HomeMy WebLinkAboutMOUNTAIN PARK ESTATES #2 BLK 7 LT 3Mountain Park
Estates #2
Block 7
Lot 3
#017-432-13
Municipality of Anchorage
Development Services Department
\ Building Safety Division "
Onsite Water and Wastewater Program. 4700 Bragaw St.
P.O. Box 196650 Anchorage. AK 995198650 Page of
t~v.d.anchorage.ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number.
SW070171 PID Number. 017132-13
N.na Todd and Anna Venhulzen Wastewater System: ❑ New ❑ Upgrade
«I 12640 Foster Road Anchorage, AK 99516 ABSORPTION FIELD
plate. 2271762 N t w a eabownr 3 p Daap Trarrdr O SWa Trawl peal O rata 001W
Sad R.4n7 Taal Doan Iron arpnr Pada
LEGAL DESCRIPTION Existing GF'dF2 Fl.
Dept to ppe txac, lmm agtr Waaa 43 w asp, aanaat pM'
soft 7 ua` 3 saean+.� Mm. Park Est. No. 2 FI. Fl
Fn exact somea nN W� Gram LWVM'
Toanrp Raga Samar FI. Fl.
nrnr.ian Nuncaaara Dranea oawaalanw�
Well: ❑ New ❑ Upgrade
c:aaadum (pinna. A. a C) Tar 6 ca 1
Existing Fl.
SEPARATION DISTANCES
To
From
Septic
Tank
Absorption
Field
LM
Station
Holdin4
Tank
vw
>100'
>100'
NIA
NIA
solace was
>100,
>100'
NIA
NIA
w fur
>T
>10'
NIA
N/A
FaFaaaan
>5•
>10'
NIA
N/A
Gal.n Dr.t
None
Noted
Ranuae
see"Waiver From Wells to Septic Tank.
Fr ar
88tH eR1r.K Data lnr
Fl. John's Excavating 7/2/2008
0C' TANK
FL
0 Septic ❑ Holding ❑ S.T.E.P.
TWU�diUPnvate —
SewerLine Anchorage Tank
mwW
>25' 1 Steel
LIFT STATION
Gr
W
M
BENCH MARK
r� Louum as a!fWltn1 . �-
Garage Slab , , , ,1, ..
❑ Other.
pzty
1,000 Gr
Norma Of z;;;.
—
TWO
n
100.00 FL
u1 i
� 9
s a
►'� .••••••aa 1
Inspections performed by: A. Harala Dates: 1 r -. 7/2812007 A, �Q�,• ;95�1�
2nd 7!2812007 .;.I w !7. �'•'F���
49�
Development Services Department Approval .. o
Conditional Approval Date: • •"'•• •• 00
• 1r4 AFUCHAEL ! ANDERSON . 4' e
Reviewed and approved
pw o i,
Date: �%
Municipality of Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
Permit No.: SW070171 On -Site Wastewater Disposal System or Well Inspection Report PID No. 017.432-13
19.032 S.F.
MOUNTAIN PARK ESTATES
SUBDIVISION NO. 2
BLOCK 7, LOT 3
N O(T03431 IU4.J
to' Utility Easement
ExisUna Aheorotion Trench
Existing Tank Pumped
Crushed and Removed
From Site.
Three Bedroom
Home
NOTE: Septic Tank Replacement Only N 00'02'11'W 103.89'
Under This Permit.
49th
......................... .....
� NICIInEL E. ANDERS13N p
„A'., No. CE -4961 ; [�
19
Existing Well
_FOSTER ROAD
PLAN AS -BUILT
SCALE V = 30'
A B
81 29 55' 26 Str
82 135.20-1 30.55'
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
Onsite Wastewater Disposal System or Well Inspection Report
Permit Number. SW070171
Existing &
Finished Grade
— 97.0
N M
V) 1� U U
L11,/0Gallon
Septic Tank
1.7 1.55
/
PID No. 017-432-13
Tank & 2 Post Tank Cleanouts Placed Under This Permit.
Existing Tank Pumped, Crushed and Removed.
PROFILE AS -BUILT
No Scale
MUNICIPALITY OF ANCHORAGE 16p
Development Services Department
On -Site Water d Wastewater Program
4700 South Bragaw Street Irak
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 20, 2007
Expiration Date: Jul 19, 2008
Permit Number: SW070171 Parcel ID: 017-432-13
Legal Description: MOUNTAIN PARK ESTATES #2 BLK 7 LT 3
Design Engineer: 0014 ANDERSON ENGINEERING Site Address: 012640 FOSTER RD
Owner Name: TODD & ANNA VENHUIZEN Lot Size: 19032 SO. FT.
Owner Address: 12640 FOSTER ROAD Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE, AK 99516-3229
This permit is for the construction of:
❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
���►/dL/LLl�/�CTTi'i�G///%�
Date: 7 2,3 -z
Date: Z
Municipality of Anchorage
• v
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-432-13
Property owner(S) Todd and Anna Venhuizen Day phone 227.4762
Mailing address 12640 Foster Road Anchorage, AK Zip Code 99516
Site address 12640 Foster Road Anchorage, AK Zip Code 99516
Legal description (Sub'd., Block & Lot) Lot 3, Block 7, Mountain Park Estates Subdivision No. 2
Legal description (township, Range & Section)
Lot Size 19.032 Sq. Ft.
THIS APPLICATION IS FOR (® all that apply):
Absorption Field
❑
Septic Tank
0
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
pa
Number of Bedrooms Three (3)
THIS APPLICATION IS AN:
Initial
❑
Upgrade
El
Renewal
❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
E
(Signature of property owner or authorized agent)
Permit/Rush Fees: 1/60 _ r) O Waiver Fees:
Date of Payment: 4 l R 1 OT % Date of Payment:
Receipt Number. Receipt Number.
(Rev. 11/05)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
July 17, 2007
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 7, Block 3, Mtn. Park Estates Subdivision No. 2
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The septic tank on Lot 7, Block 3, Mountain Park Estates Subdivision No. 2 is failing
and must be replaced. We are proposing to replace the tank with a new 1,000 -gallon
steel tank to serve the three-bedroom home on the lot. We are therefore requesting a
permit be issued for the construction of a new septic tank to serve the home. The
attached Site Plan and backup documentation identify the location and configuration of
the existing septic system and the location of the new tank. Also identified on the plans
is the existing well on the lot. The new tank will be placed in the same location as the
existing tank approximately 28' from the foundation. The existing tank will be properly
disposed on the property or removed from site. The drainage patterns will be
maintained after construction.
The ground surface on the lot slopes at shallow grades. The new septic tank will be
constructed near the location of the existing tank and as parallel with the slope of the
land as possible in conformance with Municipal requirements. The new septic tank will
be constructed a minimum of 100' from the existing well on the lot and those on the
adjacent lots and will not conflict with other facilities 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
Lot 7, Block 3, Mountain Park Estates No. 2
July 17, 2006
Page 2 of 2
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,
-Mj' .QL E
Michael E. Anderson, P.E.
Attachments
V:I.AC E. AVCgSCV
M VYq �Y
~.�1N Iwo
t
Th BYdr
onw
e.+Y err, r
err r
Y OVOYI,b 16M1.'
FOSTE OAD
D
40
�. ••
�...
.....nom .....................• AREA MAP
� '; RIGNEL E AN➢ERS&
•� f'•., No. CE a3ei SCALE 1' = 50'
MOUNTAIN PARK ESTATES SUBDIVISION NO. 2
BLOCK 7, LOT 2
to.= SY.
L
NOTE: Septic Tank Replacement Only
Under This Permit.
N 01r0a 4314 104.33'
10' Utility Easement
I .
Existing Absorption. Trench
to Remain in Service
Remove Existing Tank
Place New 1.000 Gallon
Septic Tank and Two
Post Tank Cleanouts
T
I 29'
Three Bedroom
Home
Existing Well
N 00'02'11'W 103.89'
FOSTER ROAD
SITE PLAN
SCALE V = 30'
Verify Existing Foundation Cleanout
Place If Necessary.
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 3, BLOCK 7, MOUNTAIN PARK ESTATES SUBDIVISION NO.2
GENERAL:
The scope of this project includes the pumping and removal of the existing
septic tank on the property and the procurement and placement of a new
1,000 -gallon septic tank at the location shown on the Site Plan. Work also
includes the placement of two post tank cleanouts and tieing the new tank
into the existing absorption trench. The new septic tank must be placed a
minimum of 100' from all private wells and any surface water in the area and
10' from the water service line from the well. A minimum of 4' of cover is
required over the septic tank. The foundation cleanout must be replaced if
one is not found on the property.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Department of Health and Human Services for system installations.
Owners installing their own systems must receive prior approval from
D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
A new 1,000 -gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
Lot 7, Block 3, Mountain Park Estates
July 17, 2007
Page 2 of 3
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION: - EXISTING DRAINFIELD TO REMAIN IN SERVICE
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield area minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. Contractor shall verify this condition prior to placement of the
rock. All pockets of unacceptable materials must be removed and replaced.
Lot 7, Block 3, Mountain Park Estates
July 17, 2007
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as -built of the completed system.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
' •` ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
3qq- /fao7
❑UPGPGRADE
MAILING ADDRESS Q
gRlq— fJ�3SS
LEGAL DESCRIPTION ten,, ,� % q� -
l_ -3 " �'%' v( ��t C 6 1
LOCATION
NO. OF BEDROOMS
V
DISTANCE TO:
Well
Absorbtion area
/
Dwelling /
PERMIT NO.
Y
UJ Q
F
Manufacturer ��
Mate rjalt
e 2?�l
No. o,� compartments
p�
w
Liq. capac�it ingallons
IF HOMEMADE:
Inside length
Width
Liquid depth
6 Y
J Z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
02<
zF
Manufacturer
Material
Liquid capacity in gallons
O
w=
DISTANCE TO:
ell
W:5
Foundation /
Nearest lot line /
/Ci
PERMIT NO.
76 CiO,�(O
J LL z
FZW
No. of lines /
Length of each line
/
Total len th of�lines
Trench wid/h
irk
Distance between lines
FTop
C
of tile to finish grade r /
J
Material beneath tile
f,
�� inches
Total effective absorption area
W
a
Length
Width
Depth
PERMIT NO.
Q I—
as
W
Type of crib
Crib diameter
Crib depth
Total effective absorption area
LU
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line7
ERI�41,TjVQ„O O
l �Cjj CC//
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING 1500
INSTALLER
Z 8
REMARKS
o
/
0
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
L -S
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825 L_' STREET.. ANCHORAGE.- AK. :a,+` t i L
264-4720 (v
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PERMIT t',IC+. 780040 ::'
li'1S
t' OSE PENDEE?GF:FI_ S __RA BCi?<, J_535B ":4_+ 420T'
LciCWFIOI',l t'1'T PARI-::.' E__
LEGF-11.. L= Br MT F'ARf.EST LCAT SIZE _;i=gJARE: FEET
'1`W:'E OF SOIL ABSORBT I Ot•? SYSTEM I S : TTREr•?i_ I•-1
f1fi; It'II_if1 r•?i_IME.'EI: OF BL"'C:ROOt'!_=; = 4 SOIL RATING G UD FT,'BR::= J_F-50
THE REC!I_I I RED SIZE OF THE _OIL HBSOF:F'T I Cq'•? o'•r'STEt'1 I'S:
�.._:
F__ - T " ::_;: L—. E_'- PA ®_� 7+4 _•-- '_-L fl:: -'CI:._ R__3I IFZ FA a°°°° CH, Ca E_ F.--, T 11-41 = =
THE LEN13 T H D I MEr•?_; I Or'? is THE LENGTH (IN FEET) OF THE TF::EhI H OI=: L.)RA I r•?FIELD.
THE: C:EPTT1 OF H TRENCH OR PIT 7:E. THE DI'_;TFIt'?i_:E BETWED-? THE SURFACE OF THE
Gil :iii)tfC! Ht•?C, THE BOTTOM OF THE E:>;C:RVFlTION M4 FEET).
TT-IERE_. I NO SE.T b.IIDTH FOR TF?Er•?C:1-IE_::.
THE GRAVEL. DEPTH IS THE MINIMUM DEPTH OF GIFa-VEL.. BETWEEE:r'? THE OUTFALL F`IF'E
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January 5, 1978
Mose Pendergrass
Star Route A Box 1585B
Anchorage, Alaska 99507
SubjectaLot 3 Blo ountain Park Estates Subdivision
Permit #77560
Lot 2 Block 7 Mountain Park Estates Subdivision
Permit #77559
Lot 7 Block 8 Mountain Park Estates Subdivision
Permit #77561
A permit issued by this department for well and/or sewer
system has expired.
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 should be sent
to this department to document the installation date.
If there are any further questions, please contact this
office at 264-4720.
Sincerely,
health and Environmental Protection
Sewer and Dater Section
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• _ Municipality of Anchorage
On-Site Water and Wastewater Program
(907) 343-7904rid.
Certificate of On-Site Systems Approval a AUG 1 2017
_e4=1=4A7H in
Parcel I.D-9+51427r- Expiration Date:\ 92---7-tAr
C� 17 - 93z - (3c,
`� L
1. GENERAL INFORMATION:
Complete legal description MOUNTIAN PARK ESTATES#2; BLOCK 7, LOT 3
Location (site address) 12640 Foster Rd.*Anchorage 99516
Current Property owner(s) Anna&Todd Venhuizen Day phone 907-244-0604
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
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 ❑
i
WaiverNariance request for: 10 l hifl 1--D ev Distance: if
Received by: Date: S b_ t
COSA to be release• to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Waiver Fee $ !
Date of Payment g i I1 I(� Date of Payment g J(l 117
Receipt Number Ctia: a"k Receipt Number O
ir
COSA# 0(-)C[1 13( D Waiver# asv ti 1 i (YES
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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date: 8IlSi'
4�oo4p�.,
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o 0 rrA
in accordance with the guidelines and regulations established by the Municipality of Anchorage and � .• • oc_ 4
industry practices. The reported results describe the condition of the system/s on the date/s of the ' •• Qn
evaluation. Separation distances were measured to readilyidentifiable features. Hidden defects or Vn
encroachments may exist that were not identified during the evaluation. The operational life of all wells 9 / ` 37l vDn
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, V
groundwater levels (that may fluctuate during the year), quality of construction (materials and 4
workmanship), and the water usage of the family utilizing the systemis. These conditions can vary,and
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the Qn ••
�ff • A. Games.. O
system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of Vv/m • CE ° 3 •' �D �
the well or septic system. GEG makes no representation whether an alternative well or septic system Q sf • •• �c¢4
can be installed on the property in the event either of the current systems fail to perform adequately in 4p PrP ' !! • 7" �r0o
the future. The content of this report is for the sole benefit of the person/party that retained GEG to P 01-N°4�
perform the evaluation. Reliance upon the information provided in this report by any other person or ��ppOaQo
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
#AECC884
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for bedrooms •
Disapproved
11\‘4-SVI—E. c
Conditional approval for bedrooms, with the follow ng sti dtaV
7
.0
g Original Certificate Date: 2a/ 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 __ _ Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.cloc
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: MOUNTIAN PARK ESTATES#2; BLOCK 7. LOT 3 Parcel ID: 017-432-13
A. WELL DATA PER PREVIOUS COSAS
Well type PRIVATE If A, B, or C provide PWSID# NIA Well Log (Y/N) YES
. Date completed 6127/78 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 155 ft. Cased to *48 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 6/27/78 8/2/17
Static water level 125 ft. 37.2 ft.
Well production '3.3 g.p.m. 2+ 9.p.m.
WATER SAMPLE RESULTS
Coliform NEG colonies/100 ml. Nitrate 1 05 mg./L. Collected by: GEG. Ltd.
Arsenic: <5.0 ug/L Date of sample: 7/28/17
B. SEPTIC/HOLDING TANK DATA -MISSING ON AS-BUILT SURVEY.BUT PRESENCE CONFIRMED BY GEG
Tank Type/Material SEPTIC/STEEL Date installed 7/28/07
Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN) 'YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 7/7/17 Pumper A+HOME SERVICES
C. ABSORPTION FIELD DATA `BELOW EXISTING GRADE AT MT
Date installed 1978 [ASSUMED)Soil rating (g.p.d./ft'or t/bdr ) 150 System type SHALLOW TRENCH
Length 73 ft. Width 5 ft. Gravel below pipe 3 ft.
Total depth •7.5+ ft. Eff. absorption area 529 ft Monitoring tube YES Depression over field NO
Date of adequacy test 8/2/17 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 7 in. Water added 547 gal. New depth 7 in.
Elapsed Time: 0 min. Final fluid depth 7 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date -
-SUMP ON SOUTH END OF DRAINFIELD ONLY EXTENDS ABOUT 25"BELOW INVERT
-SUMP ON NORTH END OF DRAINFIELD ONLY EXTENDS ABOUT 32"BELOW INVERT
., r
D. LIFT STATION
Date installed Size in gallons_ Manhole/Access(YIN)
"Pump on" level at in. "Pump off' level at •• '• wa er alarm level at in.
a- . •- Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES `UNABLE TO LOCATE SOUTHERN DRAINHELDSUMP ON
MOU
SEPARATION DISTANCES FROM WELL ON LOT TO: I'tTVNPARK ESTATES#2;LOT 9.BLOCK B
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100+ On adjacent lots `100'+(WITH CAVEAT)
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
•1' Building "4' Water main 10'+
Property line foundation
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
'WR#910048 "4'TO GARAGE ON PROPERTY-SEE ATTACHED WAIVER REQUEST
lookikss IL%iii
G. ENGINEER'S CERTIFICATION `47/\\>>.•'" .,,1�♦
� 1•97
4.
•
I codify that I have determined through field inspections and 4• all, •
review of Municipal records that the above systems are in • i - i
conformance with MOA COSA guidelines in effect on this * l w
date. f rrA : Jef. .: A. :�u=
Engineer's Printed Name
JEFFREY A. GARNESS • arM
���5 'E-795 :'6
Date ,.441 ,-ROFESSIN� •*
LICENSE �III iiiitaitill'
#AECC884
(Rev. 10/12/12)
ale 41.1. .. - cui1. c
GARNESS ENGINEERING GROUPLtd ''``` '" "" `.` y _ "
'',
CIVIL&ENVIRONMENTAL ENGINEERS Debate
August 14, 2017
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Mountain Park Estates #2; Lot 3, Block 7
To whom it may concern:
We are requesting that your department issue a variance of the required separation of
10 feet from a drainfield to a foundation (serving a single-car garage) down to 4-feet.
Justification for granting this waiver are as follows:
• This encroachment has existed for approximately 11 years (garage/shop
constructed in 2005 or 2006 per owner)
• The shop/garage is detached and there is no dwelling unit
• The shop/garage is "slab on grade"
We are unaware of any adverse impacts this waiver would have on adjacent wells
and/or septic systems.
e2. -rely
RI*effr: . a , P.E., M.S.
Pres d � t
3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com
Municipality13.
of Anchorage `a s�.
h.:".,
, r
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http:llwww.muni.org/Onsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV171088 COSA#: OSC171360 Permit#:
PID#: 017-432-13
Legal Description: Mountain Park Estates #2 Block 7 Lot 3
Engineer: Garness Engineering Group
Applicant: Anna & Todd Venhuizen
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the foundation has been approved. The approved separation distance is 4.0 feet. See
engineer's letter for justifications.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
V] Adjacent properties are not affected by this waiver.
Waiver is Granted: X Waiver is not Granted:
&met/Date: S/Z/Zo I7 Approved by: 6-ezeli
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
Z Frontier Surveys,LLC Project No:17-183 Date:August 9th,2017
,-,o Ordered By:Sabra Gilliland Plat:P-561 Grid:SW2839
/t{, ..-0..—.s0--e_—OSP--DA nada—..Q1..._JD. - '
P100'03'45"W 104.00
10'UTILITY EASEMENT
— —
Mountain Park Estates C
Lot 3,Block 7
19,032 sQ-ft.+/-
, 126ee Fmr..goad
2 Story Wood Frame House
W7 ut.e,ad 2 Car 04.11.
1 'R GARAGE
122''412 Q i O
I
M1li 2c O
P 127 IL
r ••1
'Ii%VIII .`Iljlll'lll E 11H�--\ `
LOT 4 •:;T..?T.�il...,r..hih:raw:4 LOT 2
::vada,••,
il;r: M3... � . 207
•
S
36.1 \ �2.1' \ $ g
W. $
CS: .. g
b
ni
m
•+ t\ 24 2' r
! g�pp
O i RETAINING WAIL
-i1On TIP t
th 3
W
r
F2
0
0
a L
a
500'03'45"E 104.00
1
f OGS Or GMvt I..OAO 1
— – — i -FOSTER ROAD— – –
Legend: --h
-
EElectric Meter/Outside Power ca, Telephone Pole _--— Guide Wires t F ' — ii n r
0Gas Meter ® Mailbox Q Concrete Walkway ' Tel.Pedestal 0 is 30 60 �J
ti- Deck ® Water Well —01e—Over Hanging Power ei••=,....... Feel
General Notes:
1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law.
2.Excepting for gross negligence,the liability for this survey shall riot exceed the cost of preparing this survey.
3.All measurements/setbacks are to the visuaVapparent building footprint.
4.Dimensions to property lines are plus/minus 0.1ft.
tThis survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and
_r .......f II L,. t conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any
/-1 • inaccuracies that a subsequent boundary survey may reveal.Itis the responsibility of the Owner to determine
•,\�;•• •••••-1 r, * the existence of any easements,covenants,or restrictions which do not appear on the record plat.Under no
F.\\ #4 circumstances should this document be used for construction or for establishing a boundary or fence line.
' q T H • ` As-Built Survey of:
...7,-....„....- r — s Lot 3, Block 7, Mountain Park Estates Subdivision No. 2
y IISEAERIC w.WAGNER: I I,Frederic Wagner,hereby certify that this Mortgage Inspection Survey was performed by me,or
•t+,�p•• p-S994ba`,� � under my direct supervision on August 8th,2017.
t% 4.
dPrGr � N- 4,:c" ~ Frontier Surveys,LLC FRONTIER*
-ta``te:. 650 W.58th Ave.Suite E Anchorage,Alaska 99518 S 4
907.460,1686-info@frontiersurveys.com
PROFESSIONAL SEAL www.frontiersurveys.com
_f
MUNICIPALITY OF ANCHORAGE
4 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 DWELLIN,, \G
Parcel I. D. # O ! - —' HAA #
1. GENERAL INFORMATION
Complete legal description Low 3�_-7) MOunr iii ®�L
Location (site address or directions) a G FeSTF/�-
Property owner VW2--J aS$o2 Day phone -��Sr 644d
Mailing address �LWI�_ P6 490vf:=:
Lending agency �^'!��- — - Day phone �IA
Mailing address
Agent
�ll,'� D� \Nb>� Day phone ,257- c�ll4-
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY: P1G.(G—VP
. Individual well s'3%-(0/7%
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 FirmAlaska Water & Phone �3 7— 6 / 79
v
6.
Address
Engineer's signature
DHHS SIGNATURE
.L Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Date :?/S
q 7
-The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
,ApprovalCertificates`based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS doesthis as a courtesyto purchasers of homes
and their lending institutions in orderto 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. 1/81) Back MOA k21 - ..
Municipality of Anchorage
*0 DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division dhlrU
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
Health Authority Approval Checklist
Legal Description: t,aT �� U-7:) Modnr-k-Aj�l Pael= Parcel I.D.: 017_4 -?2 -13
A. WELL DATA
Well type <PVT-'
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
If A, B, or C, attach ADEC letter. ADEC water system number tJ
S
E5
Date completed 41-78
t
i
Cased to 46 Casing height (above ground) BIZ
FROM WELL LOG
f. /�47 a
12,51
Wires properly protected (Y/N) VFX
AT INSPECTION
3( '�-lq7
�Z 1
Well production 3. 3 g.p.m. a " I - g.p.m.p
2, 3o e�,AvrC_5 Of- oex_
WATER SAMPLE RESULTS: /tf/� T°TAz- O(l�wDowrJ'
Coliform Nitrate ° f m N Other bacteria
Date of sample: 2A_(oh7 Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed t`O0' x"14 Tank size I ZS�O Number of Compartments Cleanouts (Y/N) YDS 24
Foundation cleanout (Y/ /N) Depression (Y/N) NOS High water alarm (Y/N)
Date of Pumping 3l-5- 47 Pumper bt,P "'DoNk.'- OS * S.Jovi owl
C. ABSORPTION FIELD DATA
Date installed A9-7 6 PEta^['r" Soil rating (g,prd-t!12 or ft2/bdrm) /5-0 System type
Length % Width Gravel thickness below pipe Total depth
Effective absorption area Monitoring Tube present (Y/N)Y�'Depression over field (Y/N)
Date of adequacy test &L91Results (Pass/Fail) P -5S For 4 bedrooms
667
Fluid depth in absorption field before test (in.); t32- Immediately after_ gal. water added (in.): i 9 y8"
Fluid depth 16 4- (ins) Minutes later: i6 9 Absorption rate = ®0 g.p.d.
Peroxide treatment (past 12 months) (Y/N) H01111�-- k -A.° If yes, give date /V4
72-026 (Rev. 3/96)' •)I� S Na W OA/ L-0-0c)N19
D. `CIFlDate installed
Manhole/Access (Y/N)
High water alarm level at*
E. SEPARATION DISTANCES
`Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot l 1 b k
Absorption field on lot �((Z
Public sewer main I�
Sewer /septic service line
'75 /*
Size in gallons
On adjacent lots
On adjacent lots
"Pump off" level at*
r
i0ZI
Public sewer manhole/cleanout
Lift station N
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ONLOT TO:
Foundation Ac Property line 30 t Absorption field
Nlq-
Water main/service line � 10 Surface water/drainage Wells on adjacent lots 115 •'F
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
1 fir/ WAkV&Z (CfWl(?) f�
Property line Building foundation 4g Water main/service line
'>- (D f
Surface water too r Driveway, parking/vehicle storage area
Curtain drain lent W ri Wells on adjacent lots -,� f OU
F. ENGINEER'S CERTIFICATION
I certify that I have determined r field inspections and review of Municipal record�F►uJ;tro`�% kms are
in conformanc wl OA u elines in effect on this date.
Signature
Engineer's Na a
J/S//,-'� G'� JCF-7953 DRi
Date—%
HAA Fee $ 3 6t) 60 Waiver Fee $
Date of Payment /! Date of Payment
Receipt Number �-�� (� %�� Receipt Number
72-026 (Rev. 3/96)*
Alaska Water & Wastewater
8471 Brookridge Drive — Anchorage — Alaska 99504
Phone (907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
8
March 7, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
RUFESS�`�'
Subject: HAA for Private Well & Septic System. Lot 3, Bk 7, Mountain Park #2. S/D.
To whom it may concern:
The subject lot has a 4 bedroom house on it which is served by a private well and septic system.
The results of the field investigation and adequacy tests are summarized as follows:
A. WELL: On the day of my inspection (3/5/97) the static level was 82 feet below the top of
the casing (B.T.C.). Water was pumped from the well at an average rate of 2.78 gpm for 240
minutes (667 gallons). The maximum drawdown attained was 150 feet B.T.C.. The total well
depth is 155 feet. At the end of the pumping period (148 feet) the water level was monitored for
31 minutes, during which time it rose 44 feet (approximately 66 gallon casing volume). This
corresponds to a recovery of 2.1 gallons per minute. Based upon this data it was determined that
the capacity of the well exceeds the Municipal requirements for a 4 bedroom house (600 gallons
per day).
As mentioned previously, the well is capable of providing 667 gallons in 4 hours, which
corresponds to 2.78 gallons per minute. Given the fact that the last 18 months have been
extremely dry in the Anchorage area, and that late winter is, typically, the most conservative time
to test a well, it is reasonable to assume that the aforementioned test results are fairly
conservative.
B: SEPTIC TANK: The existing septic tank was installed in 1978 (almost 19 years old).
According to the M.O.A records, it is 1250 gallons, has two compartments and is made of steel.
Most tanks of this type have a structural life of approximately 20-25 years. No warrantee is
made regarding the future life of the tank.
C. SEPTIC SYSTEM ADEQUACY TEST: The drainfield is a 5 foot wide trench, which is 73
feet long, and has an effective depth of 3 feet. Prior to starting the adequacy test the sump had
13.5 inches of liquid in it. Water was added into the sump at a rate of 2.78 gpm for a total of 240
minutes (667 gallons). At the end of the pumping period the liquid level had rose a total of 5.625
inches, which corresponds to 118.6 gallons per inch. The recovery of the trench was monitored
for 167 minutes during which time the level dropped 2.375 inches (282 gallons). Based upon this
data, it was determined that the absorption rate of the trench exceeds 600 gallons per day, as
required for a 4 bedroom house.
NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not
limited to, seasonal surface water infiltration, groundwater variations, septic system
maintenance (frequency of septic tank pumping, usage of biological additives), condition of
drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age),
type of substances deposited in septic system (cigarette butts, sanitary napkins, misc. objects),
and the amount of water being introduced on a continual basis. Consequently, the results of this
adequacy test are only valid for the specific day of the test. Furthermore, because of the limited
nature of this investigation, it is possible that there are hidden defects which may not have been
detected No warrantee is made regarding the future performance of this well or septic system
If you have any questions, please contact me at 337-6179, or on my digital pager at
1-800-481-1162. Thank you for your assistance.
Sincerely,
Je e .&ss,., M.S.
Pri cipal
c.c. Dan Wolf at RE/max Properties
MUNICIPALITY OF ANCHORAGE
• u DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services M
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 \—I - -
1. GENERAL INFORMATION
Complete legal description Lor 3 MTP/At< EST '472
Location (site address or directions) 12 64o FOSTEle RD fjNC6 ggS16 _
3�+s-iss-r
Property owner ELDON SABLE`/ Day phone
Mailing address 12 (o'fo FOSTER R+0 ., AN69, AK qSS/6
Lending agency N.A Day phone
Mailing address
Agent 56M Kt E REa CARPET /QnIC Hort Day phone 2'77- 46SS
Address 750 E FIREWEED r4gca, Ari
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. 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.
4. 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.
72-025(Rev.1/91) Front MOAR21
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H33NIJN3 AS N01103dSNI d0 l.N3W31tf1S 'S
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST 44
Legal Description: Lam, ELk7 MTPRRrc EST *2 Parcel LD
A. WELL DATA
Well type PR I SATE If A, B, or C, attach ADEC letter. ADEC water system number N.fi.
Log present (Y/N) y Date completed 6,12:z /�8 Driller J Ay Vr is AM S
Total depth I55 Cased to - 48f Casing height 19
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump level
a
FROM WELL LOG
(, /27/7R
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 107' To C.O
Absorption field on lot
126r
Wires properly protected (Y/N)
AT INSPECTION
52t
NvRo�MFNrqI oFgNcyo
OC'T 7 RV �c�sO'� oro
g.p.m. 3.6 ktl
154 r -- - �tD
; On adjacent lots -,,/00,
On adjacent lots 102,1
Public sewer main 7 loo, Public sewer manhole/cleanout 7/00
Public sewer service line -;;, lo -0, Petroleum tank NONE DSSF9VP n
WATER SAMPLE RESULTS:
Coliform O
co! /coorh.Q
Nitrate o•fy ov l4
Other bacteria
Ol(oam.Q
Date of sample:
`th7/91
Collected by:
FLATTOP TFGN
Svcs
B. SEPTIC/HOLDING TANK DATA
Date installed 1978 PERMIT) Tank size 1250 GAi Compartments 2
Cleanouts (Y/N) �i Foundation cleanout (Y/N) Depression (Y/N) ►�
High water alarm (Y/N) RA a Alarm tested (Y/N) N ,A
Date of pumping 9/2-1 /91 by �su�-cS
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Wells) on lot 10-7' F 914 00, On adjacent lots 115'
To property line 29 FR'^^ C•0Absorption field S1
Surface water/drainage > 100
Foundation
29t
Water main/service line —^ SO
72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE
C. LIFT STATION N./i.
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Manufacturer
Manhole/Access (Y/N)
"Pump on" level at "Pump off" level at
Meets MOA electrical codes (Y/N)
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots Surface water
D. ABSORPTION FIELD DATA
Date installed 1013$ Soil rating 150 0'1629M System type_ 5 H 4ow TRENCH
Length -2 3 ! Width 5 Gravel thickness 3 / Total depth 5S /
Total absorption area 6 2 S n — Cleanouts present (Y/N) —Z
Depression over field (Y/N)
Results (pass/fail) Nss
Date of adequacy test
for
Peroxide treatment (past 12 months) (Y/N) NOW kaoYN of If yes, give date N I /I
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot 12( On adjacent lots > 1OO Property line �•$ r need�z�f)
To building foundation `41(
To existing or abandoned system on lot — N A
On adjacent lots 28 Cutbank 14, A
Water main/service line— ^ 69
Surface water � 10`o Driveway, parking/vehicle storage area Sp
Curtain drain NOnte o6SeRVE o
E. ENGINEER'S CERTIFICATION
1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature �� � 9
Engineer's Name/7eoc orY F /`(uo�
Date 9/ 3019 /
HAA Fee $ .>
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
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Waiver Fee: $
Date of Payment 311 )Ott
Receipt Number 31r)_ \ -Ct
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9
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
rcr �a�r/9�
;.y,�'i►� K w w
OF A4
r *._;. l 9TH.
► '; Michael D. wllean AF
�. L •. L5. 7539 m
Municipality ®f Anchorage
Department of Health and Human Services dhhS
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
October 9, 1991
Ted Moore, P. E.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Subject: Waiver Request for Lot 3 Block 7 Mountain Park Estates #2
Waiver Request #WR910048, PID #017-432-13, HA910451
Dear Mr. Moore:
Your request for waiver of the required 10 foot separation
between a septic system and a lot line has been approved. The
waived distance is 1 foot from the leachfield to the north property
line.
This approval applies to the existing septic system lot line
separation only. Any future upgrade to the septic system will
require all separations be met or another approval from this
department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
DJR/ljm
Concur:
Robert W. Robinson
Acting Program Manager
On-site Services
MUNICIPALITY OF ANCHORAG^
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR910048 PID# 017-432-13 HA# HA910451 Permit
Date Received: October 1, 1991
Legal Description: Lot 3 Block 7 Mountain Park Estates #2
Engineer: Ted Moore, P. E., Flattop Technical Services
14530 Echo Street, Anchorage, Alaska 99516
Applicant: Eldon Sibley
Waiver Requested: Lot line waiver 1 foot - field to north property line
Criteria: 1. Geology:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Points:
Waiver is Granted: IN/ Waiver is NOT Granted:
List Conditions or Reasons for above: IMPAGrEp LOT /1 PFVF10AF gap
/TS J6ir/[ S YS rFn, '!-/S wOr ImfhCTFQ BY tKF j PI
art f%1"m0.v rteE SugTF[T LOT r!l6AE /S ALte AREA JCDP 4P6ROA
Date: /O - g_ y/ By:
Rec #: 23114
r
Amount: $ 70.00 Date Paid: 10-1-91
CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSTS
THEODORE F. MOORE, P.E.
PH: (907) 345-1355
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
October 1, 1991
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
RECHVE®
OCT 1 1991
Viunicipality of Anchorage
Dept. Health & Human Services
By means of this letter we are requesting a lot line waiver allowing the existing soil absorption trench
serving the residence on Lot 3, Block 7, Mountain Park Estates #2, located at 12640 Foster Road, to be
within 1 foot of the north property line abutting Lot 2. A copy of the as -built lot survey is enclosed, upon
which I have identified additional relevant wells and septic system components.
The Municipal as -built inspection report for this system is unsigned and undated, however the permit
was issued in 1978. According to the as -built inspection report, the soil absorption system consists of a 5'
wide x 73' long soil absorption drainfield containing 3' of sewer gravel, and it is located 10 feet from the
property line. The enclosed survey as -built of the lot indicates the cleanout at the north end of the
drainfield is actually 1.8 feet from the lot line, and this waiver request is for 1' to allow for possible
underground projection of the drainfield beyond the cleanout. On September 18 we conducted an
adequacy test of the system and found it to be functionally adequate for 4 bedrooms as originally
permitted, although the residence presently has only 3 bedrooms. A HAA certificate application is
enclosed along with this waiver request.
The closest cleanout of the septic system on the adjoining Lot 2 is 29 feet from the cleanout pipe in
question on the subject lot. There is no conflict between the two systems, and there appears to be adequate
room on Lot 2 to construct a replacement system when needed without being adversely affected by the
system on the subject lot. For this reason we are requesting that you grant the requested waiver and issue
the requested Health Authority Approval certificate.
Please give me a call if you have any questions.
Sincerely,
Ted Moore, P.E.
cc: Eldon Sibley
Sam Nye, Red Carpet Anchor Real Estate
it:/6 pox
T.-
5. LEGAL DESCRIPTION
7T�v `=717 17-11719
STREET LOCATION
MUNICIPALITY OF ANCHORAGE
6. TYPE OF RESIDENCE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
•
ENVIRONMENTAL ENGINEERING DIVISION
P SINGLE FAMILY
>"
Telephone 264.4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
-
PHONE
*.ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
MAILING ADDRESS
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
_ o Ll
PROPERTY RESIDENT (If different from above)
PHONE-
02-
❑ PUBLIC UTILITY
2. BUYER
2.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
PHONE
c
MAILING A DRESS
7
3. LENDING INSTITUTION
PHONE
MAI LING ADDRESS
4. REALTOR/AGENT
PHONE
r
C
MAI LING ADDRESS
i(C c
5. LEGAL DESCRIPTION
air
STREET LOCATION
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
El One ❑ Four E:1 Other
P SINGLE FAMILY
>"
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
-
K INDIVIDUAL*
*.ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
**If individual/on-site, installation date
N INDIVIDUAL/ON-SITE**
give
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
a O rrY1r-�)L1 v 0 -am/ cji ostn I Cil �11tz n c� Lo 7
to
P1L' r,,f C3 lo%- �dfLPI�P at An d-1 .-
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE _
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
®SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
L+� INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED-_-
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
OUI JDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
�79
INSTALLER
Q1I eptic Tank or ❑ Holding Tank
Size: /wl� If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACT ER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
L4_APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must ac com certificate)
❑ DISAPPROVED
-DATE
BY (Titl - -
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
