Inspector MEA
BENCHMARK (Assumed elevation) 100.0 ft
Ins dates: 15'10/21/15 10/22/15
Location and description
2'
Garage Slab.
s" 4m
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL4t
�1
OF 44 to#
Conditional Approval: Date
o'r*(.�� 49TH*
.... . .... .
/......
.........
0 ..........
�. rn MICHAEL E. ANDERSON 'I-
I-
CE-4381 ; ���
CE-4381
I�,
Y.
Approve Date iZ-
_
Inspection Report _9-1-12.doc
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WOODBOURNE
CIRCLE a"'�"'"""" N
N W
A
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP151352
ILLOU U U am
EXISTING
NOTE: Flow Diverter Valves are Ball Valves.
H 102.7
101.2 /
Original Ground
2" Insulation &
Geotextile Fabric
100.2 Drainfield Rock
Groundwater @ 94'
98.2 86.2 10-20-15
44' (Trench Length)
= 102.8
~ 101.2 /
Original Ground
2" Insulation &
100.2 Drainfield Rock
98.2 Groundwater @ 94'
86.2 10-20-15
44'(Trench Length)
rD 17)I—IF_TI F_ A<C T -)I ITI T
No Scale
Page 3 of 3
PID No. 015-351-24
N
2
98.2
98.2
H1I41Va
100.2
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: OSP151352
Tax Code Number: 01535124000
Work Type: Septic Upgrade
Permit Effective Dates: October 20, 2015 to October 19, 2016
Design Engineer: ANDERSON ENGINEERING
Subdivision: WOODBOURNE
Site Legal Address: WOODBOURNE BILK 2 LT 4 G:2741
Owner/Address: DVORNIKOFF JAMES W
PO BOX 111511 ANCHORAGE AK 995111511
Site Mailing Address: 11751 WOODBOURNE DR, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy
All construction must be in accordance with:
Lot Size in Sq Ft: 87134
Total Bedrooms: 4
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.
Received
Issued By
i
MUNICIPALITY OF ANCHORAGE
Community Development Departments r6 904
Development Services Division �oy;�J�� ' 97
On -Site Water & Wastewater Program ,v v f7•
ON-SITE SEWER/WELL PERMIT APPLICA ^ N OCT 19 �� 3
AV
w
Parcel I.D. 015-351-24 t << e`0"
Property owner(s) James Dvornikoff Day phone t
Mailing address P.O. Box 111511 Anchorage, AK 99511
Site address 11751 Woodbourne Drive Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Woodbourne, Block 2, Lot 4
Legal description (Township, Range & Section)
Lot Size 87,134 Sq. Ft. Number of Bedrooms Four (4)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(M all that apply)
Absorption Field 0 Initial ❑ Single Family (SF)
Septic Tank 0 Upgrade F (w/wo ADU)
Duplex (D) ❑
Holding Tank FJRenewal ElMultiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Dis tance:
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: 49 -t 3Y1 9b: 9/0 L/0Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number: 62.1•-5q Receipt Number:
Permit No. M,915 1352 Waiver No.
Permit App_9-1-12.doe
October 19, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 4, Block 2, Woodbourne Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer
The existing absorption bed on the subject lot has failed and must be replaced prior to
the issuance of a Certificate of On Site System Approval (COSA) and the sale of the
property. We are therefore requesting a permit be issued for the construction of a new
absorption system to accommodate the home. The attached Site Plan and backup
documentation identify the location and configuration of the proposed well and septic
system along with the proposed site. The existing 1,500 Gallon STEP Tank will be
inspected and verified suitable for continued use. Also identified on the plans are the
existing wells and septic systems on surrounding lots. No conflicts exist between the
existing well and proposed septic system and wells or septic systems on adjacent lots.
Drainage arrows are shown on the site plan showing the grade and direction of flow on
the lot. The drainage pattern will not be changed as a result of this project.
The test hole placed on the lot in the area of the absorption trenches indicated the
presence of silty gravel with some gravel (GM). The percolation rate of the material
was determined to be 4 minutes per inch. Groundwater was found at 8' below the
surface during the groundwater monitoring period and recent heavy rains. An
application rate of 1.2 gallons per day per square foot was used in the design of the
absorption system. We are proposing to utilize the existing 1,500 -gallon STEP tank
and 2 new 44' long by 5' wide by 2' effective depth absorption trenches to treat and
dispose of the effluent generated in the house. The elevation of the distribution line in
the absorption trenches will be 1' below the existing ground surface and the total depth
will be 3' below ground. A minimum of 3' of fill or 2" of insulation and 2' of fill will be
placed over the absorption trench and 4' over the septic tank.
The ground surface on the lot in the area of the septic system slopes to the north at a
grade approximating 15%. The new trenches will be constructed parallel with the slope
as much as possible in conformance with Municipal requirements. The new septic
Lot 4, Block 2, Woodbourne Subdivision
October 19, 2015
Page Two
system will be constructed a minimum of 100' from all wells and any surface water and
10' the proposed and existing water services in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely, �% ,
x ""_" -
Michael E. Anderson, P.E.
Attachments
�.� 49th •iii
MICHAEL E. ANDERSON
No. CE -4381
`1 1
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•.• PSE...........
3 49th ! V `': 1♦
;:�.: AREA MAP
♦♦� - ;MICHAEL E• ANDERSON �'�..�i
♦♦ � `:, No. cE-aael SCALE 1' = 100'
4181111a ESS
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LOT 4, BLOCK 2, WOODBOURNE SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home 5' Wide Trench System
Perc. Rate: 4 Min./Inch Existing 1,500 Gallon STEP Tank
Application Rate: 1.2 GPD/SF 2' Drainfield Rock
4 Bedrooms . 150 GPD/Bedroom = 600 SF Absorption Area
600 SF/1.2 GPD/SF/5 SF (Width)':7(Red. Factor) = 70 LF Trench Length
THEREFORE: Construct 2-44' Long x 5' Wide x 2' Effective Depth Absorption Trenches.
Flow Line Elevation in Trenches to be 1.0' Below Original Ground Surface. Total Depth to be
3' Below Existing Ground. Provide 2' Coverand 2" of Insulation Over Absorption Trenches.
Place New 1.25" PVC Pressure Line to Existing Lift Station.
,e Mound
Topsoil to
Prevent Erosion
sting Ground
Existin Ground
2" Insulation &
6"
Geotextile Fabric
6"
O
1.25" Perforated
PVC (Holes Down)
3/16" Diameter Holes
15 Per Trench @ 2.13' Spacing
Drainfield Rock
5'
TYPICAL 5' WIDE TRENCH SECTION •••.��,
(NO SCALE) ��*4P�E�
NOTE: Grade Area Over Trench to Drain Away. : u
Minimum 6' Separation From Bedrock. .........49............x...
Minimum 4' Separation From Groundwater. 0'
0 ......................
Minimum 100' Separation From Private Wells in the Area. , MICHAEL E. ANDERSON
Minimum 100' Separation From Surface Water or Streams. �j,� No. CE4381
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTH
(feet)
I-
2-
3 -
4-
5-
6-
7 -
8 -
9-
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION:
PERFORMED FOR: _
DATE: 110/13
PARCEL ID#:
OB/OG
i PROJECT No.:
TECHNICIAN: MEA
TEST HOLE 1
SILTY GRAVEL
WITH SAND
GM
LO WAS GROUND WATER ENCOUNTERED? NO
IF YES Q WHAT DEPTH? 0
I1 DEPTH OF WATER AFTER MONITORING: 8' pF
in
DATE OF MONITORING: 10/20/15 C
I
0
E. ANDERSON
CE -4381
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
10/13/15
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
3:13/3:23
10
3.13"/5.63"
2.5011
2
3:24/3:34
10
3.25"/5.75"
2.50"
3
3:35/3:45
10
3.25^/5.75^
2.5011
4
3:46/3:56
10
3.00°/5.50^
2.50"
5
3:57/4:07
10
3.13"/5.63"
2.5011
6
4:08/4:18
10
3.00"/5.50"
2.5011
PERCOLATION RATE: 4 (MINANCH) PERC. HOLE DIA--L—(INCHES)
TEST RUN BETWEEN: 2 FT. and 3 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 10/20/15
72-013 (3/85)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON—SITE SEWAGE DISPOSAL SYSTEM
AND/OR WELL INSPECTION REPORT
Name L,
Address 2 r�
DISTANCES
TO
FROM
SEPTIC
TANK
ABSORPTION
FIELD
WELL
WELL
r
Phones
�>�I�lvB-• Iii.
Permit No.
�I t�a� O'i--.
No. of Dedraoms
LOT LINE
Ea NPTION —�
LEGAL pSob
Lot
Block
2�F���
nsio
X71
Township, Renga. 5 coonFOUNDATION
AS-BUILT DIAGRAM (Show location of well, septic system. property lines, foundation,
driveway, water bodies, etc.)
TAN S
SEPTIC/-1r< [:J HOLDING
M nulaclurer
Capacity in P!1_19ns
S led
—
�y
Materia m�0.n—o
Pet CompartmentsAA-
TYPE OF SYSTEM _
_
❑ TRENCH )t<6ED$ ❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from Total depth from original gratle
original grade T
0 FT
Fill added above original grader , Gravel depth beneath pipe )
A.5_ FT t->,FT
Gravel length �^�, Gravelpitllh��,...
is 1 A �1 f'�f�T FT
Total absorption area Distance between lines
I SO FT ';!;:L -- 1,' FT
Number of lines Soil rating Pipe material
I/k SO FTP'1
InstalWn�''L� IISI Date installed S10
WELLS
PRIVATE ❑ OTHER (Identilvl
—
Classification (A,B,C) Total Depth Cased to
f�c1'�7r� IIS FT FT
Installer Date Installed:
REMARKS:
.� /_ , \ ♦
W V'
S& SNC;INGERfNe
I c _
cattily that ihi
170341 aO rver LOOR I(Clatil No. 204
Municipal
municipal an1AWQFVg3R; 7@IIAK1umIN94C(E,7
Health Department Approval:
Scale:
Dale:
���—fib-• `t c>
9 ep
Inspection was pedormetl according to all
1,42
11
Date: Dale: `�' L �tl
--
ENGINEERS SEAL
ijas e ltl, i
I
,� / �
.. ;,
r
' `•
ts;
72-013 (3/85)
k- 41) GAn
//lA&).\�l
Uepartmeni of Hea(th & Human yervxces
,)Zb L Street, Anchorage' Alaska W9501 34J-�f�;�
9�9 /
ON-�ITE 9EI'd ER P2I IiT
PermitNumber: 9O0102 Upgrade
Date Issued; o5/l5/90 Gngineer Designed
Uwner Name: CF|UCK N5ALY Day Fhone:
Owner Address: 6619 225TH AVENUE NE 206-868-7662
REDMOND, WA 9E�053
Parcel ld: 015-331-24
Lot Legai: Subdivision: NOUDBOURNG Loi: 4 Dlock: 2
Section: 29 Township: 1241 Range: 31W
LoL Size 87134 (sq.ft^ or acres)
Max Dedrooms: This PermiI: 3 Total Capacity: 3
SEPTlC !ANK: Minimum tntol septic tank capacity: 1,000 gallons. Each septic
tank must have at !easL 2 comparbnents" 8epth to Lop of septir tank(s) < 40
/eet requircom insulation ovor tank(s),
]NVTAiL PER ENGlNEEF�S APPRO�B} D�SIGN" MHINTAlN 30' UPSLOP� �
- ,
1V0' DPWN SLOPE, 1R01,1 81:0D LOCATlON. 8OTTgM DF PAY TD "E +2'
*9UYr FXISTlN(j GRADE. NO] 11 DHH5 PRIpR TU EACH lNSFECTlON.
lH1S 1E;Mj.1 }!: A [-VISION [>F SWW0102, ISHUED ON 5/16/90"
|H]'a loBU'|l[ It! lSSUE12 FOR THE EXlRTlNG 3 BEDROOM HOME ONLY AND
EX171E3 ON 12/31/90.
1 CERTF/ TXATI
1. I am familiar with the requirements tor "n-si!in sewers and wells as seL
|orth by the Municipality of Anchorage (MVA> and the State of Alaska,
V. ] will install the system in accordance with all MOA codes and regula�ions,
and in compliance with the design criteria of this permit.
J { will adhery to all MOA and State of Alaska requirements for We not hack
distances from any existing well, wastewater disposal sysiem 01 publ/(,
sewerage system on this or any aUjacenL or nearby lot,
4, l understand thaL this permit is valid for a maximum of 3 hedrooms. l
al�o undersLand that the capacity of the !otal system is 3 hedrooins and
any enlargement will require an additional permit.
�: igned:
'Owner) 011r1.
lss�.�,d /)y�
DMTE:
--y���/f--��-----
DATE:
---�r'^-`-----�---
LTi
Novembeh 21, 1990
ROBERT SHAFER, P.E.
ROGERSHAFER
CIVIL ENGINEERS
(907) 6942979
FAX 694-1211
ONSITE /
WASTEWATER
DISPOSAL SYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Municipat.Lty oG Anchohage
HEALTH AUTHORITY
APPROVALS
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTN: Susan 06watt
825 L Stheet
P.O. Box 196650
SEWER &WATER
Anchorage, Ataska 99519-6650
MAIN EXTENSIONS
REFERENCE: Lot 4; Btock 2; Woodbouhne Subdivision;
Dean. Susan,
SEWER & WATER
INSPECTION
This tetteh .is to leave as an addendum to ouh hecentty submitted septic
system in6tattation a6-buitt boh .the hebeheneed phopenty.
The septic instattati.on d 66ened Uhom our onig.inat design in .that the
ENGINEERING STUDIES
hequi.hed ab6o%Lption ahea wa6 obtained by inatatti.ng two beats at
AND REPORTS
sepakate etevations and with a cLi{{eh.ing dimen,sionat eon{.iguhat-ion.
J"t phioh to system consthuction we bound a smatt po)ttion ob the
stheam on .the souths.ide ob the pnopehty meandering etosen to the
WELL INSPECTION
phoposed abson.ption bed .than b.in.s.t observed. This caused the absohption
& FLOW TEST
bed to be nahhoweh and tongeA. Due to the ineneased Length and stight
pnopehty slope, the bed eoutd not be .instatted teveC without .the toweA
end being elevated unhea isticatty high. Thehesohe, we have instatted
.two beds at dt44e4ing etevation,5. The eonb.igwLation ob the beds .is to
SITE PLANS
use aU .the a4ea between .the cheek 6etbaek and .the 100 bt. photective
weU 4adiu6.
During .the construction oU .the ab6ohption beds the 5o.it,5 encouwtehed
ROAD DESIGN
were ctose2y obsexved. AU softs wehe at teast as good as the softs
encountehed .in ouh soits tog dated August 30, 1990. In Uact, the
UuhtheA the absohption beds extended to the east, the bettPlL the so.it6
became. This coneuh6 with ouh soits tog peh6ohmed May 2, 1990 on the
e.astside ob the tot which showed a considehabty thicken. and mope
SOILTEST
pehmeabte tayeh ob soit below the ohgani s. Attached is a copy ob ouh
,septic inspection hepoht site plan showing the toeation oU the 6o,ia
test pehbo)uned August 30, 1990.
PERCOLATION
TEST
Ib you hav a y ques.tCons, oh .i6 you hequ,ihe addit-ionat .inUaunation boh
your he W, tease contact u6.
Sin ehe2y,
STRUCTURAL&
s—
MECHANICAL
INSPECTIONS
RO T . SHAFER, P.E.
S/gm
ONSITE /
WASTEWATER
DISPOSAL SYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
'Ru6w'f.In. "$hnft�35cRCV
PERFORMED FOR: l �41„Z('JL Iy IFJaL. V F I -l?G 1 DATE PFFOWftr�'{�r'-..'�
,dl �A� �.✓a„c,;a. oat
LEGAL DESCRIPTION: L ci-r A- 2 x of; L, - YVoun g ,Township, Range, Section: r(r
T SLOPE SITE PLAN
Ir Owl
9 1
10-
11
12
13-
14-
15
16-
17-
18--
19
20 -
COMMENTS —
�o. I• WAS GROUND WATER
1'1 ENCOUNTERED? -0-
s
IF YES, AT WHAT t' -t-
DEPTH? O
P
E
Depth to Water Alter
Monitoring? �y�� gate:
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
L
A V-- V
/�
7D
30 M �4
t
1=s�
HLa
La
7:40
\0
S 1 "
'z lin
PERCOLATION RATE (minutes/Inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND '�) FT
17034 R3010 Rlvor Loop Keacl Alo, 204
PERFORMED BY:
age t r ®4fa'19x2'7
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN
72-008 (Rev. 4/85)
��—�— CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE:
Municipality of Anchorage
oroe
—' Department of Health and Human Services
825 "L" Street
Tom Fink,
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
August 17, 1990
Mr, Robert Shafer, P.E.
S&S Engineering
17034 Eagle River Loop Rd.
Eagle River, AK 99577
Subject: Upgrade Permit for Lot 4, Blk 2, Woodbourne
Dear Mr. Shafer:
A
Please be advised that the On-site Sewer permit for the subject
lot has been suspended due to the presence of a stream located
approximately 45 ft. east of the proposed upgrade location. The
permit will remain suspended until the required 100 ft. set back
distance is verified.
Please let this office know when this requirement has been met
so that the permit can be reinstated.
Sincerely,
Daniel N. Bolles
On-site Services
cc: John Smith, P.E., Program Manager, On-site Services
db/ 12.7
4)611-1,7
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
PO BOX 196650 ANCHORAGE, ALASKA 99519 343-4744
HAND WRITTEN PERMIT
Permit Number: SW90eL)f1:Q
Date Issued: 5//6-Iyp,
Design Engineer: SFS E!�•
Owner Name: GAade /t)"1 Frz�
Owner Address: 6Glq?.2S-�-
Ad,w i,wJ, uJ�. Q8U63
Permit Type: ug
Expiration Date:/r/�/4e
Day Phone:Za 846-%eeW
Parcel ID:
Lot Legal: Subdivision: 4e)dee4eame Lot: Block:
Section: Zy Township: /,ZN. Range -.Sed.
Lot Size: 87,IS41 (sq.ft. o—r- )
Max Bedrooms: This Permit:ZIZI Total capacity:,,?'/-/
SEPTIC TANK: Minimum septic tank capacity: - gallons. Each
septic tank must have at least 2 compartments, insulation is
required if depth to top of septic tank(s) is less than 4.0'.
Lift stations require an appropriate electrical inspection.
WELL LOG: A copy of the well log must be sent to DHHS within 30
days of the well's completion.
�KS'�A'`r /c2ep-- Cl2��H�e�S` a��YDUtd ��S fes. IpYaUi/��'� CO�y eJf�
e/BeY�/Ca � /Gt�Pv ii�Y! lUi'i�il QS'�eu �� Ad
I? 44Y Ale,
_V '17
c/a�•es
up7iac J , � " 3 �e�
I CERTIFY THAT:
1. 1 will install the on-site sewer system and/or well in
accordance with all codes and regulations of the
Municipality of Anchorage (MOA) and State of Alaska , and
in compliance with the design criteria of this permit.
2. I will adhere to all MOA and State of Alaska requirements
for separation distances from any existing well, septic
system, or surface water on this or any adjacent or
nearby lot.
3. 1 understand that this permit is valid for a single
family dwelling with a maximum of�4/bedrooms. I also
understand that any enlargement w 11 require an
additional permit-.
.4. I understand this permit is issued for the calendar year
and expires on December 31 of the year issued.
5. 1 will notify DHHS prior to all inspections by the
engineer or well driller.
SIGNED:
(owner/ s/ig���
ISSUED
db/115
DATE:
cs A y
DATE:���
02- 1a�LC'1lea.a, �
It, ?Xl -
Nrkne
h: f.Fi.P � � �{�aY�i ��. �• Exzz-�q_r" -z"1P.
10.
M y5�3 ti.:
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH & ��9"',••� S .lA
ENVIRONMENTAL PROTECTION !
6 i •
MAY 2 91990
{
RECEIVED ���'•* '
n
0
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Municipality of Anchorage r ,^a. 9 4 jry:' . o Ag
T/ DEPARTMENT OF HEALTH R HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650 rA�^ br
SOILS LOG — PEFICOLATION TEST q `', . " A' fi4wk,•
�1 A�oOa No.
l EL_
—^ tt Ch
PERFORMED FOR:��LDATE PERFORMED �X14,1,..,P. ,;��
LEGAL. DESCRIPTION:Z\/� I?jc�J2p—tTownship,
Range, Section:
DEPTH SLOPE SITE PLAN
IEEw p�1.i
A
2 0'
4(a! �Nn1[.tr
6 0
7
0
10 WAS GROUNDENCOUNTERED? WATER
ENCOUNTEREDI
11 s
IF YES, AT WHAT / L
DEPTH? D
12 P
E
13 Depth to Water AfterI
Monitoring? 4 gate: x"10 n
14
15-
16
17
18-
19
20
COMMENTS
17034 Eagle River loop Road Ne
PERFORMED t@ luvk"9677
ACCORDANCE WITH ALL STATE AND MUNICIPAL
72-008 (Rev. 4/85)
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
!/IA J
rG N
4
V
ti
21..53
,� .•
� `•� ®.
� ,gam
LI
p
PERCOLATION RATE _ `� (minutes/inch) PPERC HOLE DIAMETER V
TEST RUN BETWEEN 1 FT AND FT
CERTIFY THyT qts T STT JWAS PERFORMED IN
ON THIS DATE. DATE:
��
04a)MWhOrme Cdr, CCC
et 4KR`1 dWj)MM YGM/NK' RCrU:S eglofSdC
on, U),vddewyLe Gv, /To 01rrelt al
811616 QQ
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4er k oz a)o oedoAwA4 . Clo 0- l �
w ti1YG y `x%'2e v
4� Zi
)15 3S7 Ly
90 a s
yo �11
TI17 /e c�fiemc f rte. se��i� a-(
d,In, -( rays)U/10 (fie sa �Pe� `3 � e -f ez lw asp
-Fpr sLj, V -T- Lt(zn.� I 1� 11
Zvlj I'1,,) //��� � CIU cy�LF WiIO �V (/Vin 7 �./{,��n t'.P_ /
Q d%J E C ��C(�ir`6 u�.C'l� O�,o ,y�� i U �d �
(,u1�1 WoriC V YAR if
9 IDL
6s_C , �aMe_ CZ l\oo Ic f Me.
IT ro�w� ul I-t(owlv7 o,�L
w a -1 +r, �X
o.,VL -E Lc,at u/ (kv 1�") q
J (�
X
v
Cr
` K W C�i✓h.
s,zf�\-C� d� k 620\rs ?
6� 1e co V"- y
_ 311s,49S RECEIVED
AUG 14 1990
ANCHORAGE/MSTERN
DISTRICT OFFICE
%wit rr
ry. • r,
11084 Eaple Nlver 6
EapteRim ver, Ala6ka
RM
DENTA,OHAFER
CIVIL ENOINEER
994.2979
PROJFQT;.1L.I DATE OF TEST;
60CATION OF WELL (L9pnl Dencrlptlon); J[r r_� 1/)rr.(v !� Uioocl %� - - -N.r' - -
� Ir
WELL DEPTH06__ 1FT. CASINO:_ .iQ_._FT. DOR6EN;__ '""-------
DATE DRILONO COMPLETED! 'E-� -�- DRILLS: J���r; I�IN�
STATIC WATER LEVEL (Top of Casing): _ n • �.FT, DATE!
1.
Commonto, >,Jad P�ocl�ces germ oyer kDoe period Plow lrnet cyarrntod
itibagwnP Vrrtrtfonr
CLOCK
TIM!
rLAPdBDTIMIrINCE
PUMPINQ STARTED!
DEPTH TO
WATER, FT.
DRAWDOWNI
RECOVERY
PUMPINQ
RATE, QPM REMARKS
dTOPRID, MIN,
op
pt
unwi)
p
0 start
I .ice_
26Im
.. _
30
IL
140.
40
46
65
p
6011houh
'
9D--
tEOEhOule
.��..._
150
.,. .,.- •-
_
IND(9hours)
• ••• '� e
240 (4 h0Ute)
-
—''-'.rN•
"wine• o•
RECOVERY
♦ �(% •'•••••r •• we
111" A. fAahc f
t p_
0 h Nw 1467 f f _
80
—
--- ---- - -
Commonto, >,Jad P�ocl�ces germ oyer kDoe period Plow lrnet cyarrntod
itibagwnP Vrrtrtfonr
r • r~ 1
T6h II» JXAH Mrorxy Is oWars orae 7JpLIrQlgy. 5ttrvrari
TINe Cornpeny of Alaska, Ina. a somas no liability
Nr vsriatioIf any, nor repf sente this to 15a
V� " �ccnnrete at Is time, A review h s not been, mach
0jregarding sufficiency of this survey in meating
tete Company's requirements f ( any contam-
J : i`\ plated or com' g policies.on
1 =
f Y
l
g .
d
WOOOBOURNE D11.
-7^77'^N F19` 55 IS'6
r _ J.�
e11 IL4
LI is the responsibility of the builder or owner, prior to
LEGEiND hubE1 tat:k•found O
construction, to verify proposed b.•Ilding grode relative
Iron rebor -found 0
to finished grade and utility connsctlons and to determine
.Iron pipe -found 0
the existence of any easements, covenants or restrictions
which do not appear on the regarded subdivision plot•
braSS Cap -found fB
alum. Cap -found ' y
1:
Ff.
''e*Ttt
•v•
'hI�
Ci'•i i. f:.i�.�: F.t:F'1. +
taw
,.;,:.
PIM
•...� 5:^.?•'v hy:. v
�! f O
0a
L
b
,r
i•
SURVEY TYPE
t81 AS -BUILT
PLOT PLAN
CI LOT SURVEY
RECERTIFICATION
AS -BUILT
I
`�
25, ODS �
d79edJ'rf ,
' Lot Survey t'if:rtlf cation ,�•a•'a— - /� ��•fi 1
I hereby cerafy.thott have sun• A • ...... 0.,q Q
" eyed aro aova+r shots+ ars a`; • :��,f,'O
dvsclbed tbreoni and sial by 6U, • '..fs
,_.',� lrrexaerr9rdslMluledlharvKn � e;�a.9•^ * �•
arewdhinlrepfq yPros and 30.* t �••••• •• et tY/Syie
-i::: do rolt*ergpaenaro04h on �' p
001,PerneMt MOdj that
nptap• •• '•`••• ii �. te�rX
_- .. erlr9.•e'IWa sreroochonlhs �•� a.e+7 �t� a�• L
pvnI e7 n p,ettenand that Q '�j ••. 41215 ; p
IN'to'e no Noor mutlllly �+ 0 �•••I•Hpool
b r
hrft(y onvt vrsbleamaywOs Sk'VPrpfg �`\. �i
On 7910 grape 11 y ea cope a7 4 \ \r �.,L'F•1�
exkOW heron
7'
i
set
NOTE+ FENCES ARE $11OWW IN'THEIR APPROXIMATE LOCi1'1
LI is the responsibility of the builder or owner, prior to
LEGEiND hubE1 tat:k•found O
construction, to verify proposed b.•Ilding grode relative
Iron rebor -found 0
to finished grade and utility connsctlons and to determine
.Iron pipe -found 0
the existence of any easements, covenants or restrictions
which do not appear on the regarded subdivision plot•
braSS Cap -found fB
alum. Cap -found ' y
' Lot Survey t'if:rtlf cation ,�•a•'a— - /� ��•fi 1
I hereby cerafy.thott have sun• A • ...... 0.,q Q
" eyed aro aova+r shots+ ars a`; • :��,f,'O
dvsclbed tbreoni and sial by 6U, • '..fs
,_.',� lrrexaerr9rdslMluledlharvKn � e;�a.9•^ * �•
arewdhinlrepfq yPros and 30.* t �••••• •• et tY/Syie
-i::: do rolt*ergpaenaro04h on �' p
001,PerneMt MOdj that
nptap• •• '•`••• ii �. te�rX
_- .. erlr9.•e'IWa sreroochonlhs �•� a.e+7 �t� a�• L
pvnI e7 n p,ettenand that Q '�j ••. 41215 ; p
IN'to'e no Noor mutlllly �+ 0 �•••I•Hpool
b r
hrft(y onvt vrsbleamaywOs Sk'VPrpfg �`\. �i
On 7910 grape 11 y ea cope a7 4 \ \r �.,L'F•1�
exkOW heron
7'
i
set
at
set
o
set
p
Sal
tet
ws
Pre ored by
L3ENCH P ARK .1
Professlonn1I nnrl Rurvmvnrn
Scor Ill r. 100' Drown by: BJH
Liarssurveyea' 9_19-83 ;had by- REJ
Qotet7rownt 9_20-83 Grid:2741 �0�83-265
LGgd[?tsscriptlon'„7, ' ,
LOT 4, BLbCK 2 I•100DBOURNE SUBDIVISION
• F c �: O C'. I A T E L g Ft U kC E F: �.,/.
•I PJC. F' LSA _
pi U P-AdMMNIMWWQJ ' ^
Of
DIVE RK ewsET No . _ _ -- DATs---------
AN )4 CAGWIATED IY�+ —_ DATE .—
CNECKED
'b
`s
1
I
K��
|���
��� 1: Nil 1: ��� 1 ��� �� �����''����� 0
DEPARTMENT HEALTH AND ENVIRONMENTAL ROTECTION
825 'L' STREET, ANCHORAGE, HK. 93501.
264-4720
�Na ..... L_ 80 1:1 CT 141_K 3: 7FEvE too TIE 14 FOE lot 0, K Fit 1-! 1: 5
PERMIT NO. ( 820321 )
APPLICANT GALE HERLY S.R.H. BOX 2502 I45-276@
LOCATION WOODBURNE DR.
LEGHL L 4 B 2 WOODBOURNE S/D LOT SIZE 100000 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: DRHIHFIELD
MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/8R)- 140
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
Too TIE Vol -T- 1-1— -4_ ?5 0 oil U41 Cal K hi — ?"AR Fo-, F�:I] E-o"l.- F, K F" I- fV-- 22. 0"
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET)
��NEE'_. - f' NEE P4 Coll f"I I E>00-1 :1] 7.";. �u V
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OyTFHLL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET),
KEECaL_0 31 KKK> �Too: ��X C_:: � 10150 K oil 1 2! K- �1� V__ CD,��
PERMIT APPLICANT HRS 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.
_ "I-00CIT Q Zoo it ����NEE ��3: CA 54 13 Foo Fz K �NEE ���N_:.';
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN 8 WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM R 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 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
10, FEE 112 10 X 1- PEAK 004 1: K Es! 15 211.0 A.nP Vol 2_�.
I CERTIFY THAT
K I HM FAMILIAR WITH THE REQUIREMENTS FOR DN -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 4 BEDROOMS.
�
._-... ..... _.
APPLICANT GALE NEHLY "
ISSUED BY__-_____' .-.-___________.DHTE�� �... ... ....... .... .... V?0
xSOILS LOG°
- MUNICIPALITY OF ANCHORAGE
��,p( PERCOLATION
� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
�"
1 625 L. Street, Anchorage, g Alaska 99501 264-4720
—W --V LOG - PERCOLATION TEST
PERFORMED FOR: 1.-12/C� NCO /QZ ( /� [ DATE PERFORMED:
LEGAL DESCRIPTION:_�L-zj-�_.�7Ct rf'ry 2 (S
Q/ /D C-( 2- zo /
SLOPE SITE PLAN, r _
COMMENTS_ 122 C2G/�'///0' .0
�Q P-1cc,'N i L, C1 J /-n a/c X
PERFORMED BY: (;7
72-008 (6/79)
r.
WAS GROUND WATER S
ENCOUNTERED? �S L
O
P.
IF YES, AT WHAT E
DEPTH?
9 ".4. /Q •
Reading
Date
1001t" .
Net
Time
Depth to
Water
Net
Drop
v2
d a
Grae(cCp)
4
5-
/0
6-
_ 7S"
, t Z_
7
r
Z a
e -
o
-9
5P.2 C! �
9
, 4 //
D, 17
10-
/(3o
11
2T
0'/-1
12-
E z
13
14
Adj (ftio
N 2
15
� ,G
16-
17-
• %31'
O /
18-
19
20 -
COMMENTS_ 122 C2G/�'///0' .0
�Q P-1cc,'N i L, C1 J /-n a/c X
PERFORMED BY: (;7
72-008 (6/79)
r.
WAS GROUND WATER S
ENCOUNTERED? �S L
O
P.
IF YES, AT WHAT E
DEPTH?
9 ".4. /Q •
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
/0
_!
_ 7S"
, t Z_
R d H
Z a
-o-
o
-9
'Zo
, 4 //
D, 17
/(3o
/V
2T
0'/-1
E z
0
Adj (ftio
N 2
1L
� ,G
/v
• %31'
O /
PERCOLATION RATE _ __j��' J _[[ (minutes/inch)
TEST RUN BETWEEN FT AND FT
e, 2— /2/.
CERTIFIED BY:
It.)// i tL)Y 17z- - D/�IGGe'e,-
SOLD TO R o `% I YI P a lam_ SHIPPED TO
STREET & NO. --4;2 O3_W--.,s a WAV --/� _ STREET & NO
D (� /-1 �6
CITY A Nc r A L A „4KL1 �J -1 G I,56 3 CITY __
R
INVOICE NO.
1401
CUSTOMER'S ORDER SALESMAN
��e
TERMS--
V N I P
car>LErcoN
VIA F.O.B.
—�
DATE
vnrc-: �
WELL To 1b0, ' —
;t 20
e 1 ec 1,0 I yj
a ind Well If a P s
FUY n i f - viof 61a_vkJ_ vi(�
A°
-- To ra L
1'1 t-�clY ci—r�e 5T G, ked J l to' —
__�__
Tiles f C a s(y\q a-5 ( b` ' n t 0 d tYX cl 5 (n v°
TD ��vC�L�D_J 0171 a yof'
�-ak— M 8T Y 1 y( ------
� cI)C6 ue
j�,Y 1���1—_Lb)c a f��_0,19_w1 (7 1e'ci 0 \
'
_
_Mco-a s v vc° A1e vtI s Cr a wt TQ l> o f e 5g _
�REC)iF DR�(xl INVOICE --
7H 736
CAJ °r h ( � Vl C7 % F' S oi/l <� N ✓l i` vl c1
1
(/L) I a y o d( ((p dlv r/ I P1 cl `
I
ztl/(,
//GG�C�6'cGv-nCX�('�i•� 7`=r?.r�`� �/�i,l ¢uM6�-- L�S ./
r04
/ �9,9 //®7" 7-,�47-
fir,vj,
i
Z;2ckevel l live; t? rf %/ 6 / ElGS e4 C D/-tl )� l ungG
O17� l/1� t //J C� fie S �u hel4 1 /r/D�rw s' rr"r�fj1v e 4'v: a /f
-��✓v°LC 'ho-KI.� /,u/�fj f%�,t�/rvr r�-.� � r��J'i2Qt.1
/ r
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PiAr/.fY�/ N f�1'i.f K:J.i ev'l-"X a
v7aw 1;1�-//
CIVIL. & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 March 17, 1992 ANCHORAGE, ALASKA 99516
Dear Mr. Smith:
I was surprised when informed that your office had signed off on the Health Authority Approval
(HAA) certificate for Lot 4, Block 2, Woodbourne S/D. As you know I had previously evaluated the well
and septic systems serving that lot, and had come to the conclusion that there were numerous problems
and code violations which in my opinion rendered the wastewater disposal system ineligible for a HAA
certificate. After reviewing the subsequent correspondence in the DHHS file on this lot, I do not see any
convincing evidence showing my original conclusions to be erroneous. It appears to me that in signing the
HAA, DHHS must have allowed itself to be swayed by questionable arguments put forth by an
engineering firm with a vested interest in seeing that a HAA certificate was granted. In the interest of
fairness to all involved, I am reauestinSg yYo.0 to reevaluate this HAA_; such a reevaluation should include a
site inspection after the snow melts w ich would allow DHHS to make its own field m'easu ements of the
agency, it is properly your role to sort out
The issue is important to me, not only because it reflects on my ability to evaluate the adequacy of
wastewater disposal systems, but in a larger sense because property purchasers and their lenders rely on
the integrity of the HAA process to be assured that a system is adequate and in compliance with code
requirements. In submitting for HAA certificates all engineers (including those who were involved in the
original design and construction inspections) must be held to the same standards of professionalism. If
they aren't, a seller will be given an incentive to seek out whatever engineering firm is most willing to
overlook a system's flaws. Like any pri„a±e businessman, I value my clients and the repeat businese they
bring back to me, and in turn I pride myself on providing them with a thorough and conscientious analysis
of each system I test. One of the least pleasant aspects of the job is having to tell a client that a septic
system which no one suspected had problems actually does not qualify for a HAA certificate.
Recognizing that everyone can make mistakes in the collection and interpretation of data, I recommend to
clients who are not comfortable with my findings that they might want to get a second opinion. Implicit in
this recommendation is the assumption that the provider of the second opinion will adhere to the same
standards required by State and Municipal regulations, and will not let a conflict of interest influence his
analysis. No matter how expensive it may be to try to correct a septic problem, I am sure that you would
agree that it would be even more unfortunate for a subsequent owner to be unable to get his system
approved at a time of resale because of problems which existed prior to his purchase.
The following is a more detailed explanation of the measurements which led me to my original
conclusions, and my response to the written arguments put forth by S&S in their attempt to dismiss my
original findings.
RECEIVED
M.O.A. DHHS
P.O. Box 19-6650
��� 9 199
Anchorage, AK 99519
Attn: John Smith
Municipality of Anchorage
Dept. Health & Human Services
Dear Mr. Smith:
I was surprised when informed that your office had signed off on the Health Authority Approval
(HAA) certificate for Lot 4, Block 2, Woodbourne S/D. As you know I had previously evaluated the well
and septic systems serving that lot, and had come to the conclusion that there were numerous problems
and code violations which in my opinion rendered the wastewater disposal system ineligible for a HAA
certificate. After reviewing the subsequent correspondence in the DHHS file on this lot, I do not see any
convincing evidence showing my original conclusions to be erroneous. It appears to me that in signing the
HAA, DHHS must have allowed itself to be swayed by questionable arguments put forth by an
engineering firm with a vested interest in seeing that a HAA certificate was granted. In the interest of
fairness to all involved, I am reauestinSg yYo.0 to reevaluate this HAA_; such a reevaluation should include a
site inspection after the snow melts w ich would allow DHHS to make its own field m'easu ements of the
agency, it is properly your role to sort out
The issue is important to me, not only because it reflects on my ability to evaluate the adequacy of
wastewater disposal systems, but in a larger sense because property purchasers and their lenders rely on
the integrity of the HAA process to be assured that a system is adequate and in compliance with code
requirements. In submitting for HAA certificates all engineers (including those who were involved in the
original design and construction inspections) must be held to the same standards of professionalism. If
they aren't, a seller will be given an incentive to seek out whatever engineering firm is most willing to
overlook a system's flaws. Like any pri„a±e businessman, I value my clients and the repeat businese they
bring back to me, and in turn I pride myself on providing them with a thorough and conscientious analysis
of each system I test. One of the least pleasant aspects of the job is having to tell a client that a septic
system which no one suspected had problems actually does not qualify for a HAA certificate.
Recognizing that everyone can make mistakes in the collection and interpretation of data, I recommend to
clients who are not comfortable with my findings that they might want to get a second opinion. Implicit in
this recommendation is the assumption that the provider of the second opinion will adhere to the same
standards required by State and Municipal regulations, and will not let a conflict of interest influence his
analysis. No matter how expensive it may be to try to correct a septic problem, I am sure that you would
agree that it would be even more unfortunate for a subsequent owner to be unable to get his system
approved at a time of resale because of problems which existed prior to his purchase.
The following is a more detailed explanation of the measurements which led me to my original
conclusions, and my response to the written arguments put forth by S&S in their attempt to dismiss my
original findings.
From the written record in the file it appears that no one denies that the the upper "soil absorption" bed
was over -saturated with fluid despite the house having been vacant for over a month and being winterized,
which effectively guaranteed that there was no possibility of any water flowing from the house to the
system. It also appears that no one denies that the shallow test hole I dug on the south side of the bed
filled up with water and remained full for several months. The issue is only whether or not these
observations prove the system to be in groundwater. In S&S's 11/1/91 letter to Mary Anne Beckwith they
argue that since groundwater tends to follow the slope of the ground surface, and the natural ground is
sloped in this area, the fact that the water surface elevation was the same in both monitor tubes of the upper
bed proves that the water is not groundwater. This is nonsense! Once water enters a porous space where
it is able to circulate freely, such as a bed filled with clean sewer gravel, it will inevitably seek a uniform
level. Any soil absorption bed or trench which is in the groundwater will have virtually the same water
elevations in every monitor tube. In my opinion the upper bed is functioning essentially as a confined
vessel with a nearly impermeable bottom. The fact that the lower bed had only a small amount of water
flowing through it is probably due to it's being constructed on a slope, with enough peat contact area
around its lower end that the water is able to percolate horizontally out and on down slope as fast as it is
homing in.
In addressing the water which they too found in our shallow test hole, S&S makes the argument that it
is not groundwater, but is simply snowmelt which has not had time to absorb into the ground. As you
know AO 90-48(S-1) Chapter 15.65.010 defines groundwater as "subsurface water permanently or
seasonally occupying the zone of saturation". 18 AAC 72 similarly defines groundwater as "the
subsurface water permanently or seasonally occupying the zone in which the voids in the rock or soil are
filled with water at a pressure greater than atmospheric. Using these definitions, I don't see how the water
in our shallow test hole (which has been observed to persist over a period of several months) can be
classified as anything but groundwater.
In making the assertion that they do not feel that the water ponded in the upper bed is the result of
groundwater, S&S failed to provide any other explanation as to the source of the water, or any reason why
it remained after the house was winterized. If one were to try to make the argument that the water was
simply left over from the time the house was last occupied, that would prove that the bottom and sides of
the upper bed were totally impermeable, which is an equally necessary reason for failing the bed. In my
opinion the only plausible source of the observed water in the bed is the result of longitudinal migration of
shallow groundwater through the native peat into the southeast corner of the upper bed.
In your memo dated 1/17/92 to "All Parties Concerned" you required the installation of additional
groundwater monitor tube(s) to confirm that the system does not encroach on groundwater. In retrospect,
perhaps it is unfortunate that you did not specify where these groundwater monitor tube(s) were to be
installed, as S&S chose a location which is apparently shielded by the combination of a curtain drain
located east of the system (carrying water to the north) and the bed system itself which acts as a second
leg of the curtain drain (carrying groundwater off to the west). Thus, it is not surprising that no �—
groundwater appeared in S&S's monitor tube, however that certainly doesn't prove that the bed system is
not permeated with groundwater. At the present time there are two test holes located on opposite sides of
the soil absorption beds, one dry and one full of water. Given the conflicting information from these two
test holes, it is difficult to understand how it can be argued that the absence of groundwater has been
conclusively demonstrated.
The second issue of non-compliance which I raised in my original report was that there is not sufficient
room between the well and a creek for the system to be configured as shown on the as -built inspection
report without waivers of the required 100 foot horizontal separation distances. I based this statement on
the fact that the reported minimum width at the east end of the lower bed is 12 feet. From the cleanout
located in the east end of this bed I measured a distance of 104.5' to the well located north of the bed, and
a distance of 106 feet to the stream located to the south of the bed. Thus, the maximum possible distance
from the well to the creek is 210.5 feet. Unless I measured incorrectly, it is impossible for a 12' wide bed
to fit in this space without some portion of it being less than 100 feet from either the well or the creek.
This issue should be easy to field verify once the snow is gone from the ground. In my opinion the
location of the creek shown on the as -built survey submitted by S&S is not accurate and an encroachment
does exist.
The third issue of non-compliance which I raised in my original report was that the beds do not have
the required 6 feet of vertical separation from the impermeable stratum shown on the soil log. This
statement was based on my measurements showing the bottom of the monitor tube in the west end of the
lower bed to be only 0.5' higher than the elevation of the natural ground surface west of the bed. Since
the soils log indicates there to be only 4' of soil overlying impermeable clay, the vertical separation at this
point is only approximately 4.5 feet. Of course, if the bed bottom were constructed level, the vertical
separation from the impermeable stratum at the east end of the lower bed would be considerably less, due
to the upward slope of the natural ground and subsurface soil interfaces.
The last issue of non-compliance mentioned in my original report was that the bottom of the lower bed
is not level as required by code. I have alluded to this earlier in this letter as possibly explaining why
significant static water levels were not measured in these monitor tubes. My measurements made through
the monitor tubes in the lower bed indicated a slope to the west of approximately 0.7 feet between the
monitor tubes. I also measured a vertical elevation differential between the east end of the lower bed and
the west end of the upper bed of only 6.5 feet, which is a significant departure from the 99 feet reported
on the profile portion of the engineer's as -built inspection report.
Because I believe DHHS is seriously commited to trying to ensure that all wastewater disposal systems
are designed, built, tested and approved in compliance with applicable Municipal and State regulations, I
have confidence you will carefully reevaluate the important concerns which I have raised and take
appropriate action. If you require further clarification or backup material, please give me a call. I shall
look forward to receiving your response.
Sincerely,
T�X_
Ted Moore, P.E.
cc: Mary Anne Beckwith, Fortune Properties
MUNICIPALITY OF AN6 A GE
6qI11
7
Development Services Department 2018 Phone: 907-343-7904
On-Site Water & Wastewater Section '--- pUG d v u Fax: 907-343-7997
N,
Certificate of On-Site Syste,`.. z� •prov�, c
Ol 6 9 L
Parcel I.D. 015-351-24 p Expiration Date: / (-2/
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•
1. GENERAL INFORMATION
Complete legal description Woodbourne, Block 2, Lot 4
Location (site address) 11751 Woodbourne Ave. Anchorage, AK 99516
Current property owner(s) Dennis Pollard Day phone
Mailing address 837 E. 45th Court Apt A Anchorage, AK 99503
Real estate agent Day phone
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well 0 Private Septic CI
Water Storage ❑ Holding Tank ❑
Community Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver request for: Distance:
Received by: Date: O JD i ((S
COSA to be released to the engine ,unless otherwise requested by the engineer.
COSA Fee $ tE24 op Waiver Fee $
Date of Payment WWI'g Date of Payment
Receipt Number Receipt Number
COSA# OSC1$1341 Waiver#
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, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) 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 (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation.
Name of Firm Forge Engineering Phone 907-522-7773
Address 1399 W. 34th Suite 203, Anchorage AK 99503
Engineer's Printed Name Michael E. Anderson, P.E. Date 8/08/18
xxv
Ai*: 49 TH /\ *"
6. DSD SIGNATURE
X System #1 Approved for ' bedrooms
Michael E.Anderson
System #2 Approved for bedrooms ���icsl�q�% 4381-E ��'
Disapproved ill���`"�r�
Conditional approval for bedrooms, with the following stipulations:
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Original Certificate Date: /(-21—1
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Woodbourne, Block 2, Lot 4 Parcel ID: 015-351-24
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 6/8/82 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 100 ft. Cased to 95 5 ft. Casing height (above ground) 24 in.
FROM WELL LOG AT INSPECTION
Date of test 6/6/90 8/03/18
Static water level 40 ft 51 .3 ft.
Well production 4 g.p.m. 1 '6 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate 0.735 mg/L
Arsenic ND ug/L Date of sample: 7/18/18 Collected by: Forge Engineering
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEP/Steel Date installed 10/26/90
Tank size 1 '500 gal. Number of Compartments 3 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y
Date of pumping 4/25/18 Pumper Alaska Sewer & Drain
C. ABSORPTION FIELD DATA
Date installed 10-22-15 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 •2 System type Shallow Trench
Length 2 x 44 ft. Width 5 ft. Gravel below pipe 2 ft.
Total depth 4.2/4.5 ft. Eff. absorption area 628.6 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 8/03/18 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 2104/2578 gal. New depth 3.5/3.5 in.
Elapsed Time: 1440 min. Final fluid depth 3.5/3.5 in. Absorption rate >= 600 g p d
N
Any rejuvenation treatment(past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed 10/26/90 Size in gallons 1 ,500 Manhole/Access (Y/N) Y
"Pump on" level at 42 in. "Pump off' level at 28 in. High water alarm level at _ 45 in.
Datum Bottom Cycles tested 10 Meets alarm&circuit requirements? Y
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot >1 00On adjacent lots >100
Absorption field on lot >100On adjacent lots 100
Public sewer main >75' Public sewer manhole/cleanout >100'
Sewer/septic service line '25' Holding tank >75'
Animal containment areas Manure/animal excrete storage areas >100
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation �' Property line >5' Absorption field >5'
>10'Water main Water service line >10 Surface water >100
Wells on adjacent lots 100'
ABSORPTION FIELD ON LOT TO:
>10'Property line Building foundation >10 Water main >10
Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >10'
Curtain drain None Noted Wells on adjacent lots X100'
F. COMMENTS
G. ENGINEER'S CERTIFICATION %,pF N.A\u,q 4k
I certify that I have determined through field inspections and ...rcte .• .04.
review of Municipal records that the above systems are in ��•' �►'�" •'9��
conformance with MOA COSA guidelines in effect on this date.
�*: 49 TH /\ ..*�
Engineer's Printed Name Michael E. Anderson, PE • -'
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Date 8/08/18 (♦l *• Michael E.Anderson .• %
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COSA brown sheet 10-10-12.doc
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MUNICIPALITY of ANCHORAGE
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Phone: 907-341 7904
Development Services DepartrWrit `- - . Fax: 907-342. 7997
On-Site Winter &Wastewater Section
0 semi _ -�4 c.kc.0 a Lift Station1Purm Vaukt
`-i'kl'` " ' Maintenance Log
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Phorie — �– Legal D .
5tic Tants:
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-Pumping: uiret=.! y�� •P+urrt��sr( tt ip€etGd :Q.
-Sludge level inchesinches � _
Lift 4.1aliolvt 'i
-F'Jmio basket eleaned yes Dc.1 41_ -Effluent filter cie-n d .0-5a0.,J+i'l-
•COntrot floats cleaned 4 x t• •Proper float Settings ctrnisrmedna
•Cperation satisfactory .)Lfir.
stem:
*( ed electrical atarn circuit rr .Auditile and visual alarm ingirif: dwell-inf.! 0_111
•Alarm system operation ,, +fa °r
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-Ground water intrusion at riser to tank connection = +.
-Ground water intrusion around tlpe penetrations es •tN c�k
h �furioticnal 6 fpr,
-Manhole lid. Functional �e 2 Insulated ,LL Properly cured ,f1gt HI
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.4 manufacturer require:I inspections and maintenance completed 6A..J.1KZ
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Signature — - , Date/ (
i i . :.-crass- 0 Box 13SS5 ' Anctir+:aqH.Alaska 995194650.' www.muniFSrp ail
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Municipality of Anchora
On-Site Water and Wastewater Progra
(907) 343-7904 SUN 0 a ''y
S A F E T Y
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42.
Certificate of On-Site Systems Appr• a oc 6 51. �`'
Parcel I.D. 015-351-24 Expiration Date:
1. GENERAL INFORMATION
Complete legal description Woodbourne, Block 2, Lot 4
Location (site address) 11751 Woodbourne Drive Anchorage, AK 99516
Current Property owner(s) Dennis & Beverly Pollard Day phone
Mailing address 837 E. 45th Court, Apt. A Anchorage, AK 99503
Real Estate Agent Day phone
2. TYPE OF DWELLING:
O Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: V, 4 Miert)/440/7&i Date: (e/7//-2
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ 5c21.0 Waiver Fee $
Date of Payment (o/511? Date of Payment
Receipt Number NO 55-- Receipt Number
COSA# 06CJ?/.- / Waiver#
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,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Anderson Engineering Phone 522-7773
Address Pa Box 240773, Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 6-1-2017
OF gamtie
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6. DSD SIGNATURE �7V7 :9
f _ [
X System #1 Approved for Li bedrooms ,MicHAE6,_E.-ANDERSON,•, g?
�J• CE--438f .'�.�`"v
System #2 Approved for bedrooms OQ •FBF•• -i7•.-'���
Disapproved '�si$ E �.�►�
Conditional approval for bedrooms, with the following stipulations:
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WAST�LI,p ND m
GRAM `P
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By: �^ i -'-.� Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet_f c
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Woodbourne, Block 2, Lot 4 Parcel ID:015-351-24
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log(Y/N) Y
Date completed 6/8/82 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth
116 ft. Cased to 95.5 ft. Casing height(above ground) >12 in.
FROM WELL LOG AT INSPECTION
Date of test 6/8/82 10/29/15
Static water level 35 ft 38.3 ft.
Well production 10 g.p.m. 2.3 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0* colonies/100 mL Nitrate •54 mg/L
Arsenic NDug/L Date of sample: 5/19/17 Collected by: Anderson Engineering
* Resampled 5/30/17.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/STEP Date installed 10/90
Tank size 1,500 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N
Pumper A Plus Home Services
Date of pumping 5/1/17
C. ABSORPTION FIELD DATA
Date installed 10/22/15 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type 5 Wide
Length 2 @ 44 ft. Width 5 ft. Gravel below pipe 2 ft.
Total depth 4-5 ft. Eff_ absorption area 628.6 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 5/23/17 Results(Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 0** in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment(past 12 mo.)(Y/N &type) N If yes, give date
**Absorption Trench System was constructed less than 2 years ago. No water found in either trench
and an adequacy test was deemed unnecessary.
D. LIFT STATION
Date installed 10/19 Size in gallons 250 Manhole/Access (Y/N) Y
"Pump on"level at 42 in. "Pump off' level at 28 in. High water alarm level at in.
Datum Bottom of Tank Cycles tested 3 Meets alarm&circuit requirements? Y
E. SEPARATION DISTANCES - Community Water System
WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property line >5 Absorption field >5
Water main Water service line >10>10' Surface water >100
Wells on adjacent lots >200'
ABSORPTION FIELD ON LOT TO:
>10'Property line Building foundation >10 Water main >10
Water Service line Surface water 1 00 Driveway, parking/vehicle storage 1
Curtain drain None Noted Wells on adjacent lots >200'
F. COMMENTS
Existing Absorption System is less than 2 years old. The old system is connected
with a series of ball valves at the lift station for possible future use.
G. ENGINEER'S CERTIFICATION oo�, OF A i 'It
,........C,4 d0
/ certify that / have determined through field inspections and ,c'A.\);•'. rF$ *-':S/1-'t�1
review of Municipal records that the above systems are in ..'GJ.oft " ':9 �0
conformance with MOA COSA guidelines in effect on this date. 1t: 7Fi `�
Engineer's Printed Name Michael E. Anderson, P.E. „ti ;;; �Jo c-•• �^-..... r'�,✓1
O :MICHAEL E. ANDERSON • d
Date 6/5/2017 I, = `'
�,� CE-4381 �.!
#¢ �f�.• L •s=r7 ...��
Iwo i PROFESS\O oo�
COSA brown sheet 10-10-12.doc
Parcel
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Cor
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as (Single Family andlor Duplex)
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age
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WaiverNariance-request for:
oisiance:
Received by: ,��G�
-
Date:
' COSA to be released to the engineer, unlessvtherwise r
ues ed,by the engineer.
COSA Fee.
Waiver Fee $
/
Date `Iof Payment
Date of Payment
Receipt Number
C� Cb
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Receipt Number
COSA#
1(,4-2
Waives#
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,
5. STATEMEN
ive
Ac
Er.
6.
D:
If more than 1 septic system is on the lot:
COSA Checklist # of _
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: Woodbourne, Block 2, Lot 4
A. WELL DATA
Well type Private
If A, B, or C provide PWSID # _
Date completed 6/8/82
Sanitary seal (Y/N) Y
Total depth 123 ft.
Cased to 25.5 ft
FROM WELL LOG
Date of test
6/8/82
Static water level 35 ft.
Well production Unknown 9-1)M_
WATER SAMPLE RESULTS:
Coliform 0colonies/100 mL Nitrate '546 mg/L
Arsenic ND ug/L Date of sample: 9/22/15
B. SEPTICIHOLDING TANK DATA
Parcel ID: 015-351-24
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) >12 in.
AT INSPECTION
10/29/15
38.3 ft.
—.-2.3 9.p:m. a
Collected by: Garness Engineering
Tank Type/Mhterial STEP/Steel Date installed 11/8190
Tank size 1,500 gal Number of Compartments 3 Cleanouts (YIN) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Nigh water alarm (Y/N)
Dateofpumping 9/18/15 Pumper A Plus Home Services
C. ABSORPTION FIELD DATA
Y
Date installed 10/21/15 Soil rating (g.p.d./ftz or ftz/bdrm) 1.2 GPD/SF System type 5' Wide
Length 2@44 ft. Width 5 ft. Gravel below pipe 2 ft.
Total depth 4.5 ft. Eff. absorption area 62$.6 fe Monitoring tube Y Depression over Feld N
Date of adequacy test New Const. Results (Pass/Fail) For _ bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N if yes, give date
D. LIFT STATION
Date installed 11/8/90 Size in gallons 250
"Pump on" level at 42 in. "Pump off' level at 28
Datum Bottom Cycles tested 3
Manhole/Access(Y/N) Y
in. High water alarm level at 45 in.
Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot >100' On adjacent lots >100'
Absorption field on lot >100' On adjacent lots >100'
Public sewer main >75' Public sewer manhole/cleanout >100'
Sewer /septic service tine >25' Holding tank >75'
Animal containment areas >50' Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >51
Property line >51 Absorption field 5
Water main >10' Water service line >10' Surface water >100'
Wells on adjacent lots >100,
ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10' Water main >10'
Water Service tine >10'. Surfacewater >100' Driveway, parking/vehicle storage >10'
Curtain drain Nolle Noted Wells on adjacent lots >100'
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Date 11/11/2015
COSA brmn sheet te-10-12.doc
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tlCHAEL E. ANDERSON
CE -4381 ; a`®
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o PIPE
SEPTIC PIPES u
$ 8757'00'
V 393.86' MANHOLE 0� /
Lot 5 I
I
*,�--10' UTILITY & I
i
DRAINAGE EASEMENTS HOUSE DETAIL I
i
4.0' STAIRWELL
2.0' CANT 1.5' CANT
10.0'x10.1' DECK 'ry 59.0'
N
Y Is.0• 1 STORY
o ^ �.Z• RESIDENCE N
W/ DAYLIGHT 30.31
14.9' BASEMENT
0.0' b
M
O
18.a' 1.4' CANT
PLOT PLAN AS BUILT X SCALE _IL = 100' GRID SW 2741 Project No. 15-332/A1
Lan & Associates inc.11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang (907) 522-6476 Phone 000O4p�0
Registered Land Surveyors (907) 522-4625 Fax OF q�p�4
ken®langsurvey.com / Jonathan®langsurvey.com Ch
........... �SQOO
I hereby certify that I have surveyed the following described property: �p(�.OQ
LOT 4, BLOCK 2, WOODBOURNE SUBDIVISION (PLAT 78-237) TH C
* ; 49— * p
Anchorage Recording District, Alaska, and that the improvements situated thereon are ...........�
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible oo. � KENNETH LAN
easements on said property except as indicated hereon.
Dated this the 2151 Day of c��C'v�n. 2 SIJ �Q�� ' •LS -520%.. --
at Anchorage, Alaska
��� FfS510NA� c�
It is the responsibility of the owner to determine the existence of any easements,
covenants. or restrlattons which do not annear nn the recorded subdivision alai.
• T MUNICIPALITY OF ANCHORAGE �A
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 1. D.#HAA#Qucz
1. GENERAL INFORMATION
Complete legal description Lot 4; BCoek 2; Woodbouane Subdiv,i6.ion;
Location (site address or directions) 11751 Woodbourne Drive
Property owner _ Het-tAick - Day phone 243-1414 ext 709
Mailing address 11751 Woodboun.ne Dhive Anchorage, A2ahka 99516
Lending agency
Mailing
Day phone
Agent Manu Ann Beckwith FORTUNE PROPERTIES, INC. Day phone 562-7653
Address 3000 A street, Anchorage, Akahka 99503
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well XX
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XX
Holding tank
Community on-site
Public sewer —
NOTE: 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
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 furtherverify 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 S & S ENGINEERING Phone
17034 Eagle River Loop RoacI NOL 213
Address Eagle River Alaska 99577
Engineer's signature
THE CUNDITIUNS OF THE HEALTH AUTH111?IT11 APPROVA'
ISSUED 1-17-92 HAVE BEEN MET.
6. DHHS SIGNATURE
A Approved for
Disapproved.
Conditional approval for
Additional Comments
bedrooms.
Date 2' t L -X12
bedrooms, with the following stipulations:
By: �� ( ��44ITHDate 2
i111TIC
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.
72-025(R".1/91) Back MOA n21
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
DATE: January 17, 1992
TO: All Parties Concerned
FROM: John Smith, P.E., Program Manager, On-site Services
Department of Health and Human Services ,,'UJ' ,t i`Ri-
SUBJECT: HA910603 Conditional Health Authority Approval for Lot
4 Block 2, Woodbourne Subdivision
Background:
Reference attached letters from Flattop Technical Services
(10/28/91) and S & S Engineering (11/1/91.).
The subject Health Authority Approval is issued conditionally
with the following stipulations:
1. A groundwater monitoring tube(s) must be installed to
confirm that the bottom of both the upper and lower beds do
not encroach on the required 4 Ft. vertical separation to
groundwater. Groundwater must be monitored for seven days.
2. If the system is found to encroach on groundwater, the
system must be upgraded or a holding tank installed.
3. The as -built location of the system with respect to surface
waters and property lines must be confirmed.
4. All work must be completed by June 15, 1992. Failure to
complete all work will cause the subject Health Authority
Approval to become void.
kt S S (L=moi -1/-x
It -
P,,
Zr
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
February 10, 1992
Munici.paZity oU Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTN: John Smith
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
ROBERT SHAFER, P.E.
ROG ERSH AFER. P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-121 1
RECEIVED
FEB 101992
Municipality of Anchorage
Dept. Health & Human Services
REFERENCE: Lot 4; Block 2; Woodbourne Subdivision;
11751 woodboukne Drive
HA910603
Dean. Mr. Smith,
Request you issue .the attached Heatth Authority Approval releasing the
condiiiou oU .the rebereneed approval dated January 17, 1992.
The UoUow,ing 2s to address the conditions oU the previous approval:
A groundwater monitoring tube was tnsta ted next to the septic
leach6ield on the reUenenced property as we have discussed and
as shown on the attached as -built suitvey oU which I have
annotated. The groundwater monitoring tube was .installed on
February 3, 1992 to a depth oU approx,i,mately 8 Ut. below the
bottom oU the adjacent absorption bed. The tube was monitored
on February 10, 1992 and {pound to be diLy. ThereUore, no
groundwater encroachment exists.
2. Not appticable.
3. Attached .is an as-buiZi survey pe&6ormed by a Registered Land
Surveyor. I have used the location oU the septic pipes shown
on the as-bai2t to approximate the location oU the septic
system components under the ground. Again, no encroachments
exist.
4. Not applicable.
At this point I wish to {further address your concerns on the re{erenced
property. Your concerns, pa}tticutarly with the poss.ibi'uty oU a
groundwater enc4oachment, appear to be a resuU ob a report perbormed
by Flattop Technical Services dated OctobeK 28, 1991. In this report
Ted Moore deseAibes how waters was Uound within the absorption bed,
water was encountered within a sha tow hole near the absorption bed,
the two were assumed to be related and both were assumed to be
groundwater.
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Page Two
Lot 4; Btock 2; Woodbourne Subdivision;
February 10, 1992
In my tetter. dated November 1, 1991 to Many Ann Beckwith oU Fortune Properties,
Inc. I gave exptanations " to how the water .in the absorption bed coutd not
be retated to the water bound within Ted Moore's shaUow Note. I atso
explained the ohig.in oU both waters. ReaP,iz.ing the eonUtiating opinions which
existed I met with Dan Bottes oU youA o66 ice on the property on December. 3,
1991 so that youA o64ice may Dorm a decision a/., to whethm or not there .is a
reason to suspect a groundwater encAoachment. At .the end o6 my meeting with
Dan 1 understood he betieved the water within the shat2ow hole eou2d not be
related to the water within .the absorption bed. Aao, since .there exists a
deep Uoott.ng dAa.in around the house which was Uound to be dry duA,ing Dun's
visit, I also 6eP.t he beUeved a groundwater encA.oachment could not exist.
ThereUore, we applied 5or a Health Certi6icate at that .time. IU I had known we
would stitt need to tnsta2C a groundwater monitoring tube we could have avoided
the delay Urom December 3, 1991 to February 3, 1992.
During the instateat.ion oU .the groundwater mondtming .tube on February 3, 1992
which Dan Bo to witnessed, we sti.0 bound wate.jL within Ted Moore's shallow
hole. Dan questioned my ea)Uier explanation that the water was a resutt oU
warming weather. I beet the water st-iPt exists within Ted Moore's shaP.eow hole
due to the existing snow cover. The earth under .the insutating snow cover .is
not Urozen at :this .time. (Thin .is even in Februa)cy which makes this a somewhat
unusuat year.) On top ob the warm earth .lies approx.imatety 4 Ut. oU snow.
ThereUoae, .the earth -snow .interUace .is continuousty wet. This moisture is
trapped within .the tundra and peat and .is keeping Ted Moore's sha tow hate
saturated. As exptained beUore, once this peat tayer is removed (as .is .the
case under .the abso)tption bed) water ,us not allowed to remain. It .us .the
organic peat on top oU the ground around Ted Moore's Note which acts as a
sponge sitting on poorty premeabte soils. This .is ver%6.ied with the
tnstatlation o6 the recent groundwater monitoring tube which Uound the softs
betow the organic peat tayer to be dry. This was also veiti6 ied during the
.installation oU the groundwater monitoiLing tube .installed in August oU 1990
which was used to design the absorption bed. In Uaci, the .instaUat.Lon oU the
recent monitoring tube was a dup.Picati.on oU work we did .in August oU 1990 when
we .insta ted the original groundwater monitming tube.
IU you have any mare questions, concerns, or require additionat .inUaunation bor
your. review, ptease contact us.
S.ineerety,
ROGER J. SHAFER� P.E.
RJS/gm
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CIVIL & IiNVIRONMENTAL I!NGINEAMNG • NNP.RGY CONS1IRVAnON & ANALYSIS
THEODORE F, MOORE, P.E. 14530 ECHO ST.
PH: (907) 345.1355 October 28, 1991 ANCHORAGE, AIASKA 99516
Mary Anne Beckwith REE
Fortune Properties � V��
3000 "A" Street
Anchorage, AK 99503 41x0 1,9 1,991
lout?/ o/ptli
Dear Ms. Beckwith: Ak 44eutth & �u�an S rug®
Per your request on October 24 we conducted adequacy tests of the water supply anT%Iowater
disposal systems serving the Hetrick residence on Lot 4, Block 2, Woodbourne S/D, located at 11751
Woodbourne Drive. The measured well yield of 2.0 gpm exceeds minimum Municipal criteria for-.
approval of a 3 bedroom residence, however the wastewater disposal system cannot be approved because
it is in the groundwater. The following is a more detailed explanation of our test results - copies of
relevant backup documents are enclosed.
1. Water supply system: According to the driller's log the well was completed in June of 1982, at which
time it was reported to have a finished hole depth of 116 feet and a yield of 10 gpm. On the date of our
test the static water level stood at 48' below the top of the casing. After the water level was drawn down
to the level of the pump intake at 97 feet, we measured the well to have a sustainable yield of 2.0 gpm.
This yield is adequate for Municipal approval, however it does not meet the FHA criteria of being able to
supply water at 3 gpm over a 4 hour period. Water samples collected on October 22 were satisfactory,
showing 0 coliform or other bacteria per 100 ml., and 0.2.3 mg/l of nitrate -N,
2, Wastewater Disposal System: The present 3 bedroom wastewater disposal system was installed in
November of 1990 and includes a 1500 gallon septic tank with all integral lift station, The lift station
pumps the septic tank effluent into two mounded soil absorption beds connected in series. Despite the fact
that the house was winterized and had been vacant for over a month, the first soil absorption bed was
completely saturated with groundwater, and the second had some groundwater in it. We dug a shallow
hole in nearby undisturbed soil to confirm the presence of groundwater. A soil, absorption bed saturated
with groundwater cannot be approved, because Municipal and State regulations require that the bottom of a
soil absorption system must be 4 feet higher than the seasonal groundwater table. Several other aspects of
the system which we noted as being out of compliance with code are as follows:
(1) There is not sufficient room between the well and a creek for the system to be constructed as
configured on the "as -built" inspection report without waivers of the required 100 foot horizontal
separation distances.
(2) The beds do not have the required 6 feet of vertical separation from the impermeable soil shown on
the soil log.
(3) The bottom of the 2nd (lower) bed is not level as required by code.
In my opinion the installation of a holding tank will probably be the only feasible solution for this
property. Please feel free to give me a call if you have further questions on this report.
Sincerely,
Ted Moore, P.E.
it,
NovembeA 1, 1991
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694
FAX 694 1211
HEALTH AUTHORITY C
APPROVALS
Matey Ann BeckwPROPERTIES,
FORTUNE PROPERTIES, INC. 0Y 3000 A Stheet Suite 0101 000
SEWERB WATER Anchorage, Atatka 99503
MAIN EXTENSIONS
REFERENCE: Lot 4; Stock 2; WoodbouAne Subdi.ViAi.on;
11751 Woodbourne DA.Cve
SEWER WATER DeaA Ma. Beckwith,
INSPECTION
At you)! Aequest I vi,6ited .the re6meneed property on oatobeA 31, 1991
in ,the pAeae.nee 06 .the poten iaC. buyeA and Pete Katamakides o6 2001
Reatty. The purpose o6 thta vi6it was to inbpeet .the Septic aya-tem and
ENGINEERING STUDIES comment on Ftattop Teehnieat Sekv,ices' AepoAt concluding .the existing
AND REPORTS ayatem i4 Within gnaundwtteA.
Aa stated, .the septic teaeh6ietd aAea con6i6ts o6 ,two mounded
absorption beds connected .in SeAies. The initiat bed receives at/ the
WELL INSPECTION e66tuent 6Aom the dept Lc tank and once the .ini,iiat bed is 5atu4ated,
d FLOW TEST e6 btuent apil C6 oven .into the aeeond bed.
During my v.iait I bound liquid .in the .init-iat bed whereas the aeeond
bed was dry. Etevation measurements weAe taken 6Aom the two monitoring
SITE PLANS tuba within the in.itiat bed. The elevation o6 the wateA sur6aee .in
each tube was the same. This i6 as ,it Shoutd be.
Since there i6 a 6ai/c slope to the propeAty and gkoundwateA tendo to
ROAD DESIGN 6ottow the Stope 06 the ground 5ur6ace, it is probabte that .i6 the
tiquid teveCs within the teaeh6.ieCd were a Aesutt o6 groundwateA
int4u6ion, then the wateA tevets within the teaeh6ietd bed would be at
di66eAent etevationa. It would at6o Seem probabte that i6 the upper
SOILTEST bed is .inundated with groundwater then the .Cowen bed, which i6 at a
.Cowen eCevat-ion and v.iAtuaUy the Game depth .in respect to the
auAAounding ground elevation would atso be inundated with groundwateA.
HoweveA, the .Cowen bed tis dry.
PERCOLATION
TEST we also obavcved the aha tow hole dug by Flattop Teehnicat SeAvicu.
Th.i.S hole was neaAty 6u.11 06 water. In 6act, the entire area aAound
the Shallow hote, which consists 06 tundra and peat, was aatunated with
wateA. The aatunation o6 the area appears to be a result 06 melting
STRUCTURAL&
snow 6Aom the Aeeent wa&meA weatheA. The anowtnelt has saturated the
MECHANICALor anis to v 06 aoit above the pookty permeable ao.iPJo below. This
INSPECTIONS watve had not had time to either absorb .into the
natwcat 5uL6aee drainage. g!cound oA 1=066 0,5
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Page Two
Lot 4; Btock 2; Woodbourne Subdivision;
Novembeh 1, 1991
Ftom my observationb I do not 6eee the ii.qu,id bound .in the absorption bed iz a
rezu,U o6 groundwater, not do I eurrentQy bee tea4on to eudpeet the sybtem i's
encroaching groundwater.
However, .it .i6 concetni.ng to 62nd water bti t pte6ent within the absotptton bed
a.ince the property has been vacant bot over a month. Even though the ayatem .i.e
new enough ao adequacy testing it not required to obtain a HeaP,th Certi6icate,
I would recommend pe46o4m.ing an adequacy test to vevci,6y the abborpti.on capacity
o6 the teach6.ieCd ptt,ot to obtaining a Hea.Q,th Certi6icate on the property.
16 you have any quehtc:ons, of .t6 we may be o6 6urthet aeAv,ice, pi'eabe contact
UA.
Sincerely,
ROGER J. SHAFER, P.E.
RJS/gm
MUNICIPALITY 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. # � \- QLA HAA # I
1. GENERAL INFORMATION
Complete legal description Lot 4; BCock 2; Woodbowme Subdivizion;
Location (site address or directions) 117;1 Wo] Uor1hr�h�o nni%,o
Property owner
Day phone
Mailing address 11751 Woodbourne Anchorage, Ak.. 99516 _
Lending agency
Mailing address
Da% phone
Agenaa�Ann Beckwith FORTUNE PROPERTIES,INCBeckwith FORTUNE PROPERTIES,INC. Day phone 562-7653
Address 3000 A S.tneet Anchorage, Ata/sha 99503
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 V
3. TYPE OF WATER SUPPLY:
Individual well XX
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XX__
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
7M25 (Rev. 1/91) Ronl MOA N21
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 Phone
S & S ENGINEERING
Address 77034 Eagle River Loop Road No. 204 q
Eagle River, Alaska 99577
Engineer's signature Date
4r�dr,�
+. a1'r , . _ , ,
�.'a• 600c LSH `ER. P.E. •44
p
Y A L 9215 �
6. DHHS SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for -3 bedrooms, with the following stipulations:
Additional Comments f3 Ef,� I t&lO Td
By. JCtj( 4 S -(-\)T-(4 Date I 1
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.
72-025 (Rev. 1/91) Back MOA #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL. CHECKLIST
Legal Description: A "t �l�t�- 2" _ Parcel I.D.
A. WELL DATA
Well type ae1✓�_
If A, B, or C, attach ADEC letter. ADEC water system number
Log present((y7lV) Date completed 82= Driller Ind
r I
l �
,
I a( 1 q
Total depth (��
__
Cased to—VW y (o Casing height
1Q- k
y
Sanitary sealON)
Wires prroperlerly protected (%'N)
FROM WELL. LOG AT INSPECTION
z
w �
Date of test
(� N
t I
�o
V w
6)
LU
Static water level
Q q
o�
Well flow
1/�
,,) C_Q
g.p.m. g.p.m.E a
-
LU
Pump level
1� �)
a w
_
-'
U_J
20
C
SEPARATION DISTANCES FROM WELL TO:
1 }-�
Septic/holding tank on lot k_(_�? ; On adjacent lots
Absorption field on lot \ La ; On adjacent lots
Public sewer main N C) fc-, _ Public sewer manhole/cleanout � � _I
Sewer service line Petroleum tank �pte V -t -9Q t--�
WATER SAMPLE RESULTS: /^
Coliform �l Nitrate Other bacteria _ �!
Date of sample: �2� �� '� Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed _ ((_ 6-41.C_) Tank size —�!2TZX Compartments
CleanoutsON) - 4 Foundation cleanoutON) Depression (Y15)
High water alarmON) Alarm tested�V?N)
Date of pumping I2 — �2 —� _ Pumper __� l_ �Qll �, `�u�L� 6
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
` t•� I'
Well(s)onlot— � \�On adjacent lots— Foundation_
t
Topropertyline_ L42 Absorption field Water main/service line (� I
1
Surface water/drainage � C>c�> 4—
72-026 (Rev. 7/91) Front - CONTINUED ON BACK PAGE
C. L T STATION rr,, 11 [
Date insta 11- � �� Manufacturer kl. C �-, &,-+\—
Size in gallons �/� Manhole/Acces�N)
A ti
Vent(t N) 7Y Pump on" e t �L "Pump off' level at SIS
U
High water alarm level Q� �_- Cycles tested ('45
Meets MOA electrical codes.kO N) _
SEPARATION DISTANCE FROM LIFT STATION TO:
I
Well on lot C7 On adjacent lots
D. ABSORPTION FIELD DATA
I'- Surface water LCA-> \�
Date installed — 8 —q L-> Soil rating �Sh �� System type S DS
Length —Width Gravel thickness Total depth
Total absorption area Cleanouts presenter/N) y
Depression over field (Yop
Resultsas ail)
Peroxide treatment (past 12 months) (YA19T,-
Date of adequacy test
for
If yes, give date
Z - -7-91
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
i f
Well on lot � � On adjacent lots � `�� I— Property line ( t -D
To building foundation �� — To existing or abandoned system on lot
t ` I
On adjacent lots ?J� a Cutbank L bP S Water main/service line ( �
1 I
Surface water l Eb Driveway, parking/vehicle storage areab
Curtain drain �0tfC
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in
S 81 S ENGINEERING
Signature vnaA Pngln R'vPr t nnn Remd No .9()4
.aule Riva, Alaska 99577
Engineer's Name
Date
112�>-*52kI
HAA Fee $ 170 t Waiver Fee: $
Date of Payment /A-( 3 '9 ff Date of Payment
Receipt Number °� �� l ���X Receipt Number
72-026 (Rev. 0/91) Beck MOA 21
bedrooms
of this inspection.
4 r 1
. MUNICIPALITY OF ANCHORAGE
Department of Health &Human Services ovict
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel LD. 8 HAA ik
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 4; BPock 2: Woodbourne Subdiv bion
Location (address or directions)
(b) Property owner Steve 7 Man.{okie Ted4ick Telephone : (home) Business
Chuck 9 Kay Nealy
Mailing Address
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent—MARSTON-REAL-ESTATFATN ch tf—T4mbtinz-ap
Address 2804 Wa t Nonthe>in Ligh.tb Blvd. Anehoaage, Ah. 99508
Telephone 248-2804 (�� �-hwsJ_ S,m �< �- `/ 3 S /OC)
(e) Mail the HAA to the following address: (or check hereRk if hold for pick up.)
List contact person and day phone number below:
5 & S ENGINEERING
'7034Eagle_RivP_c-Lonp_It=LNo.20_a
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family KX Number of bedrooms .3
3. WATER SUPPLY
Individual Well I&X 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 XXX 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. 7188) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INZWEC IONS, TEST'S, PILE SEARCH, DAIM 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 n r
Address 170-14 F,191e River Loop Road No. 204_ —
Ea9IP Riaer; Alaska 79577—
Date
G. DMI -IS APPROVAL
Approved for /r_''_abedrooms by
Approved ___ Disapproved
Terms of Conditional Approval
Telephone -- __ 66l't
__ Conditional
� t
` I
i.11 r
X
Date //— I /-- 9O
O
Mc11Y
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Flealth Authority Approval
cerificated 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.
72025 (13" 7/88) Mack Page 2 of 2
,
� t
` I
i.11 r
X
Date //— I /-- 9O
O
Mc11Y
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Flealth Authority Approval
cerificated 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.
72025 (13" 7/88) Mack Page 2 of 2
�Pp°c. pCv
\adp
p4P\AGES`JMUNICIPALITY OF ANCHORAGE (MOA)
P�� SSR • '� Health Authority Approval (HAA)
�'4�C�P �� 1puQjO CHECKLIST - FEBRUARY 1984 w 1
`\1�')�� Legal De criletion: 744
Lam_ `� - 2
A. WELLATA�
Well Classification — (tJ�1 J1 �� If A, B, C, D.E.C. Approved (Y/N) A
Well Log Present((VN) Date Completed (e Yield aetr�
Total Depth V Cased to l2-12 Depth of Grouting
I 1
Static Water Level !!�� Pump Set At
2"
Casing Height Above Ground Sanitary Seal on Casing (!7DI)
Electrical Wiring in Conduit MN) Depression Around Wellhead (Y49) a
SEPARATION DISTANCES FROM WELL:
I t
To Septic/Holding Tank on Lot ( I S ; On Adjoining Lots I ��
I.L
To Nearest Edge of Absorption Field o Lot _ 1 E-t�I _ ; On Adjoining Lots
To Nearest Public Sewer Line _ t� � To Nearest Public Sewer Cleanout/Manhole "
I
To Nearest Sewer Service Line on Lot
Water Sample Collected by �� S � Date a- -t>\
Water Sample Test Results1
Comments
B. SEPTIC/HOLDI
'NG
ooTANK DAT/a�
ly-
Date Installed �-_!1d SizeeQo No. of Compartments
Standpipeso/N) y -Air-ti
Depression over Tank (Y16P
Pumping/Maintenance Contact on File
Holding Tank High -Water Alarm (Y/N)
ght Caps(22'N) __y___ Foundation CleanoutN)
r-1 IDa Last Pumped _ NI
(Y/Ny for
Y Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Building Foundation
To Water -Supply Well
To Property Line % CJ 14 -
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
To Disposal Field
C:> (4-
72-026 (Ftm 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata nom,
p �%ZO Type of System Design
Date Installed j - ICE>—qfl Length of Field 1
Width of Field �� I ��• Depth of Field
i
Gravel Bed Thickness
Square Feet of Absortion Area �oStatndpipes PresentCUN)
Depression over Field (Y/6) t4 I Date of Last Adequacy Test
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD
r
To Water -Supply Well D� f To Property Line ./ a
i
To Building Foundation �� To Existing or Abandoned System on
!1
Lot �%0'� ; On Adjoining Lots °�70 4,
t
To Water Main/Service Line % To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date InstalledI � -,B --9 O 4 Dimensions 6 Pl .
Size in Gallons I`5—Do s •T C �. Manhole/AccessQl?N) `/
LI U
"Pump On" Level at elr— II "Pump Off' Level at
High Water Alarm L ve-l/at '::'f,5Vent&5N) V
Tested for ._�- _� /`t AIR -0 Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codeso(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 o
inspection. £
Signed S & 5 ENGINEERING
17034Ingle River L.00p 130 -id No. 204
Company .a0te fiver; Alajslk, fi77
Date
MOA No.
Receipt No. 2 ,2 y Yr j /j
Date of Payment
Amount: $ / o o
Receipt No.
Waiver Fee: $
Date of Payment
72-026 (Rev. 7iee) Back Page 2 of 2
tl°:thejd,�fe,of this
ue��neron�e
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
--- - �',``p
5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343 �`'
G•
FEDERAL TAX I.D. #92-0040440
ANALYSIS REPORT BY SAMPLE fox Work Order # 29846
Date Report Printed: NOY 7 90 @ 12:53
Client Sample ID:L7 B3 BROADWATER HTS
PWSID :UA
Collected NOV 1 90 @ 21:10 his.
Received NOV 2 90 @ 16:10 his.
Preserved with :AS REQUIRED
Analysis Completed :NOV 7 90
Laboratory Supervi or STEPHEN C. EDE
Released By
Special
Instinct:
Chemlab Ref #: 904638 Lab Smpl ID: 1 Matrix: WATER
Parameter Tested Result Units
---------------------------------------------------------------------------
NITRATE-N 2.2 my/l
Sample ROUTINE SAMPLE.
Remarks: SAMPLE COLLECTED BY RJS.
------------------------------
1 Tests Performed
See
Special
Instructions Above
ND= None Detected
See
Sample
Remarks Above
NA= Not Analyzed
LT>Less
Than,
GT -Greater Than
Client Name S G S ENGINEERING
Client Acct SNSENGP
P.O.# NONE RECEIVED
Rey #
Ordered By : R. SHAFER
Send Reports to:
1)S G S ENGINEERING
2)
Allowable
Method Limits
------------------------------
EPA 353.2 10
UA=Unavailable
ALASKA eI iOIROWnTAL COUROL SCR US, InC.
Engineerinq & Enuironmenlal Studies
OCTOBER 12 1983
STEVE TEDRICK
SRA BOX 2502
ANCHORAGE AK 99507
SELLER — BUYER — STEVE TEDRICK
SUBDIVISION — WOODBURNE BLOCK — 2 LOT — 4
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN UNKNOWN AREA.
THE SYSTEM IS CAPABLE OF ACCEPTING 675 GALLONS OF WATER PER DAY.
THE SURGE. CAPACITY OF THE SYSTEM IS 1000 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON 10/13/83 .
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
a
of A 1. ®q0p
r�(,�,'\ a�ee
aerae�e veee"Y�f1Vt1
4. f
eee
r
FN
id•. r•'•o. 2251Eej`
1200 West 33rd Ruenue, Suite B • Anckorage, Alaska 99503 • (907) 276-1361
1
WOOD 80URNE 0R
G
5' T-5
Wim
41I Q)
,q_!
17
0
3 393. SG
II
5
SURVEY TYPE
❑ AS -BUILT
®PLOT PLAN' ORf�/NAGE
❑ LOT SURVEY
❑ A"IN AS -BUILT
7
N
RECERTIFIC NOTE: FENCES ARE SFOWN IN THEIR APPROXIMATE LOCATIONS ONLY.
■
II is therespo.s,bilily of the builder or owner, prior to LEIiEND hub a tock -found ❑ set -
consiruclion, to ve,,fy proposed bwlding grade relative Iron rebor -found O Set
.6110
to finished grade and utility connections and to determine .iron pipe -found O Set
the existence of any easements, cwenonls or restrictions brass cap -found 5et (QX5 .
which do not appear on the recorded subdivision plot• alum. Cop -found Set
Prepared by
I of Survey Certification /n�� S'e BENCH IWARK INC.
I Fir eby ur tit y Hal l have sure- �.�,,..........
tyodm,progody0h and a� ,r ♦ Professloncl Land Surveyors
d�vibodh« ,andmal n s� TH�r(A}��j :� Scolr.l" 100' Drawn by BJH
imprwea,enls sH uH. the'an
* �• 49— * a �; •,
ore wrtdn rhe prooMyMm and •..•� • ••t tial p D�Surveyed- Checked by.
doro'merlapa encroach on G/`',e%.t P1.4Y 21; 1982 - REJ
niFY my prarxrty and that no .' ... • r•: • •I
rrprv,.y„ent s on adjocml prep' � / Dct(Drawn: Grid: X10#
c .o 0 opo a c,00cnonlho •'• A _ MAY 21, 1982. 2741 82-060
premists n p+estan Ord Ila1 ••. n 12 \ o'
there one no roodwoyc, uhbty l' ;P/� •• ••••••'• j+'R L cription.
hn6 o Otter visbkooe ilz q,gofessbs�\ �� LOT 4, BLOCK 2 WOODBOURNE SUBDIVISION
an sad proper ty except as `h�Orr
rc+6cated horoon
\ 1.
�f000aove,vE DFN
2
— F )45 34
I
W'
of
At
L s.a?c
9 3, S!a
I
S
II r
SURVEY TYPE
® AS -BUILT .
[� PLOT PLAN
❑ LOT SURVEY
❑TIFICATION AS -BUILT
a
� T
3
a writ W m
T �
o
s
W 6
25dWi
---
i
RECER NOTE: FENCES ARE SHOWN IN THEIR APPROXIMATE LOCATIONS ONLY.
8
J
I
II is the responsibility of the builder or owner, prior to LEGEND hub et tack -found ❑ set it
construction, to verify proposed building grade relative iron rebar -found 0 set •
to finished grade and uhllty connections and to determine iron 'pipe -found O set 0
the existence of any easements, covenants or reslnctions brass cap -found ® set '(7agVC
which do not appear on the recorded subdivision plat`- alum. cop -f Ound a set
Lot SurveyCertlfication
Preparedby
thereby certify.tiwtlhave sarv- �� �F•a�gsoo B!_ -NCH ll ARK INC.
eyed nie propeAy shown and Q•,.•' 0 Professional Land Surv�ors
deacrlbodhoreoa,ondthatthe -��; 9TH ••.•/7.9*0� Scokl�� 100 Drown by: BJH
invmemenls siluotedthErn0a *4 -- —_-
are wdhlnthcpropertylnesmd ��• .rf.•••••Aa• ••tf.,ijJ0 ---
do,alovr-vlopwencrocchont
`'\ 1 i 0 DateSurveyed- 9-19-83 Checked by: REJ
odpx-[nt property ardthatno`•.. d:1;.:. ' �-6�•� ----- —
,nproomeatsa,odjocm-1+ir
ao.r i. Jo«ns� Dat[Drawn Grid: X104
erlvr�.aWw encroochon do 0•'^� , a' 9-20-83 2741 83_265
premises in lhot ®Q �fe .•��41215• Loyd Description.
ii,,,vreno nvodways, utddY 4�'�Arvle'*} al 9&o LOT 4, BLOCK 2 I•IOODBbURNE SUBDIVISION
Iuxs a oilier visbkroEmx+nte% i�
onw,dp,Wcrtyex los
m6ccled herein
:Permit ik: 820321
January 31, 1983
TO: Permit Applicant
Subject: Lot 4 Block 2 Woodbourne Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If. you have drilled the well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If. a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely(
C� C �('g-
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/1jw
enc: Copy of Permit
SWP/057
A►PPLI( NT FILLS
OUT UPPER HA 'ONLY
Property Owner `s
-, 61Y // it/'
— Phone
Time �-
0
s<✓s !�lvr`-
Address rf '
Ma-dng �
.--� !c Tj �, ti �1_ gLC�C-�
Zip Code
Buyer G, /: r'.•'r .S /1� =r %, J'rs�..�
1\
Atltlress.. c, /- ✓1
ZIP Code
Lending InstitutionPhone
./�/.1 aA'/7 Fey/
Dat I q
r.A) ira11
Inspector
—
Inspector
Address c) , , A
ZIP Code )it-, 2.
Realty Co. & Agent
..n-
Phone
'
Zip Code-^—�-
Address
Legal Description
Street Location
Type of Residence
MMSingle Family
ENVIRONM"cNl'AL PROTECTION
ultiple Family No. of Bedrooms —
.
❑ Other
LI.Yf—U CIWA61 dK- ri
��""
Water Supply T
Individualr_�,-���--%
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
.
❑ Community G' '�
For wells tlrilled prior to that date, give well depth (attach log If available).
❑ Public Utility
( ) APPROVED BEDROOMS
Sewer Disposal
�Individual
Year Individual Install ed:
,
❑ Public Utility
When Connected to Public Utility: ^CLAC_=• —
(_] Holding Tank
( )
NOTE THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
w) -76(o5
Time
Time
Tim
Time �-
0
1\
Date
Date
Date
Dat I q
Inspector
Inspector
—
Inspector
Inspector
Field Notes:
MUNICIPALITY OF ANCHORAGE
DEPT. OF H_`ALTH i,
-
ENVIRONM"cNl'AL PROTECTION
.
LI.Yf—U CIWA61 dK- ri
��""
SEP 11%6.3
,,EF 16 tac,;s
RECEIVED
( ) APPROVED BEDROOMS
-----
'CONDITIONS OF APPROVAL
DISAPPROVED
CONDI'r(ONAI. APPROVAL'
j _ _
; )
, ��� �.7� `
- /l •
( )
DATE
Soils Rating
Date Sewer Installed
Well To Absorption Area Q V T
Well
L
Well to Tank 0
i
Septic Tank Size -
72.0231];821
5Qptember 20, 1983
Bobby and Ga.i.l. Nealy
?1 sox 2505
Anchorage, AK 99507
Sub.fect.a but 1, Block 2, ':flood Bourne S.rodi.vi.s.on
Approval. .tor the individual :fewer and water facilities cannot,
be granted until. the Lol.l.owinq items have boon completed:
isA wol.l tort subrai_ttcd to this WHco for our: We5 ano
1/ r vi -Ow. Shpv .Iow rate.
EYF'r2� n
°
The pero iit for the :i.n to l l aLion of the on-site sower _'ycs ter.i
We have not recoi.vud the
as-bu.rl.ts of the -installation .in this oi'c.icu. It a private
engineer i-nspucted the system, Vleaso sena] us the report
for our kilos and review.
The lift station mu,t have a :secured lid plus successful
inspection by the Municipal Elect:ri.cal inspector at 3500 i .
Tudor..
Please notify this Department f`.or a i:'e..inspucti on schen the
noised discrepancies have: been corrected. It there etre any
further questions, please call this office at: 264-4720.
Sincerely,
Cary Ail.l.i.s
C✓d�iU/e]/1?.
A. S.