HomeMy WebLinkAboutT15N R1W SEC 8 LT 2Onsite File
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Municipality of Anchorage
On-Site,rdater and Wastewater Program • (907) 343..-JO4 Page of
ON-SITE !!!WASTEWATER INSPECTION REPORT
Permit Number: OSP161299 PID Number. 051-091-17
Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade
Name:
Jeffery P. Huesers
ABSORPTION FIELD
❑ Deep Trench ❑ Shallow Trench ® Bed ❑ Mound
Address
21434 Blair Avenue, Chugiak, AK 99567
❑ Other
Phone
Number of Bedrooms
Sail Rating
Total depth from original grade
4
0.7 GPDISF
3 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.5 FL
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
2
Fill added above original grade
Varies 0.89 — 2.7 Ft
Gravel length
58 Ft.
Township Range Section
15N 1W 8
Gravel width
15 Ft.
Beds: Number of Lines
3
Distance between lines
5 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
S
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
d
Field
Tank
Line
870 FfZ
. --
-- Ft.
Well
100+
100'+
NA
NA
NA
TANK ® Septic 0 S.T.E.P. 0 Holding 0 Other
Manufacturer
ANCHORAGE TANK
Capacity
1250 Gal.
Surface water
100'+
100'+
NA
NA
Material
STEEL
Number of compartments
2
Lot Line.
5'+
10'+
NA
NA
NA
Foundation
51+
10'+
NA
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
NA
*50'+
NA
NA
Remarks *None known.. Existing field decomm.
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
in place per code. S.T. & field insulated
2' MOA Sand at 3-5' from orig. grade.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Installer OWNER —JEFF HUESERS
Drainfield 3034 CO/MT 3034
Inspector ARCTERRA
BENCH MARK (Assumed elevation) 100 ft
Inspectionda: 1" 10/14/16 10/15/16
Location and description
znd
3'd 10/19/16 4" 10/20/16
Road CL
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL_
Engin
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Conditional Approval: Date
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Approved A,�'R C�!7tlt,> Date 3 i'y 1
��ZSSIot`?Y
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Inspection Keport_9-1-12.coc
AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP161299
LOT 2 SEC 8 T15N R1W SX PID# 051-091-17
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10B No.: 13-199
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10B No.: 13-199
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On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number:
OSP161299
Tax Code Number:
05109117000
Work Type:
Septic Renewal
Permit Effective Dates: October 06, 2016 to October 06. 2017
Design Engineer:
ARC TERRA CONSULTING INC
Subdivision:
T15N RIW SEC 8
Site Legal Address:
T15N R1W SEC 8 LT 2 G1357
Owner/Address:
HUESERS JEFFERY P
21434 BLAIR AVE CHUGIAK AK 995670000
Site Mailing Address: 21434 BLAIR AVE, TRLR 21434, Chugialk Lot Size in Sq Ft: 108900
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy N PrivateWell N WaterStorage
All construction must be in accordance with:
1- The attached approved design.
2- All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions:
1. The location of abandoned absorption fields are unknown. If, during construction, any field is
located, construction of the system will stop and a design change is to be submitted for On -Site
review and approval.
2. One of the wells is to be decommissioned per AMC 15.55 or both wells are to be used to serve
the house.
10161lo- Oy-len-�A-Norl 6�-
Received By
Issued By:
Date:
Date:
MUNICIPALITY OF
Community Development Department
Development Services Division 0*
On -Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907 -343-7997
ON-SITE SEWERIWELL PERMIT APPLICATION
Parcel LD.12S�l - C_>?l -7
Property owner(s) Alu e5yp. 57
Day phone.
Mailing address I
Site address
Legal description (Sub'd., Block & Lot) Z, -T -p '�!/ W
Legal description (Township, Range & Section)
Lot Size _ZaZ�2� Sq. Ft. Number of Bedrooms
APPLICATION IS FOR: APPLICATION IS AN:
(0 all that apply)
TYPE OF DWELLING:
Absorption Field Initial El
Single Family (SF)
Septic Tank Upgrade
(w/wo ADU)
Holding Tank Renewal
Duplex (D).
Privy
Multiple Dwellings
Private Well
(SF and/or D)
Water Storage
THIS APPLICATION INCLUDES A VARIANCE WAIVER REQUEST FOR:
Distance:—
I certify that the above information is correct. I further certify that this
is in accordance with
applicable Municipal Codes.
property owner or authorized agent)
Permit/Rush Fees: — �4 - Waiver Fees:
Date of Payment:
Receipt Number:
PermitNo._.. 0�5p/6/2,29
Permit App_9-1-12.doc
Date'of Payment -
Receipt Number:
Waiver No.
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: OSP131333
Tax Code Number: 05109117000
Work Type: Septic
Permit Effective Dates: September 24, 2013 to September 24, 2014
Design Engineer: ARC TERRA CONSULTING INC
Subdivision: T15N R1W SEC 8
Site Legal Address: T15N R1W SEC 8 LT 2 G:1357
Owner/Address: HUESERS JEFFERY P
21434 BLAIR AVE CHUGIAK AK 995670000
Site Mailing Address: 21414 Blair AVE, Chug iak
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy
Lot Size in Sq Ft: 108900
Total Bedrooms: 3
N Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions: The location of abandoned fields are unknown. If. during construction, any field
is located, construction of the system will stop and a design change is to be submitted for On -Site
review and approval.
Received
Issued By
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 051-091-17
Property owner(s) JEFFERY P. HUESERS Day phone
Mailing address
Site address 21434 BLAIR AVE., CHUGIAK, AK 99567
Legal description (Sub'd., Block & Lot) T15N R1W SEC 8 LOT 2
Legal description (Township, Range & Section)
Lot Size 108900 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(M all that apply)
Absorption Field
F�
Initial F]
Single Family (SF)
Septic Tank
Upgrade M
(w/wo ADU)
Duplex (D)
Holding Tank
Renewal El
Multiple Dwellings
Privy
(SF and/or D)
Private Well M
Water Storage 0
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
N
Permit/Rush Fees: - 530.
Date of Payment: 1%. 11
Receipt Number:
Permit No. c)-> 101 �61
Permit App_9-1-12.doc
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
C-0 _7319
ARcTERRA
CONSULTING, INC
212 E. 5 1 " Ave, Anchorage, AK. 99503
,��,p'00ffice (907) 868-3791, Fax (907) 868-3793
ri NO
October 5, 2016
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: OSP131333 RENEWAL — T15N R1W SEC 8 LOT 2
The owner has applied to renew the septic permit of the subject lot. Per
discussions with you, the absorption bed may be reoriented as shown on the
attached marked permitted design. This is a result of the location of the service
line exiting the house and the configuration of the foundation. This will allow
for a gravity -fed system with a 1250 -gallon septic tank. The septic area is flat and
the testhole is dry. All other permitted design items remain the same.
We do not expect there to be any adverse effect on adjacent lots by the
development of this system. ff you have any questions, please contact me at 868-
3791 / FAX 868-3793.
Respectfully submitted,
M. Western
20441 PTARMIGAN BLVD - EAGLE RIVER, AK 99577-8736 - PH (907) 868-3791 - FAX (907) 868-3793
APcTEP.P.A
CONSULTINC4, INC
f 212 E. 5 1 " Ave, Anchorage, AK. 99503
Offlce (907) 868-3791, Fax (907) 868-3793
September 10, 2013
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit — T15N R1W SEC 8 LOT 2
The absorption field of the subject property is to be decommissioned in place per
code. Subsequently, the owner has requested we proceed forward to obtain a
septic permit to upgrade the septic system.
The general slope of this lot is from south to north at a grade of approximately 0-
5%. On August 23, 2013 a testhole was performed to investigate soils and
groundwater. The results of this test are attached for your review. The proposed
upgrade will serve a 3-bedroorn house. We propose to install a pressurized bed
with sand filter. Groundwater was encountered at excavation and monitoring at
9' and 7.9' respectively.
The property and adjacent lots are served by private water. There is no surface
water within 100'of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3792 / FAX 868-3793.
Respectfully submitted,
ArcTeffa Consulting, Inc.
Kenneth M. Duf P
Attachments: On -Site Sewer Application
Wastewater Absorption System Details/ Site Plan
Soils Log/ Percolation Test
20441 PTARMIGAN BLVD - EAGLE RIVER, AK 99577-8736 - PH (907) 868-3791 - FAX (907) 868-3793
IWELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLA
T15N RlW SEC 8 LOT 2
rmuc- I ur -j
PRIOR TO CONSTRUCTION
DESIGN DETAILS
4 BDRM X 150 GPD = 600 GPD
600 GPD/0.7 GPD PER SO. FT. <SAND FILTER <1 MIN/IN.)= 858 SO, FT
(858 / 15' W x (8.5' GRAVEL) = 58 FT. BED
USE 1 BED - 58' (L) X 15' (W) X 0.5' <ED)
Totat depth of system Is 3' from original, grade,
INSTALL 2' MOA APPROVED SAND AT 3-5' FROM GRADE PRIOR TO ADDING SEWER ROCK
NO PUBLIC WELLS WITHIN 200' OF
PROPOSED SYSTEM,
NO PRIVATE WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED,
NO SEPTIC SYSTEMS WITHIN 200' OF
PROPOSED WELL EXCEPT AS NOTED.
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NOTES1
1. INSTALL 1500 GAL STEP & INSULATE TANK IF <4' COVER.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL.
MIN. 2' FILL WITH INSULATION, >3' COVER NO INSUL REQ.
3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK.
4� CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC...
PREPARED FOR1
JEFFERY P HUESERS
21434 BLAIR AVE.
CHUGIAK, AK 99567
FIELD BOOKS
BOUNDARY. BouN
STAKING: STAKIP
ASBUILT. JLS
D� RLE.
ACAD F�' FILE
COMPUTED:
DRAW: E)mw
CHECKED: KMn
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JOB No.: 1 3_1 99
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WASTEWATER DISPOSAL SYSTEM
T15N RlW SEC 8 LOT 2
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PRESSURIZED DISTRIBUTION SYSTEM HOLE SPACING DESIGN
1. RESIDUAL HEAD = 5'
2. HOLE SIZE = 3/16' = 1.00 GAL. PER HOLE @ 30 PSI
3. 30 GALS (PUMP DELIVERY)/1.00 GALS./HOLE = 30 HOLES
4. 159 LF LATERAL/30 HOLES = 5.3' SPACING PER HOLE
5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS.
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PREPARED FOR,
JEFFERY P HUESERS
21434 BLAIR AVE.
CHUGIAK, AK 99567
FIELD BOOKS
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PAGE 2 OF 3
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WASTEWATER DISPOSAL SYSTEM DETAILS
T15N RlW SEC 8 LOT 2
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PRESSURIZED DISTRIBUTION SYSTEM HOLE SPACING DESIGN
1. RESIDUAL HEAD = 5'
2. HOLE SIZE = 3/16' = 1.00 GAL. PER HOLE @ 30 PSI
3. 30 GALS (PUMP DELIVERY)/1,00 GALS./HOLE = 30 HOLES
4, 159 LF LATERAL/30 HOLES = 5.3' SPACING PER HOLE
5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS,
law q� OF 4,4,1%�
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PREPARED FORi
JEFFERY P HUESERS
21434 BLAIR AVE.
CHUGIAK, AK 99567
FIELD BOOKS
�WNDARY BOU�Nl
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-SBUILT JLS
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ONPUMD:
DRAM: BMW
MEMO: KMD
DAM 9/11/13
MID: NW1357
JM N., 13-199
Scate: 1'= 30'
PACE 2 OF 3
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PRESSURIZED DISTRIBUTION SYSTEM HOLE SPACING DESIGN
1. RESIDUAL HEAD = 5'
2. HOLE SIZE = 3/16' = 1.00 GAL. PER HOLE @ 30 PSI
3. 30 GALS (PUMP DELIVERY)/1,00 GALS./HOLE = 30 HOLES
4, 159 LF LATERAL/30 HOLES = 5.3' SPACING PER HOLE
5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS,
law q� OF 4,4,1%�
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PREPARED FORi
JEFFERY P HUESERS
21434 BLAIR AVE.
CHUGIAK, AK 99567
FIELD BOOKS
�WNDARY BOU�Nl
sTAmNQ STAKI�
-SBUILT JLS
DW. nLE;
AM Fl" FILE
ONPUMD:
DRAM: BMW
MEMO: KMD
DAM 9/11/13
MID: NW1357
JM N., 13-199
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PACE 2 OF 3
WASTEWATER ABSORPTION SYSTEM DESIGN DETAILS
P.I.D. 051-091-17
Permit
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T15N RIW SEC 8 LOT 2
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FINISHED GRADE (ADD UNCLASSIFIED FILL)
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FILTER FABRIC AND INSUL-�
S.T,E,P.
Lift Stat1w
5'--1--- 58' BED
2.5'(typ)—\
1 1/4' PVC FROM TANK TO FIELD
1 1/4' PVC FOR MANIFOLD
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NOTESi 58' 1
1. TANK MAYBE INSTALLED IN 3' OF WATER, HEREBY REQUIRING ADDITIONAL WEIGHT
FOR INSTALLATION.
2. CONTRACTOR WILL ENSURE A BOTTOM OF TANK DEPTH NO GREATER THAN 91 MAXIMUM.
3. FILL OVER TANK WILL BE CLASSIFIED AND COMPACTED TO 95% DENSITY
4. TANK TO HAVE A MINIMUM OF 2.5' OF COMPACTED COVER.
5, CONTRACTOR TO VERIFY GROUND WATER AT 8.0' FROM SURFACE OR GREATER.
6. GROUND WATER LESS THAN e.0' MAY REQUIRE ADDITIONAL SADDLE WEIGHT.
7. MOA APPROVED MATERIAL TO BE USED FOR SAND FILTER.
PAGE 3 OF 3
PREPARED FOR1
JEFFERY P HUESERS
21434 BLAIR AVE.
CHUGIAK, AK 99567
FIELD BOOKS
BOUNDARr.
STAXINQ NA
ASBUILT: JLS
Om. FILE..
ACAI) FILE:
COMPUTED:
DRAM: KMD
CI-IECKED1 BMW
DATE: 9/11/1
GRID: NW135�
" No, 13-199
Z:\Slo�e\WELL & SEPTIC - Filed by Legal\Sawarci Meddian\TlStl, RIW\See. 8\Lot 2\dwg\ft-9 for detidgrAwg
FRI
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53 LF 1 1/4' PVC W/3/16- HOLES
2 5.33' SPACING (TYP)
M. T,
T
Lo
—I
G,d.
NOTESi 58' 1
1. TANK MAYBE INSTALLED IN 3' OF WATER, HEREBY REQUIRING ADDITIONAL WEIGHT
FOR INSTALLATION.
2. CONTRACTOR WILL ENSURE A BOTTOM OF TANK DEPTH NO GREATER THAN 91 MAXIMUM.
3. FILL OVER TANK WILL BE CLASSIFIED AND COMPACTED TO 95% DENSITY
4. TANK TO HAVE A MINIMUM OF 2.5' OF COMPACTED COVER.
5, CONTRACTOR TO VERIFY GROUND WATER AT 8.0' FROM SURFACE OR GREATER.
6. GROUND WATER LESS THAN e.0' MAY REQUIRE ADDITIONAL SADDLE WEIGHT.
7. MOA APPROVED MATERIAL TO BE USED FOR SAND FILTER.
PAGE 3 OF 3
PREPARED FOR1
JEFFERY P HUESERS
21434 BLAIR AVE.
CHUGIAK, AK 99567
FIELD BOOKS
BOUNDARr.
STAXINQ NA
ASBUILT: JLS
Om. FILE..
ACAI) FILE:
COMPUTED:
DRAM: KMD
CI-IECKED1 BMW
DATE: 9/11/1
GRID: NW135�
" No, 13-199
Z:\Slo�e\WELL & SEPTIC - Filed by Legal\Sawarci Meddian\TlStl, RIW\See. 8\Lot 2\dwg\ft-9 for detidgrAwg
FRI
?�CTERy 'I
lop
AALP.cTERRA
CONSUI,TING, INC
212 E. 51" Ave, Anchorage, AK. 99503
Office (907) 868-3791, Fax (907) 868-3793
Ar�
01' A44
�01 T H*
4 T— -
KENNETH—TrIDUFC-
Ale
SOILS PERCOLATION TEST
Performed for: Jeff Huesers DatePerformed: 8/23/2013
Project: T15N RIW SEC 8 LOT 2 TEST HOLE # TH 13-1
Depth
ORG/01,
GW / sw
Water percolated/absorbed
rapidly in gravelly / sandy soils.
B.O.H.
12-
13-
14-
15-
16-
17-
18-
19-
SAND FILTER REQUIRED
20 -
SEE ATTACHED SITE PLAN
C
FOR HOLE LOCATION
Was Ground water encountered? YES What depth? 9'
Depth to water after monitoring? 8.1' Date? 9/10/13
Readiug
—
15-a—te—
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
8/23/13
1:00
6"
-
2
—
1:01
1 min
dry
6"
3
1:02
6"
-
4
1:03
1 min
dry
6"
3
6
7
After 20 min still unable to fill hole
8
9
10
12
*
Water
Added
Percolation Rate < I (min/in) Perc Hole Diameter 6"
Test Run Between I feet and ___A_feet
L Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
M~JNtCIPAIJTY OF ANCHORAGE
DEPARTMENT O,F NEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telel~hone 264-4720
ON-SI-['E SEWAGE DISPOSiAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
[~N EW
UPGRADE
~A_~'I Z¢&, H A E l
MAll_lNG ADDRESS
LEGAL DESCRIPTION
LOOATION
~Liq ~R
Abso~tion area ]' ~welffng
Material
Inside length
Dwelling
Well
DIS-FANCF TO'
- /Uc> ~ j,~
u~h' ]C~:c~ty in ga o s
'j .,) ~(,) IF HOMEMADE:
DIS YANCE TO:
Yap of tile to finish grade
Type of crib Crib diameter
DISTANCE TO:
Building foundation
DISTANCE TO:
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALl. ER
REMARKS
t Ma't ~rial
Foundation Nearest lot line
Total length of lines T~en~
Material beneath tile
NO, OF BEDROOMS
72 013 (Rev. 3/78)
APPROVED DATE LEGAl.
'koa6:~ 9/~9- ~9' tJk2Zz. 0:,'/-°- ~,r~?,
Crib dept,h.. Total effective absorption area 7 )~ ¢:t~ ~ ~' ~ '/
Bu lclinq, foun/o~Jation Nearest lot line '9:~ ~., ,I
Driller Distance to lot line PERMI~,
Sewe~ line Septic tank Absorpt on mea(s)
PERMIT NO.
No. of eompQ~tm.nls
Liquid depth
PERMIT NO.
Liquid capacity in gallons
DEPAF(TMI~IqT OFiFIEAL,TH AND ENVIRONME]qTAL,. F'RO]'ECTIOIq
825 L 8TREEI', ~NE;I"tOI::dtI3E, AK 99',50 1
264-4720
I::'EF~M I T NO; 84" 7:] 6
DATE ISSUE:D: 08129184
APF'I... I [;ANT',
ADDRESS:
CONTACT PHONE:
LEGAL. DL.,. L, Fd, I .
L,O'T EiIZE:
LOT L. ElbAI tON.
MAX BEDF~O[IMS:
MICI4AEL. E CURI=¢Y
SR :1. BDX ~.267~
CHU(~IAI<~ AK i99567
688-9642 ;
,A. IE D .I. V 1 ,~ r ON ,,
..*E[.] ION. 8 TOWNSHZF:':
.... 5A (~>g..l T. OR AE, I~E,,~)
BL. AII~
LDT ~: 2,
RANGE: IN
El I)(,I., NA
Lis'Led belclw are the clpt:Lc)nsi available
sysLe?m. Choose 'Lhe c~p'L:i.~n thai{ best f.~.'L~.~
'E~, Eg] ][}
DEF:"TH TC) F:'IF:'E BOTTOM (F'"T,.)
GRAVEl,. DEF'TH (FT,.)
'l"Ol'Y~L DEPTH (FT.)
(3R~VEL N]:D'I'I"i (F:'T.)
GRAVEL. L..ENDTH (FT.)
GI:~AVEL VOL, LIME ([',lJ, YDS. )
TANI< SIZE (GALS)
SOIL. RAI'ING (SQ.FT. /BR)
5 ,, 5 .~,,.~
0,, 5
4,, 0
1'7.0
:3zl,. 0
2:1,. 5
0()0 ~ 0 .~...x~
125
~'~ DEPTH TO PIPE: BO'T'"r'OM < 4.,() F:'T,, FlAY REQLJIRE A L. II::'T S"I"AT]:ON'
,~.~,, T'ANK MUST HAVE AT LEAST: TWO [',[:IMF'AFCI],IEI,,ITS
I cer'Lify 'Lha't.:
1. t am familiar with 't.i]e i~equ:i, rEmlerrLs for on-site ,=:,.,(..w~...*r,:'.~ and v,m~].].s as set
fat"Lb by 'Lhe Mur~ic:il~l:i.{y eM' Arlct'~c~rage (FIO~) and 'Lhc~ State o~ Alaska,
,=")'.I wi].]. :i. ns'Lall 'Lhe ~yste' m J.r'l aC[:l:l]l"d~':u]ce wi't.h all FIOA c(::ldes and r, egulat:i.c]r~s.
and :Ln c:c~mp].iance with ~'t. he cies:i.~r~ c:riteria c:H' this pe)rmJ,'L.
· .,..~r,, Z w:LI1 adhere to ax].]. MOA al"id S'tal..e eli Alaska I"~H:]L~ir~z,~fll~w~t~ i'CH' '~..h(.] set back
seweH-ag~ ~{;yst. e~m C)l"l 'Lhig~ lip arly ac:l,jacerYL or i]e~lr'by ].ot.
4. I LLl"lC]e)P~3'~Lal~d 'l~hat 'LhJ. s pel'mJ.t J.s valJ. d lop a maximum c)f 3 bedrc)c)ms arid
any en].argement will rE~qL~J, re an addi'Lional
IF: A I...]:1=']" STAI"ION ].,:~ INSTALL.ED IN AN AREA []]VE:RED BY MOA BUI[ DING
THEN (1) AN L.I....EL, II-~.[L.,AL. I~ERId.I.T AND INSF'ECTI[IN MLIST BE (]BTA:I:NED; (2) A,.) LLJ].I_..I,.~
WIL..L NOT BE AF'F'ROVED WI"I'HOUT AN F~I....[:[]TF~I[}AL INSF:'E[]TIOIq RI~:F:'OF~T; AND (3)
EL.E[;TR I CAI_. WORI< MLIST BE DDNE~ BY A L I CENSED ELEL, I I-~.[[,].AI I.
C:..~. ,..., ,.... ~-.~ ............................................................................................................
AI=I::'L I CANT: M I C:}I'"IAE[L, E ~E;L.~/~
PERFORMED FOR:
LEGAL DESCRIPTION:
4
SOILS LOG
MUNICIPAI. ITY OF ANCHORAGE
DEPARTMENT O~ HEALTH AND ENVIRONMENTAL PROTECTION [] PERCOLATION
TEST L
825 L. Street,i Anchorage, Alaska 99501 264-4720 (~ ~_~ ~7~
SOILS LOG - PERCOLATION TEST
i I SLOPE SITE PLAN
10,
11
13
14
15
16
17
18
19
20
~VAS GROL)ND WATER
ENCOUNTERED?
DEPTH?
Gross Net Depth to
Reading Date Time Time Water
PERCOLATION RATE
COMMENTS
PERFORMEI) BY: ~-[~lJr ~ ~0e M0~ ~'m¢CERTIFIEDBy:
(minutes/inch)
~ - FTAND ~ FT
~./'~ la~'oY,¢~ ,~r~,e~/ .~.o '~ ~r~1'
72-008 (6/79)
F
MAll lNG ADDRESS
LEGAL DESCRIPTION
LOCATION ~ ~-A i~
DISTANCE 'FO:
Manufacturer
IVlUNICIPALITY OF ANCHORAGE
I ' N
DEPARTMENT OF FIIF. ALTH & ENVIRONMENTAl. PROTECTIO
ENVIRONMENTAL ENGINEERING DIVISIQN
825 L Street - ~nchorage, Alaska 99501 Telel]hone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
' PHONE
Ne. OF BEDROOMS
(~ C~, IF I IOMEMAD E:
DISTANCE TO: W:II
No. of lines nfiti~ of eacE line
I Absor ption~ ~.~e~ [Dwelling
Material
Width
PERMIT NO1
Material beneath tile
[-[~.~ EW
UPGRADE
Distance between lines
inches
PE IT NO.
Length ,~ &J-/ WidtE ~ ) Depth
Type of crib Crib depth
DISTANCE TO:
DISTANCE TO:
Bui[dinfl leu ntlation
Drifter
Sewer line
:rib diameter
DeptE
Bui}ding foundation
Total effective absorption area
Nearest lot line
Distance to lot line
Septic tank
OTHER
PiPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
72-013 (Rev. 3/78)
DEPARTMIENT' []FI HEAl_TH Ah. ID I:.':NVT. IRDI~II~IE:.NT~I.~ PIROTECTtOI\I
8R5 L,~. ST'IREET~ ANE',HORAGE~ AK 9950 1
264......Zl. 7270
PERM :IFT' NJ):
DATE ISSUED."
A F:~F:'I... i C AI',I'Iu
ADDRESS
CONTACFI" I'::'I~IOI~E~:
I .E:.'E)AL
LOT SI
LOT I....OCA'I' I 0 N ,",
MAX BI.~]DRCIOMS:
688-9642
SUBb I VI S',I:DN: ! NA
8E:[.~T I OBI: ~] TOWNBH I P:
2.5A (f~E,!. f:r]' . 01:~: ACRP]'~ )
3
LOT: I:!: :./2-2'. BL..OCI., IqA
15N RANGE: :LW
l....is'Le.d be].ov~ ar'e 'hh(~ opt:i, cmt~ ava:i, lable '1:.o you J.i-i de.,s:i, gning your' sept:Lc
DEF:'TH TO F:'IF:'E[ BOTTOM (F'T,,)
[i';RAVEL t)li!{l:~"l'l-{ (F"]",)
'I"OTAL, DEPTH (F'T.)
GF~AVEI..,. WIDTH (F'I".)
GRAVE]_ LEN[3TH (FT.)
GRAVEL VOI..UI~E (CLI, YDD. )
TANI< SIZE (GALS)
SOIl.. F~A]"IIqG (SD. FT. /BR)
~'* DEF:'TH TO F ].F I:; ]BOTTOM ".. 4.0 FT. MAY REQUIRI~.: A L. IF'/ S]'A"I*IOIxl
.x-.*. TANK MUS]" HAVE AT LEAST TND E;OMP~RTItEIq]'S
I certify that:
:J,,, I ~111 f'am:i, lJ.a[' with the r'~equi~'emen'hs for' ore-'site s~;~wel"*~, and we].ls a~ set
for, th by {lie I~lL~rl:i. cil::Ja].i~Ly of Ang:hoPage (MOA) ar'id the State c:)[ Alaska.
......I w:i,].l ins'Lall the system J. rl accordance ~:i. th all MOA codes:; al~d r'~L, gu].at:i, cJns,
arid ir1 cc:)mp],iancca w:i, th the design Cl'J. tel'ia o[ this pePm:i.t,,
,.,:,.I w:L].l adher'e to a],:l. MOb and .Lat~= o~' Alasl<a r'equir'em(,~]l'~rf~.s roi" 'hhe set back
4,, ]: L,u"~dePs'Lal-ld tl'~,~h this-pepm~,'l'. :Ls va],:i,d J'oP a m~::u~:i, mum (::)t .... .., bedr'oc~ms arid
any enlapgement wil:l, pe~::lui~e an add:i.'Lional per'mJ.t.
,[,~ IN.:~IALL.,E,D IN AN AREA COVERED BY MOA BUILDING CODE.,..,h,
].N,:)I I::(.I ION MIJST' BE OBTAINE]); (R) A,,~ ~UJ, L.].~
NIl..I.,, NOT BE AF'F'ROVE~D WI'T'HOU]"~ AN EI..E[,,TF~IE, AI_ ]:NSF'Iii[FI'ION ft[CI..O[~], AND (..:,) ]"HIE
E.I..E:L, FI~IL, AL.. WORK MUST BE DEllqEi BY A I_ICEIqSED ELECTIRI[XI:AN.
S ]: GNED
AF)PI_ I CANT
1. ,:~,.:ILI[L D ElY
PERFORMED FOR:
,..A,. OESOR,PT,ON:_..
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
~ots'r', 5ot:7'
4
§
6
7
9
10
11
12
13
14
15
16
17,
18-
19-
20-
SLOPE
WAS GROUND WATER
ENCOUNTERED?
iIF YES, AT WHAT
iDEP'FH?
$OI LS LOG
PERCOLATION
TEST
SiTE PLAN
Reading Date Gross Net Depth to
'rime Time Water
COMMI:'NT8
gERCOLATION RATE (minutes/inch)
g~ ~K ikO ~,~, ~r__~TiTEST RUN BETWEEN ,~--,..~,. FTAND
72-008 (6/79)
Gr�ZATER ANCHORAGE AREA BORO?tC7H
( I
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA "501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
SEPTIC TANK:
DISTANCE FROM
rIN? 631
OF
I s-loyck, 5v�nl- Zan" 16t-.5-06 LIOUID
LIQUID CAPACITY 157)(2 GALLONS. INSIDE LENGTH -INSIDE WIDTH -DEPTH -
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH LENGTH DEPTH fl�
LINING MATERII I/^- DISTANCE FROM WELL AZL6612 /1101 BUILDING FOUNDATIOme2
�12�-
NEAREST LOT LII JIVE ABSORPTION AREA (WALL AREA)— 55 f —SO. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF
ABSORPTION
BETWEEN
FT. LENGTH OF EACH LINE
NEAREST LOT
TRENCH WIDTH
TOTAL LENGTH
OF LINES—
EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE—IN. ABOVE TILE—
DISTANCE FROM WATER
TYPE ZrQt/ /Ld DEPTH BUILDING FOUNDATION. --SAMPLE NEAREST
NEAREST E SEEPAGE,,O�m. OTHER
S P"��� 0
LOT LINE SEWER LINE-7ANK . SYSTEM CESSPOOL—, SOURCES—
DISTANCES:
/vczll'=_-
a-wx z lFb
S.C., / cw"Avx.��
.0 C-44 L41- n�!e.
e5- 0
DIAGRAM OF SYSTEM
DATE APPRGVED�
2/2/7/ Y HEALlrAUTHQRllY
If I j/ /
ro� (00)
GREATER ANCHORAGE AREA BOkt3UGH
DEPARTMENT Of ENVIRONMENTAL QUALITY PERMIT NO. ll!�Sa
3500 TUDOR ROAD POUCH 6.650
ANCHORAGE. ALASKA 99502
TIELKINONE 279-6686
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT kfl P r/l 1 el k �/ I 'n fj 1-1 — MAILING ADDRESS . 'd I PHONE
INSTALLATION LOCATIONA-P -� 13 /5 to erV Lo a e 13 11 r- to 1) t, , ll�l e) IQ
LEGAL DESCRIPTION 14-t V, Y E / "T A/ / if) IS- zj'
INSTALLATION OF: SEPTIC TANK P�
PIT lf� DRAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO 13E SERVED
FINANCED THROUGH S � Z r- TO BE INSTALLED BY Y7 C7 dj "160"k )E Y(7.t7 V
SOIL TEST RESULTS 91- -�2 NOTIEt THIS PERMIT IS NOT "LID WITHOUT SOIL. TIEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
. I - --L
sEpTicTANKSIZE AWl) TYPE ',�A-'ek SEEPAGE AREA SIZE TYPE '15g
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT
SEPTIC TANK — SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK -----------
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK. — SEEPAGE PIT
TO RIVER. LAKE. STREAM.
DRAIN FIELD
DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIS CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
A INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
41 e �7
-4:-41L -- � ;W'C�
HEALTH AU MORITY
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE — APPLICANT*S SIGNATURE