HomeMy WebLinkAboutDEARMOUN LT 14 Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP161144 PID Number: 018-401-03
Dwelling: . Single Family (SF) El Duplex(D) ❑ Multiple (SF and/or D) Project: El New ❑� Upgrade
Name:
Steve and Jolene Nokelby ABSORPTION FIELD
Address
❑ Deep Trench [' Shallow Trench El Bed 1=I Mound
13841 Ervin Road Anchorage, AK 99516 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
3 1.2 GPD/SF 5.0 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 1.0 Ft. 4 Ft.
DeArmoun 14 Fill added above original grade Gravel length
Township Range Section 2.9-3.2 Ft. 38 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 5 Ft. Ft.
To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
Tank Field Lift Station Tank Line
From 380 Ft2 1 Ft.
Well NA >100' NA NA >25, TANK ❑ Septic ❑■ S.T.E.P. ❑Holding ❑Other
Manufacturer Capacity
Surface Water NA >100' NA NA Existing Gal.
Material Number of compartments
Lot Line NA >10' NA NA
NA -
Foundation NA >10' NA NA LIFT STATION
Manufacturer Capacity
Curtain Drain None Noted Gal.
Pump on level at Pump off level at High water alarm at
Remarks Absorption Trench Only Placed Under
This Permit. Existing Absorption Bed Remain: in. in. in.
in Place for Future Use. Ball Valves Placed Pump make and model Electrical Inspections performed by
to Access Existing or New Trench.
PIPE MATERIAL House to tank Tank to D3034
Installer drainfield
Denali Excavating Drainfield D3034 CO/MT D3034
Inspector MEA BENCH MARK (Assumed elevation) 100.0 ft
Inspeeatio: 1,17/6/16 2nd 719116 Location and description
3`d 7/10/16 4th Garage Slab.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL 4.♦��\'rrA Stamp
lit
.. 1111
... . .. ...OF � 1t
Conditional Approval: Date ,`P••' 4 �
,�
y
„fir: 49TH *f
i
MICHAEL E. ANDERSON
�,• CE-4381
• <i••.l0•2-07 ' wA
Approved ate,,,,,, atr,trUDate 10/3// 7 -1i1 �„S`w�+'�
Inspection Report_9-1-12.doc
Municipality of Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
Permit Number: OSP161144 4700 South Bragaw Street Anchorage, AK.99519-6655-343-7904 PID No.018-401-03
DEAMOUN SUBDIVISION
Existing®
Well LOT 14
>- LOT 13
v 49,500 S.F.
co
S89°54'00"E 267.00 ' / ` i —
I `30 —7 ® 33
fr ()CO g
I Existing ,' A I B r`
Q N
M1 70.7' 67.4' Q
oo\ Well
o
Ct l — - _ .-.:4•i-...,.7, ,,
. •'';". _ w CCD. Z
} `- •i:.w.Xv. ';a —I . r
:' < - _ VIII II II 1 / 73
.� Three Bedroom II II II II ! u .0c I
Z
�!` :.;•t1;4 Home 111111111 /Existing m fA W
I . -Gravel Vii. I71#1
/Absorption a O
j o \ _Asphalt:;;� LOT 14 `/' Bed / �, s= 0o 1Y >�� ip 8
LrJ o 1 4r' a '''.•':'.,i = ° N
Z a i;r'4 :t / 7}MH o
f / Mt Za W
o
in \\ .o
-1 N Goroge iTH1• \\ Z
('r7
— 4 / co
I I -•:,_`— — G
i
__
Absorption Trench
30 I _—- _ _ 22
Ytea. I
I Shed
Existing 2.000 I
Gallon STEP Tank N I"
s# _ OF *+# S89°54'00"E 267.00
�` ' * .,.1 N LOT 15 LEGEND
Ar i49th MT — Monitor Tube
•
NOTE:
FCO — Foundation Clean Out
MICHA E.ANDERSON '�,r No Conflicts with TH — Test Hole
0.62. ./ • �,:I Neighboring Wells or V IT \PLAN CO — Clean Out
v -ip .. . !N CE-4381 ._� Septic Systems. MH — Man Hole
..F,p a -�-1,10'.. �' FSV — Flow Splitter Valve
♦ej f tiOFESS\XPi. SCALE'i"=40'
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655-343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP161144 PID No, 018-401-03
0
JAL 111 1111
U
N
0 M
Exislin.Grade
Finished Grade
2,000 Gallon
STEP Tank
EXISTING
I
99.2 -
/ 96.3
Finished Grade
Onginal Ground
2"Insulation and
Geotextile Fabric
95.3 J Drainfield Rock 95.3
91.3-'
38'(Trench Length) / 81.3
! No Groundwater
5-30-16
NOTE: Absorption Trench Only Replaced Under This Permit.
30 -6" Holes at 1.25' Spacing.
AT
49th �+
PROFILE AS-BUILT �r, MICHAEL E.ANDERSON •
: •
No. CE-4381
No Scale ��, i0 -y: r,.••'r '�:
CIYIL& ENYH~ONMENTAL ENGLNEERLNG '* ENERGY CONSERVATION & ANALYS~
TIIEODORE F. MOORE, P.E. 14530 ECHO ST.
Pti: (907) 345-1355 July 10, 1991 ANCHORAGE, ALASKA 99516
M. O. A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for a
permit to upgrade the wastewater disposal system serving a 3 bedroom single family residence on Lot 14
of DeArmoun S/D. Soils logs, a site plan, design drawings and specifications are enclosed for your
review.
The original wastewater disposal system serving this residence was installed in 1971. In 1974 the
system was upgraded, at which time the residence was classified as a 4 bedroom duplex. In 1988 the
wastewater disposal system was totally replaced with a 2000 gallon septic tank and integral "Orenco" lift
station followed by 41 feet of soil absorption trench containing 7 feet of sewer gravel. Since the residence
was still classified as a duplex at the time, the documentation was submitted to D.E.C. (copy enclosed).
The dwelling has since been convened back to 3 bedroom single family status, and is in the process of
being sold. When the soil absorption system failed to pass an adequacy test, it became necessary to come
up with this design. On July 101 verified that this is a single family residence. An internal stairc, ase has
been installed, and the range removed from the lower floor, leaving a wet bar only. The staircase ns
installed in the location of what had been a 4th bedroom.
As can be seen from the soils logs, the soils consist of a shallow stratum of relatively clean sand
overlying silty gravelly sand which peres at approximately 60 minutes per inch. The overlying clean sand
strata in the vicinity of test hole #3 have a measured pete rate of 2 minutes per inch and faster. The
proposed design is to build a shallow absorption bed on top of this clean sand at a depth of approximately
1.75 feet. The system size is based on 0.7 gpd/sq, ft., which is the allowable rate for filter sand. The
total required area is (3 x 150)/0.7 = 643 square feet, which can best be accomplished with a bed having
dimensions of 20' x 33'. The proposed bed location overiies test hole #3, however this should not create
a settlement problem due to the relatively shallow depth of that test hole. Due to the limited horizontal
extent of the demonstrated accepting soils, the use of a width of 20 feet is preferable to 15' in this case.
The topography in the vicinity of the proposed construction site is level. The site plan shows all
known wells and septic systems within 200 feet of the proposed construction site. Construction of the
proposed soil absorption bed will have no impact on the ability to develop on-site water supply and
wastewater disposal systems on adjacent lots. There will be no impacts on reserved space/surface and
subsurface, or on drainage.
Please give me a call if you have any questions on this submittal.
Sincerely,
Ted Moore, P.E.
LOT 13
'"' :'"'"Y'~'~ SEPTIC SYST£1~ uPGRADE
" ~ _ . OOtE.
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~attSl~ Technlcal Services
: "' 14530 Echo Street
Anchorage, Alaska 9~~
LoT
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SEC T lO N 'A - A" 14530 Echo Street
' .~fichorage, Alaska 99516
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~-) ...... -' ............. ~ I~ PLAN__d- SECTION
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Flattop Technical Services
14530' Echo Street, Anchorage, AK 99516
Phone (907) 345-1355
Lot 14, DeArmoun S/D
13841 Ervln Road
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project includes construction of a new 20' x 33' shallow soil absorption bed with
pressurized distribution piping connected to an existing lift station.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform with Municipal and State
requirements.
1.3 All separation distances shall be in conformance with Municipal requirements.
,.
1.4 The conn"actor shall be responsible to obtain any necessary utility locates, and to work around any
buffed utilities.
2.0 Septic Tank and Lift Station:
2.1 The existing 2000 gallon septic tank with integral "Orenco" lift station is to be retained in service.
The contractor shall verify that the lift station is operating properly and that the floats are set at th~ correct
levels at the time the discharge line to the soil absorption bed is connected up to the lift station.
3.0 Soll absorption system:
3.1 The 20' x 33' soil absorption bed shall be constructed by carefully removing the peat and reddish
sandy loam strata only from the bed area to expose the top of a brown gravelly sand stxatum at a depth of
approximately 1.75 feet below ground level.
3.2 The bottom of the soil absorption bed shall be level. A few yards of medium pit run sand
.(meeting the .M. unicipal specification, s for filter sand) m~.y have to be spread in the bottom of the excavation
m order to achieve a level surface vathout over-excavanon. '
3.3 A total depth of 9" of sewer gravel shall be used in constructing the soil absorption bed. Sewer
gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve.
3.4 The pressurized distribution pipe network, configured as shown on the design drawing, shall be
buried in the sewer gravel such that the bottom of the distribution pipes is no less than 6 inches above the
bottom of the sewer gravel. All piping, including the pressure line from the lift station, the non-perforated
manifolds and the perforated laterals shall be 1.25" diameter, Schedule a,0 PVC. All pipe connections
shall be glued. Each distribution lateral shall have 5/32" diameter holes drilled in the bottom on 2' centers.
3.5 Monitor tubes of 4" diameter shall be installed in the locations shown on the design drawings.
The portion of the monitor tube extending through the sewer gravel shall be perforated.
3.6 Approved Filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum
of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet,
two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in
addition to the filter fabric. Fill slopes shall not exceed 3:1. The final surface shall be neatly graded to ·
· ' smooth contours. Topsoil and seeding is not included in this contract unless separately arranged by the
owner.
4.0' Inspections:
4.1 Atotal of 4 engineering inspections will be required during the course of the project: (1)initial
stakeout with the contractor to establish the location of the system and to discuss the plans, specifications
and construction procedures, (2) after the native material has been excavated to expose the infiltrative
stuface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3)
after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic
tank, but prior to placement of insulation or filter fabric, and (4) after final backfill and grading is
complete.
4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
.Flatt0i5 Technical Services
'" ' 14530 Echo Street
Anchorage, Alaska 99516
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
5
6
8-
9-
10-
11-
12-
13-
14-
~5 ~.#.
16-
17-
18-
20-
~'~tO~ Tec~nlccz] Sez~¢es
14530 Echo Street
Anchoraae, Alaska 99518
MuniclFalit¥ of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street. Anchorage. Alaska 99502-0650
SOILS LOG'~ PERCOLATION TEST
~UE t~/ILLIAH%
L bE/tRHOUN
DATE FERFORMED=
Township, Range. Section: SEC 2.$. TI2
SLOPE SITE PLAN
SILTY .'~ll~bY' LoAM
C,T ^VE .LV SI'T
0
SILT'~ GR~V£LU'I .~ANb
H.~,T£RI~L ~EEHS LooSE
tT tS ~EN~EL~
CO~PACTEb I~
WAS GROUND WATER
~OCK~TS O~ ~F YES, ATWHAT 0
DEPTH? p
. CLE~ER hATERIAL ~.~ Dr~ E
De,ih to Water ~er
Monitoring/ ease:
Reading Date Gross Net Depth to Net
Time Time CPf///) Water Drop
PERCOLATION RATE _-~ /{~ (minules/inch) PERC HOLE DIAMETER
PERPOR~EO ~OR:
LEGAL DESCRIPTION:
2,
3-
4-
5-
6-
8-
g-
10
11
13-
14-
15-
16 - /
17-
18-
19-
· 20-
COMMEN~S
.Flattop Technical Servlcem
14530 Echo Street
Anqlmraae, Alaska 99516
Munlcil~ahty el Anchorage
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG'-- PERCOLATION TEST
T.~I. ~2
L~./ILLIAt4~,
]. I~- DE~I~H0uN
DEPARTMENT OF HEALTH & HUMAN SERVICES
Township, Range, Section: $E¢ 2.%. TI2 H, 1~ 3 Iv'
REDDISH SILTY SANDY LoAM
SLOPE SITE PLAN
WASGROUNDWATER
ENCOUNTERED7 ~0
S
IF YES. ATWHAT
DEPTH? p
E
Depth to Water A/ter I"'fo~ e~or T(~ J)~ Dry
Monitoring? Dale:
Reading Date Cross Net . Depth to Net
PERCOLATION RATE __
(m,nules/mchl PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
PERFORMEDB¥: FLATTOP "~e¢~ ~V¢,~. t ~.~.~c CERTIFYTHATTHISTESTWASPERF(~RMEDiN
ACCORDANCE WITH ALL STA~TE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE;
72-~08 (Rev. 4/85)
PERFORMED FOR:
LEGAl. DESCRIPTION:
1 SPt
3 Sp
4-
5
6
7
8- E.I.I.
9-
I0-
11
1:3-
14-
15-
16-
17-
18-
19-
90-
~attol5 T4chh;c~ S~hricee
14530 Echo Street
Anchorage, Alaska 99518
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street. Anchorage. Alaska 90502-0650
SOILS LOG -- PERCOLATION TEST
~{JE LdlLLIAt4C,
DATE PERFORMED,
Township. Range. Section: ~,cC 2.~" TI2N,
SLOPE SITE PLAN
~ILTY 5ANby ZoAt4
FINE SAIqb SOME SILT
~IL'IY GRAVF-'~.Ly f, Aqb
?oc~:e'ts OF ~L/GH
GILT R~b GRAVEL
WAS GROUND WATER
ENCOUNTERED? · HO
S
IF YES, AT WHAT L
DEPTH? pO
f'lomter T~¢ Dry E
gel)th I~ Water k/ler
Monitoring/ Date:
'd'~ Readlng Date Gross Net Depth to Net
Time Time Water Drop
12'.to; 3o I 22'/r
PERFORMEDBY: FLAT'roP 'TeC~ EV¢$.
ACCORDANCE WITH ALL STA~TE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
72-008 (Rev. 4/85)
PERCOLATION RATE __~-... J (m,nuteu,nch) PERC HOLE DIAMETER C~ ~
TEST RUN BETWEEN ,,, ~ ,O FT AND ,~ *~* FT
CERTIFY THAT TH~S TEST WAS PERFORMED IN
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3-
4-
5-
6-
GH
'7-
8 B.g.
9-
10-
11
}"laitb-~ T68I/nlca! Services
14530 Echo Street
/[hchoraqe, Alaska 99518
Munlclpa"l~ty gl Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0G$0
SOILS LOG'-- PERCOLATION TEST
L I1.~ DE~RHOclN Gib Township. Range. Section: $F--.C. 2.~. TI2H',
REbDI$~I SILTY SANb¥ Lo.qH
51L'r'l ~RAV£LL~t SA,qb
$OPIF
WAS GROUND WATER
ENCOUNTERED?
IF YES. AT WHAT
DEPTH?
13 - Depth to Water After
MonitognO? Oate:
14-
15'-
16-
17-
18-
19-
20-
SLOPE SITE PLAN
E
'~Raading Date Gross Net DeRth to Net
Time Time Water Drop
~ ~0 I:oo: 30 2~ Y~
I:o~: 3o ~ 2~ ~/~ I
*~o I:0~ 2S a/f
PERCOLATION RATE ._~ (mmules/inch) PERC HOLE DIAMETER . "~ ~;
TEST RUN SETWEE. 3.0 FTAND ,30~' FT
PERFORMED By: FL~OP ~CH ~C~. I ~ ~ CERTJFY THAT THIS TEST WAS PERF~RMED iN
ACCORDANCE WITH ALL ~T~TE AND MUNiCiPAL GUiDELiNES iN EFFECT ON THIS DATE. DATE: 7/1 ~/?~
72~ {Rev. ~}
PERFORMED FOR:
LEGAL DESCRIPTION:
PT
I- $~
2
3
SP
4-
10-
11
13-
15-
16-
17-
18-
19-
· 20-
· .~alto~5 Technical Services
14530 Echo Street
Anchorage, Alaska 99518
Munlclpatity pi Anchorage
DEPARTMENT OF HEALTH & IIUMAN E, ERVICES
825 #L" Street, Anchorage. Alaska 99502-0650
SOILS LOG'-- PERCOLATION TEST
~U~ t~ILLIAFt~.
L I~- bE/tl~HouN
DATE PERFORMED:
Township, Range, Section: SEC ~, TI2H,
SLOPE SITE PLAN
BRo~I CRAVELL¥ 5/INb
WAS GROUND WATEn
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
,,,,,,,,,,nr,,,,t
Monitoring? Dale;
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
lin,autos/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
PERFORMEOBY: F£A'r'roP "I'E(~ ~V¢~.~. I _'~r'-..e~.<~.,,,~. CERTIFYTHATTHISTESTWASPERF~RMEDiN
ACCORDANCE WITH ALL STA~TE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE:
72-008 (Rev. 4/85)
REC£1Vi
' OOT 1~ 198~
.ANCHORAGEJWE
D
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL'CONSERVATION
APPLICATION FOR ON-SITE WATER AND SEWER
SYSTEM APPROVAL
I. G~ENERAL INFORMATION
II. WATER SUPPLY SYSTEM ·
~Weil {O~'illecI Or C)tlven) r~ Suffice {Idmntlf¥) rIpr~lt, ~Non. ~ChloHnltion
~/~/ ~ /~' ~/~/
~ ~/~ ~j ~ -- __ ~ ~ ~ /~4 --~ ~ Buyer ~ Engineer
.,,.. c..v ~. ~/~ ~t";'~';~°'' , ../.. a ~...,,,,.,o,~ o.,.
I C~ )f~ lh~t th~ ~bove jnfprmation il corCect:
III. WASTEWATER DISPOSAL
I
New System
O Ownet/S~Jilcler [--I Cectifled Instllle~ ~ Other: I Ty~l/M~.uf~ufe, -- / / .... . .
Minlmum. Gr~ne C~,. ~,c A~orp- I T.nkMinlmum Grou~ CMIr over S~lic CseptlcelflOUTTin~Pi ,UC~S Inlt,ll~ off ~biolel~u~l O~P~ISyS Ifllt,ll~ on
certify that the above information is correct:
Existing System
I~ Owner/Sullder
i-) Pc. i-I Fe~l
IMinlmum G~'ound Cover over Septic Cie&hour PIplk'Clpl Inltelled on I Cieenout Pipe~/CeOi Inltell~d on
_..,,.0,.0,,::.,-.,,.,,.,,,,:,
certify that the above information is correct:
ANCHORAGE/UESTERN DISTRICT OFFICE
3601 C STREET. SUITE 1334
ANCHORAGE, ALASKA 99503
563-6??5
November 7, 1988
Alaska Environmental Control
Services
ATTN: LarDy C. Reid. PE. PhD
1412 Uest 33rd Avenue
· Anchorage, AK 99503
SUBJECT: Lot 14. DEARMOUN SUBDIVISION. T12N, R3U. Sec.
Anchorage 8521-DA-045. 8821-FA-043
Dear Dr. Reid:
The Department has reviewed the Engineer As-built plans fo~ the
subject project. Final approval is hereby given for the sewer
and uater systems and the "Certificate of Approval" for the seuer
system is attached. The "Certificate to Operate" for the uater
system may be issued upon receipt of a current (uithin 30 days)
satisfactory total coliform ~ater test. Any future expansion of
the subject project uill require additional approval from this
office.
Sincerely,
Michael P. Leuis_, PE
Environmental Engineer
MPL:pkk
ENCLOSURE
· ALASRA ENVIRONMENIAL
CONTROL SERVIC,E .~INC.
1200 West 33rd Avenu~ ...'iulte B
ANCHORAGE. ALASKA"'~9503
(907) 561o5040
CALCULATEDBY ~ !'~.4',~
OF
DATE
DATE
/:
C.. mElD,
GREI. . ANCHORAGE AREA BOR'"' H
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MAILING ADDRESS ~J~'P'~ /~/~'s~'~'/' PHONE ..~Y~/-/~/~/
~ NUMBER OF
MANUFACTURER ~ ~ ~/~ATE RIAL ~ COMPARTMENTS
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/~GALLONS.
At'/t'~-~ TOTAL LENGTH 7
DISTANCE FROM WELL ///~ / FOUNDATION f~/'~ NEAREST LOT LINE ~ //OF LINES
NUMBER OF LINES / DISTANCE BETWEEN LINES ~ TRENCH WIDTH ~ ~. TOTAL EFFECTIVE
ABSORPTION AREA ~76 SQ. FT. LEITH OF EACH LINE ~7 ~ ~ 7~;$~/. --
DEPTH: TOP OFTILE TO FINISH GRADE ~ / DEPTH OF FILTER ~ /
MATERIAL BENEATH TILE ~. ABOVE TILE ~ IN.
WELL:
TYPE ~.,"¢~""~/*"/~-~---~ CONSTRUCT ION ~
BUILDING ,! NEAREST NEAREST
FOUNDATION ~ ~ LOT LINE /~ H SEWER LINE
DEPTH /~ DISTANCE FROM:
SEPTIC-- ,/ SEEPAGE ,4~/'/~.
TANK '-~'~", SYSTEM //~/
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED ,~
DISTANCES:-)~t~-4/Z//
INSTALLED BY: ~
SEWER LINE DEPTH:
DIAGRAM OF SYSTEM
PIPE MATERIAL: ~"~"~//~'~/f~z~
LOT SLOPE:
REMARKS:
x,v~./~Yx~J .
DATE * · ·
G.A.A.B.
~ GReATEr ANCHORAGe ArEA BOROUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO,
INSTALLATION OF: SEPTIC TANK ~""~"~/~'"~' =EEPAG[ PiT ~~ DRAIN FI[LD ~ OTH[R
SOIL TEST RESULTS ~ ~/~ NO~; THIS PERMIT IS NOT VALID WITHOUT ~IL ~ST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
~--.,F/-r/~'//v/- /~//~-~'- /'~-/~-'~'~-' ~J~ ~ '/~
DIAGRAM OF ~Y~TEM ~--'
FOUNDATION TD SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
WELL TO sEPTic TANK ,./'Z-'~'--/'"""~----
DRAIN FIELD
DRAIN FIELD
DRAIN FIELD ~- ~
· SEEPAGE PIT . ~
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE
DATE /~"'-/'~'/"~,~ A PPLIOAN,'S SIGNATURE:
GI~"ER ANCHORAGE AREA BOROL~,,~
D~RTMENT OF ENVIRONMENTAL QUALI'!, ----'- "~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING .~.~,,,~.?,,. ,~, ,s~'~PHON
NAME
LOCATiON~~ ~ LEGAL DESCRIPHON ~~ ~P~ ~- ~
SEPTIC .ANK: ~~ ~p.
NUMBER OF
DISTANCE FROM WELL ~ v~ MATERIAl ~ ~--~ CO~PA~EN~S ~
LIQUID CAPACITY ~ ~ GALLONS. INSIDE lENGtH ~ INSIDE WIDTH ~ DEP~H~
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS /// OUTSIDE DIAMETER ~ OR WIDTH
LIN NG MAIER AL ~~ ~'/~l,/,,,~./' . DISTANCE FROM WELl
NEAREST LOT LINE _/~m~*--~At?'~',~9 · . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
· LENGTH ~-~ , DEPTH ~;~ /
BUILDING FOUNDATION~-~ ~
· so. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE
NUMBER OF LINES ~TWE~N LINEs ~ TRENCH WIDTH
ABSORPTION ARE~'''''''~ SO. FT. LENGTH OF EACH LINE~
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE
WELL: ~,~.,,/..,.,~-~--/~'~,~,~fz,~/,,'.~"~- ~',~ DISTANCE FROM /
~PE~ DEPI~//~ / ,BUILDING FOUNDAIION.
SEEPAGE
NEA,EST /~ ~ SEPtiC /~
LOT LINE /~ /~ SEWER UNE TANK ,~ . SYSTEM
TOTAL LENGTH
· OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
~AMI~L~E,"f/~O J,'~ ,NEAREST
OTHER.,
, CESSPOO~ .~/,z~ _ SOURCES~--.~/~
DISTANCES:
DIAGRAM OF SYSTEM
.... ' .....
~. ' '' ,. t
.. :.. . ~.:...
....... .......
GREA'~ ER ANCHORAGE AReA BOruUgH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTAL~TION OF: SEPTIC TANK ~ SEEPAGE PIT ~ DRAIN FIELD
FINANCED THROUGH TO BE INSTALLED BY
OTHER
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
FINAl. INSPECTIONz 24 HOUR NOTICE: RE:QUIRED. BACKFll.LING OF ANY SY~II:M WITHOUT FINAl. INSPECTION BY THE:
HE:ALTH DEPARTMENT AUTHORITY ~Nll.l- BE: SUBJECT TO PROSECUTION.
MINIMUM DISTANCES. REOUIRE:ME:NTS
FOU"OAYION YO SE.'rlc TAHK
FOUNDATION TO SEEPAGE PIT ~'~
DIAGRAM OF SYSTEM
DRAIN FIELD
SEPTIC TANK ~ SEEPAGE PIT ~": '~" DRAIN FIELD
WELL TO ."'.C T^.K SEEPAGE .'T
WATER MAIN TO SEPTIC TANK ~ ~EEPAGE PIT
DRAIN FIELD
~N JNTO~NO OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
GRAVEL. DACKFll-I-
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORA ~AREA BOROUGH ORDINANCE NO, 28-68
OESCRIBEO SYSTEMISINACCOROANCEWITHSAIDCODE, ~~/ '~/~..?~.
AND THAT THE ABOVE
Performed For
"' GP~ER ANCHORAGE AREA BOROUG"'"~
DEPA...;ENT OF EriVIRONMENTAL QUAL
3500 TUDOR ROAD
ANCHORAGE; ALASKA 99502
CASE
Leonard williams
Date Performed 10/18/71
Legal Description: Lot 14 Biock/z~..Subdivision De Armoun J"~w~'.~_._=
This Form Reports Sotls~g x Percolation Test
Depth
Feet Soil Characteristics
Broom silty aand (SM)
Gray rsilty sand with scattered
gravel
Gray. sand (SP)
.Was Ground Water Encountered?
If Ye~, At What Depth?
N
Reading Date Gross Time Net Time Depth to H20 Net Drop
Percolation Minute
Proposed Installation: Seepage Pit x Drain Field
Depth Of Inlet ·Depth To Bottom Of Pit Or Trench__
COMMENTS:
205 souare feet of dra(na~e mrea (s read(red per bedroom with the bottom of the
· ~r)b set at ll feet deep.
Test Performed By R, E, Carlisle Data Certified By:~ational Testtn~ Svs. Inc.-
Date: ~...
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Divlslon 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. # C)l~- ,LI(~- ('~
,1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner .'
Mailing address
Lending agency
Mailing address
Agent NONE
Address
139z~1 ERV~M
q3oo N4'~eoNg ,'
Ct'T"/ -HORT(~AG E
Day phone 3q5'-
/~' '~5~, ." ..,
Day phone.
~ ~ ~.._~ ~ ~' "' e~o2.' -. ". ~'~ :', ·
Day pho~
-
Unless otherwise re. quested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
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.
Se
STATEMENT OF INSPECTION BY ENGINEER
t
As certified by my teal 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 inves.tLqation and inspection, the on-site water
supply and/or wastewater disposal system is .ir~ compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of t.his inspection.
NameofFirm [2LA I ~OP 'T'EcN,
Address 1u~$3o ECHO
Engineer's signature" ~'~/
Phone
Date ~-/'//gV'
DHHS SIGNATURE
"~';~;'i Approv'~d for '~'
AMP
:- Disapproved.
': t: :' Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The D H HS 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. Mun c pality of Anchorage is not
responsible for errors or. omissions in the professi(!n~l eng!nc=~,s. W~rl~.,.
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescription: Lo-r lU~ 'l:)E/~t, lOuN HOI~E~TE'/tb ParcelI.D.
If A, B, or C, attach ADEC letter. ADEC water system number I~.A ·
Date completed [5,~FoRE ~ol"/! Driller
Cased to ~,' ~0 ~ Casing height I~,
Wires properly protected (Y/N) "/
A. Well Data
Well type ~RIV/~TE
Log present (Y/N) ~
Total depth I ~0 t
Sanitary seal (y/N) ¥
FROM WELL LOG
.g.p.m.
AT INSPECTION
Jl~t
Date of test
Static water level
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 15'~
Absorption field on lot 102 ~
Public sewer main ~. leo
Sewer service line '~. I OD
~' "7. g'P'~
1 On adjacent lots
; On adjacent lots '~/00
Public sewer manhole/cleanout ~/0o ~
Petroleum tank NONE
WATER SAMPLE RESULTS:
Coliform (~ ~o(linC) /','~,,~ Nitrate ~,03 ~h~ //~
Date of sample: I/3.1/~q- Collected by:
Other bacteria ~/o,~ ~
FZA'FroP TEcH.
B. SEPTIC/HOLDING TANK DATA
Date Installed II
Cleanouts (y/N)
High water alarm (y/N) ~./~.
Date of pumping
Tanksize 2ooo G. Compartments 2.
Foundation cleanout (Y/N) ~ NC) ~ Depression (Y/N)
Alarm tested (Y/N) ~.A.
~/ I?-. ! 9 ¥ Pumper ~o/~, ~'oo~¢~'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot ~ ~;'5 On adjacent lots ~. Ioo Foundation It-'/
To property line I t Absorption field
Surface water/drainage >'
'~' DOUBLE (:.0. '~£F'ORE TANK ,~iLLO~'£
72-ms (:~3). Fnx, t CONTINUED ON BACK PAGE
C. UFT STATION
Date installed it 1%1 Sa Manufacturer /~ N C tlo~,~G E
Size in gallons tN 2oeo GAl. ~=P'hc 'T~K Manhole/Access(Y/N)
Vent (Y/N) y 'Pump on' level at i'Z ~ - 0"" E~:/.. 'Pump off' Level at
High water alarm level i"z.* -I" G'~'/., Cyclastested 7. fo
Meets MOA electrical codes (Y/N) NO VIO[/~T/OI,,I$ O~S£RVE~
'TA~
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot 1(~3 On adjacent lots
loot Sudacewater ~ Ioo i
D. ABSORPTION FIELD DATA
Date installed ~ III °,t Soil rating (GPD/Ft~) 0.7 System type BED
Length 3 ~ ' Width' 2 o ' .Gravel thickness 0,"/$ ~ Total depth L/. ~
Totalabsorptionarea (o$0 ~'{;~ Cleanoutpresent(Y/N) bio. ~,~-~. Depression over field (Y/N)
Date of adequacy test t I:z I I ~ ~ Results (pass/fail) ~A 55 for 3 Bedrooms
Water level in absorption field before test 0 After test 2."
Peroxide treatment (past 12 months) (Y/N) NeVI ~H O~,~d If yes, give date ~ .t~.
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot I 0 3. On adjacent lots ~./o0 Property line (o0
To building foundation '7(~ To existing or abandoned system on lot ~5' '
On adjacent lots ~. 7o Cutbank N. ~. Water main/service line ~ Io~ '
Surface water ~ IO o ' Driveway, parking/vehicle storage area ~..Eo '
Curtaindraln floN~' O~$E~VE~ " ~.~ '
E. ENGINEER'S CERTIFICATION
I cerb'fy that I have checked, ved§ed, or conformed to all MOA and HAA guidelines in effe~_~og ~e~ of this inspection.
S,gnatu ,..... ....... ..........=.'..[
Date
HAA Fee $
Date of Payment
Receipt Number
72-026 (3/93)' ~ack
Waiver Fee $
Dat~ of Payment
Receipt Number.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HOMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. if
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
0 I~ z.tOI 0'3 HAA #
1. GENERAL INFORMATION
Complete legal description
LoT Id DE~£NaJ~I Ho~'1Es'rE71'b
Location (site address or directions)
A~c~t.
Property owner
Mailing address
Lending agency
Mailing address
Agent ~. A ·
Day phone -3g/'/-lG~! '
Day phone
Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: -~
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
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.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the vaiidation 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.
Phone ~c'.
Name of Firm [:'LATTOP 'I'ECP~
Address 1'-{5'3o ECHo ST,
Engineer's signature ~/"~/'-~ ~,
DHHS SIGNATURE
Approved for
Disapproved.
,·
THEODORE F ~.'~OORE ..' ~
c. -sss; ..'
bedrooms.
Conditional approval for
Date ____~/5' / ~/
bedrooms, with the following stipulations:
By: ' Date
Additional Comments, _
The Municipality of Anchorage Department of Health and Human Sen/ices (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.
Municipality of Anchorage
Department of Health &.Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~- Jut ~)~'/~E~tOU~,/ ~OPtE~T£Ab Parcel I.D. OI~ ~010~
A. WELL DATA
Well type
Log present (Y/N)
Totaldepth tt~O
Sanitary seal (WN)
If A, B, or C, attach ADEC letter. ADEC water system number ' ~.~.
LINK,~o~
I~,
,/
Date completed ;e~'ce~: ;ol~l/ll Driller
Cased to ~ z{O~ Casing height
Wires properly protected (Y/N)
FROM WELL LOG
Date of test ' ";
Static water level
Well flow "
Pump'level
AT INSPECTION
'11 ~ tt,,,~fll~N~r.t,~AL $~vtC'~S D~tStON
AUG - 5 1991
g.p.m. ~ G.~ g.p.m.
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot I~'-~ t
Absorption field on lot
Public sewer main ~/oo
; On adjacent lots '~.
; On adjacent lots
'Public sewer manhole/cleanout ~, zoo ' '
Public sewer servlce line
WATER SAMPLE RESULTS:
Coliform O Co~.o~/Ioo
Date of sample:
Nitrate
Petroleum tank
Colleoted by:
Other bacteria
B. SEPTIC/Id~-BIN~ TANK DATA
Date installed 1!18]~
Cleanouts (Y/N) "//
High water alarm (Y/N)
Date of pumping
Tank size 2. ooo (~, Compartments
Foundation cleanout (Y/N) HO - Depression (Y/N)
~t.A. Alarm tested (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well (s) on lot J 5~ On adjacent lots '~,/oo Foundation I I '7
To property line ii ~ Absorption field ~0 t Water main/service line ~' I~ '
Sudacewater/dralnage '~/oo~ ~"" :" '"" "' "";:' '~
~ Dou~t.E C.o. ~¢F'o~E
I'ANIc ALLO~,S cLEARoNG IN. I~oTR 131EEC?
CONTINUED ON BACK PAGE
C. LIFT STATION
Date Installed
Size in gallons
vent (Y/N)
High water alarm level
Manufacturer
:20o0 CA~. ~;.'r. Manhole/Access(y/N)
"Pump on" level at I'= (r
12 I B6L
Meets MOA electrical codes (Y/N) No VJocA'~loN$
SEPARATION DISTANCE FROM LIFT STATION TO:
Wellon lot - I G~ On adjacentlots
D. ABSORPTION FIELD DATA
Date installed
Length 3~ "Widt'~
Tota absorption area ~0 FT'z-
Dep ressi0n ~ov, er. field' (Y/N)
Results (pass/fail)
"Pump off" level at ~l~-
Cycles tested
Surface water
Soil rating. O,'7. GP=/gr~' System type.
Peroxide treatment (past 12 months) (Y/N) NO
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot 102
To building foundation
On adjacentlots ~'7o
Surface water ~./oo '
Gravel thickness
Cleanouts present (Y/N) t~o -
Date of adequacy test N-/~.
for '~
If yes, give date iq ,.4,
Curtain drain flo.e OE~.$~nvE't,
E. ENGINEER'S CERTIFICATION
O.'7~' Total depth
On adjacent lots ~. Ioo ' Property line
To existing or abandoned system on lot
Cutbank N,~. Water main/service line
Driveway. parking/vehicle storage area
I certify that I have checked, verified, or conformed to all MOA and HAA
Signaturs X
Engineer's Name ~ ~:, o~'o,,~.. ~ ~o~{
V
HAA Fee S /7
Date of Payment
Receipt Number
bedrooms
Date of Payment
Receipt Number
Waiver Fee: $
guide_l~P~effect on the date of this inspection
· .~,O~ ,
.......... , .... ·
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