HomeMy WebLinkAboutNORTH WOODS BLK 5 LT 2
Municipality of AnChorage Page / of ~-'
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. BOx 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
N.~f~O~ Wastewater System: C New ~pgrade
Address:
~3/ ~o~ ~ ~u~ ABSORPTION FIELD
P~.~/~ ~ IN°'°'~r°°m,: ~ Deep Trench ~ShailowTrench ~ed GMound ~Other
Total Depth from original grade:
LEGAL DESCRIPTION so, R~,~: ~,5 ~PD/sq. ~t.
Lot: Block: Subdivision: 3epth to pipe bosom from original grads: Gravel depth beneath pipe
Range: Fill added
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Casing Height Above Ground: TAN K
Ft, Ft.
SEPARATION DISTANCES a septic ~ Holding ~S.T,E.P.
To ~ptic Absorption ~ff Holding 3,,~c/~dvate Manufacturer: Capacity in gallons:
Su~ace
w~ ~/~9 > LIFT STATION
Pump Make & Model Electrical Inspections pe~ormed by:
R~marks: BENCH MARK
ENGINEER'S SEAL
Department of He; Ith and ~ices approval ~..~-.,.
Reviewed and approved b ~ : I~ ~ Y
72-013 (1/91) MOA 25
Permit No. -- SW950256
Page 2 of 2
Municipality of 'Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: .34,3-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legol Description: NORTHWOODS LOT 2 BLK 5 .
PID No.: --051-731-02
5/~ REBAR UARKER
FINISH GRADE
It
LOT 2
FILTER FABRIC Os
O, 0 · ,%0o
d' 0 o
,,SEWER ROCK
shed
1500 GAL.
BOX 1-1/4" PVC
~ LATERALS
NORTON CT.
ELEVATIONS ~-~ sw coR OF SARAOE co.c .AD
(NOT TO SCALE) ~ ASSUMED ELEV = 97.85
FINISH ORIGINAL -~
GROUND GROUND :~
FINISH f 9R.B ~0
G~]D. +l'l ADDED FILL ' / 98.8 ~m
PLUG
COUPLIN(
/4" 45' EL
1-1 4"
PRESSURE PIPE CLEANOUT
SWING TIES
A-C = 16.2
B-C = 30.6
A-D = 43.1
B-D = 69.2
SCALE 1"=50'
~- ABAONONED TRENCH
· - MONITOR TUBE
o - SEWER CLEANOUT
~ - KD(BOX
NEW LEACHFIELB
EASEMENT
11/14/95
Halmar Electric
PO Box 1864 Palmer AK 99645
Ph./ 745-8883, 696-8883
To:
CCC Construction
POB 770647
Eagle River AK 99577
Date: 11-28-95
Ref:
Petersen Res.
Norton Ct
Chugiak
Northwoods Subdiv.
This is to certify that on site sewer lift station
at above mentioned property has been wired in accordance with
the National Electrical Code and manufactures specification.
Systems were checked and performed as specified in
the systems manual.
~.4unJoipalJt¥ o[ Anchorage
Dept, Hea~th & Human ServicesHalmarLio.~,~ l~ctr,ic
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE 1 OF
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW950256
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:PETERSON GLENN A & NORA L
OWNER ADDRESS:22431 NORTON CT
CHUGIAK, ALASKA 99567
DATE ISSUED: 8/31/95
EXPIRATION DATE: 8/31/96
PARCEL ID:05173102
LEGAL DESCRIPTION:
NORTH WOODS BLK 5 LT
LOT SIZE: 32890 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 (18AACS0) .
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVI S IONi:
MAINTAIN A MINIMUM 35 FT. SETBACK FROM SHOULDER OF
SLOPE BREAK.
RECEIVED BY: I~--~~ ~'~-~ l
ISSUED BY:~~ ~ ~~
DATE:
DATE:
Rick Mystrom,
Mayor
Mtmic .pality of Anch 'age
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
September 1, 1995
Lou Butera, P.E.
Eagle River Engineering Services
PO Box 773294
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 2 Block 5 North Woods Subdivision
Waiver Request #WR950039, PID #051-731-02, SW950256
Dear Mr. Butera:
Your request for a waiver of the required 10 foot separation
between a septic system and a lot line has been approved. The
waived distance is 5 feet from the absorption field to the lot
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.
S'~~i~cerely¢ ~~~
~mes P. Williams
Civil Engineer
On-site Services
JPW/ljm
MUNICIPALITY OF ANCHORA'~--
Department of Health and Human Services
On-site Services Section
WR# WR950039
Waiver Review Worksheet
PID# 051-731-02 HA#
Permit #~_~~
Date Received: August 23, 1995
Legal Description: Lot 2 Block 5 North Woods
Engineer: Lou Butera, P.E., Eagle River Engineering Services
PO Box 773294, Eagle River, Alaska 99577
Applicant: Glenn A & Nora L Peterson
Waiver Requested: Property line waiver of 5 feet from the absorption
field to lot line
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: N_ Waiver is NOT Granted:
List Conditions or Reasons for above: ~ A01 &//~J~ ~/~
Date:
*****~~m'~ of Reviewer
Rec ~: #01232/2529 Amount: $ 115.00 Date Paid: 8-23-95
August 23, 1994
Louis Butera, P.E.
Registered Civil Engineer C~ - "-)3 h - tO
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Northwoods Lot 2, Block 5
Narrative & Upgrade Application
Re:
Dear Mr. Cross:
The proposed septic upgrade will increase the number of bedrooms from three to four, and we
have therefore performed two test holes and documented a possible replacement site as well as the
primary site on the attached site plan. The upgrade will have very limited impact on adjacent
properties for the following reasons:
2.
3.
4.
The subdivision is served by public water.
Immediate neighboring septic systems are all +30' distance.
Reserve space is adequate, due to absorption capacity.
Drainage will not be affected and is not a major consideration in our design.
Due to limited
1.
replacement area on thq~subject lot, we are requesting one waiver and one variance:
A variance to/26'4 from the standard 50' leachfield to slope break setback. The
slope is naturally occurring and fully vegetated and we do not expect a surfacing
problem at the reduced distance.
A waiver from the standard 10' lot line setback to a distance of 5'.
If you have any questions please call our office at 694-5195.
Louis Butera, P.E.
\G:\WPDOCS\ 1995\95-073B.NAR
P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, At( 99577
(907) 694.5195
JOB
SHEET NO
CALCULATED BY
CHECKED BY
SCALE
OF
NOrthwoods Lot 2, Blk 5 - REVISED 08/23/95
PRESSURIZED SYSTEM~ SIZING
Flo~ ratelfrom lift station !. ~..i 28 gpm
Assumes 5' liead at orifice
0.42 gpm:per t/8" orifiee
28 gpm + 0.42 gpm = 67 orifices
Spacing = 216': ofifi~S = 3~22' ot"38.,3/4"'spacing
~.~wpnor~\ 1c~c~s\c~_O73B, E ^ 1' =
LOT 1 LOT 3
SEPTIC +30'
O O T 0
~ 1500 GAL ~ LATERALS
~ SEPTIC
BOX~ ~- EXISTING TRENCH
i~ TO~ OF DITCH ~ -- TEST HOLE
~ ~ ~, · - MONITOR TUBE
o - SEWER CLEANOUT
NO KNOWN CURTAIN D~AINS N O RT O N C T. + - KEYBOX
PROPOSED LEACHFIELD
COMMUNI~ WATER SYSTEM EASEMENT
LEGAL: NORTHWOODS LOT 2 BLOCK 5
JoB ~ 95-073AI DATE: 0a/2,~/9,~ t SCALE 1"
(907) 694-5195 FAX: (907) 694-329?
O O ? O
S' 5' 3'
/ ~-.5' !4.5
~ 3'
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 95-073
Calculated By: LB
Date: 8/15/95
Legal: NORTHWOODS LOT 2 BLK 5
Single Family 4 Bedroom Dwelling
TEST HOLE 2
Bed Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom = 600 gallons
Percolation rate = 7.6 minutes perinch
Wastewater application rate = 0.5 gallons per day per square foot
Required absorption area = 1200 square feet
Bed width (W) = 20 feet
Gravel depth (D) = 0.5 feet
Required length = Required absorption area / Bed width
Required length = 1200 / 20
Required length = 60 feet
Total Excavation Depth = 3.0 feet
With 1'
mounded
and insulated
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 95-073
Calculated By: LB
Date: 8/15/95
Legal: NORTHWOODS LOT 2 BLK 5
Single Family 4 Bedroom Dwelling
TEST HOLE 1
Bed Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom = 600 gallons
Percolation rate = 8 minutes perinch
Wastewater application rate = 0.5 gallons per day per square foot
Required absorption area = 1200 square feet
Bed width(W)= 15 feet
Gravel depth (D) = 0.5 feet
Required length = Required absorption area / Bed width
Required length = 1200 / 15
Required length = 80 feet
Total Excavation Depth = 2.0 feet
With 2'
mounded
and insulated
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anct~orage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
7-///
LEGAL DESCRIPTION:
10
11
12
13
DATE PERFORMED:
/_ ~ ~'~- Townsl~ip, Range. Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED? ' r
S
yES. ATWHAT
DEPTH?
E
oe~. ,. w~- A~r ~/~/~
14
15
16
17
18-
19-
2O
COMMENTS
T/zr-v ,~ I ~ 5,=c Z/
SITE PLAN
Gross Net Deoth to Net
Reading Date Time Time Water DroI=
PERCOLATION RATE ~ (mtnutes~'mcl~) PERC HOLE DIAMETER (5/'"
TEST RUN BETWEEN ~' FT AND ~' FT
PERFORMED BY: ~'~/~ ~'-~ I~ ~~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATF_ ~"////~/~D--
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PER FORMED FOR:.
LEGAL DESCRIPTION:
10
11-
12~
13-
14-
15-
16-
18
19
2O
DATE PEREORMED:
Township, Range, Section: 7"/5-,,~/
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Oepth to Water Alter '7.
Monitoring7 Date:
Reading I Date ~r~
Time /
Net
Time
PERCOLATION RATE ~' ~ (minutes/tach) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ ~ FTAND 5'% 5~ FT
COMMENTS
PERFORMED BY: //~'~/~'J'"" I ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE;
72-008 (Rev. 4/85)
Louis Butera, P.E.
Registered Civil Engineer
August 10, 1994
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re:
Northwoods Lot 2, Block 5
Narrative & Upgrade Application
Dear Mr. Cross:
The proposed septic upgrade will increase the number of bedrooms from three to four, and we
have therefore performed two test holes and documented a possible replacement site as well as the
primary site on the attached site plan. The upgrade will have very limited impact on adjacent
properties for the following reasons:
2.
3.
4.
The subdivision is served by public water.
Immediate neighboring septic systems are ail +30' distance.
Reserve space is adequate, due to absorption capacity.
Drainage will not be affected and is not a major consideration in our design.
Due to limited replacement area on the subject lot, we are requesting two variances:
A variance to 25' from the standard 50' leachfield to slope break setback. The
slope is naturally occurring and fully vegetated and we do not expect a surfacing
problem at the reduced distance. ·
A variance from the standard setback of existing leachfield to new leachfield from
11' (2 x 5.5' gravel depth) to 5'. The proposed leachfield has a total depth of 2'
and therefore we do not anticipate interference from the eXiSting field with a total
depth of 10'.
If you have any questions please call our office at 694-5195.
Sincerely,
\G:\WPDOCS\ 1995\95-073A.NAR
P.O. Box 773294 · Eagle River, AlaSka 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297
N FILTER FXBRI¢
00
LOT 1 LOT 5
SEPTIC +50'
2" evc
Box r / ~ ~ ~ ~- EXISTING TRENCH
~ ( TOP or DITCN ~ ~ -- TEST HOLE
~~ ~- · - MONITOR TUBE
N CT o - SEWER CLEANOUT
· PROPOSED LEACHFIELD
COMMUNI~ WATER SYSTEM EASEMENT
LrOAL: NORTHWOODS LOT 2 BLOCK S
OWNER: PETERSON -
JOB ~95-075A[ DATE: 08/10/951 SCALE 1" = 40'
A EAGLE RIVER ENGINEERING SERVICES ¥~ '. CE-6756 .' %~
P.O: Box 77~294
EAGLE RIVER, AK. 99577
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 95-073
Calculated By: LB
Date: 8/7/95
Legal: NORTHWOODS LOT 2 BLK 5
Single Family 4 Bedroom Dwelling
TEST HOLE 2
Bed Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom = 600 gallons
Percolation rate = 8 minutes per inch
Wastewater application rate = 0.5 gallons per day per square foot
Required absorption area = 1200 square feet
Bed width(W)= 15 feet
Gravel depth (D) = 0.5 feet
Required length = Required absorption area / Bed width
Required length = 1200 / 15
Required length = 80 feet
Total Excavation Depth = 2.0 feet
With 2'
mounded
EAGLE RIVER JoB
ENGINEERING SERVICES SHEET NO
P,O, Box 773294
EAGLE RIVER, AK 99577 CALCULATEDBY.
(907) 694-5195 CHECKED BY
SCALE
OF
DATE
Northwoods Lot 2, Blk 5 J 08/10~95
PRESSURIZED SYSTEM SIZING
Flow ratefrom.lift station = 28 gpm
Assumes 5' head,at orifice
0:,42 gpm,per t/8" orifide
28 gpm + 0.42 gpm = 67 orifices
Sp~i'ng = 222'r' 2767 orifices ~"3,3I!"o~i39z3/4" spacing
August 28, 1994
Jim CroSs, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Louis Butera, P.E.
Registered Civil Engineer
RECEIVED
AUG 1 1995
Municipality of Anchorage
DePt, Health & Human Services
Re:
Northwoods Lot 2, Block 5
Narrative & Upgrade Application
Dear Mr. Cross:
The proposed septic upgrade will increase the number of bedrooms from three to four, and we
have therefore performed two test holes and documented a possible replacement site as well as the
primary site on the attached site plan. The upgrade will have very limited impact on adjacent
properties for the following reasons:
2.
3.
4.
The subdivision is served by public wat'er.
Immediate neighboring septic systems are all +30' distance.
Reserve space is adequate, due to absorption capacity.
Drainage will not be affected and is not a major consideration in our design.
Due to limited replacement area on the subject lot, we are requesting one waiver and one variance:
A variance to 35' from the standard 50' leachfield to slope break setback. The
slope is naturally occurring and fully vegetated and we do not expect a surfacing
problem at the reduced distance.
A waiver from the standard 10' lot line setback to a distance of 5'.
If you have any questions please call our office at 694-5195.
Sincerely,
~ouis Butera, P.E.
\G:\WPDOCS\1995\95-073B.NAR
P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL:
Northwoods Lot 2, Block 5
REVISED 08/28/95
Co
GENERAL
1. The septic plan is for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health
requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the
contractor to meet Municipality of Anchorage requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements
and to locate any adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
8. It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
SEPTIC TANK/LIFT STATION
1. Septic tank and lift station shall be 1,500 gallon Orenco/Anchorage Tank model
OSI 05-20-HHF.
2. Receipt from certified electrician stating the lift station was wired to applicable
codes to be supplied to Engineer.
The existing septic tank shall be pumped and properly abandoned.
BED
1.
2.
The bottom of the bed shall be level, plus or minus 1.5".
The total depth of the bed excavation is not to exceed 2' at deepest point. If over-
excavation is required to reach suitable soil material, filter sand backfill is
required.
The effluent line from the tank to field is to be 1-1/4" PVC schedule 40 to a 2"
PVC manifold in the field.
The bed gravel is to be covered with typar fabric material.
A combination of soil and extruded board insulation to a depth of 3' or equivalent
is to be placed over the leachfield, 18" soil minimum with 3:1 side slopes.
The area over the bed is to be finish graded to prevent ponding of surface water
runoff.
The septic tank and leachfield must not be closer than 100' to any existing private
well, 150' to any Class "C" well, or 200 feet to any community well.
TOTAL DEPTH = 2' GRAVEL DEPTH = 6" under pipe, 2"over pipe
BED LENGTH = 60' BED WIDTH = 20'
SOIL RATING = 0.5 GPD/ft2 BEDROOM CAPACITY = 4
SEPTIC TANK SIZE = 1,500 gallons with lift
Twenty-four (24) hours notice required for all inspections.
G:\WPDOCS\1995\95-073B.SPC 1
~--'~ 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
PHONE E~I~j~W
dAME p,.~.~ , [] UPGRADE
MA,L,NGADDRESS i 0 " (¢ / ,
I Well ,~ /
DISTANCE TO: I ~'(4~/¢~. '
Manufacturer
· capacity in gallons I ...... ,,--
~ (,,CO O IF ~urvm~v~DE:
DISTANCE TO: We
Absorption are~ ! --- !1 Dwellin¢
· Materia~
I nside length / Width
NO. OFBEDROOMS
PERMIT NO.
No. of compartments
Liquid depth ~'
Dwelling PERMIT NO.
Manufacturer Liquid capacity in gallons
DISTANCE TO:
No. of lines
Length of each line~ 7
Top of tile to finish grade
Foundation
Material
Nearest lot I;n~)
Trench widt~
't~ ~ inches
Total lengt~f ~ne~s
Material beneath tile
Depth
PERMIT NO. ~'~/O~/Of
Crib depth
Building foundation
Distance between li~j~./~,,,~,,,
Total effective absorption area
Width
Crib diameter
Well
PERMIT NO.
Total effective absorption area
Nearest lot line
Depth Driller Distance to lot line PERMIT NO.
DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s)
PiPE MATERIALS
OTHER
SOIL TEST RATING
INSTALLER
REMARKS
APPROVED
DATE LEGAL
PERMIT NO.
8PPLICBNT
LOCRTION
LEGRL
[:'EiPRRTMENT i HERLTH RN[:' EN'v'IRONMENTRL .~:OTECTION
" 825 '"L" STREET., RNCHORRGE., RI':::. L~.9501 ~ "~)'~_~,
264-4720
NCRTzNF"-I"~:: S CT. :I. el~'~lbLHLUM [.' ~ ?0-"%'5 -r) ,'Tq~ L/~\ ---]~.~..' 4-8:1.~1'
LOT 2 BLK 5 NORTHWOOD SUB LOT SIZE --'.':2898 SQURRE FEET
TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH
MRXIMUM NUMBER OF BEDROOMS
SOIL RRTING (SD FT,,"BR)= 288
THE REQUIF.:ED _.IxTtE"fE'~ THE .=,U!L H,..,SURF~L,TIUN_~),~"'Y'Ei'4 I-..
THE LENGTH DIMENSION IS THE L. ENGTH (IN, FEET) OF THE TRENCH OR DRBINFIELD.
THE DEPTH OF ~ TRENCH OR. PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND ~ND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRB'v'EL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFF~LL PIPE
RND THE BOTTOM OF ]'HE EXCF~VBTION (IN FEET).
PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTFtt...LFITION INSPECTIONS OF I=INY WELLS RDJRCENT TO THIS PROPERT"r' RND THE
NUMBE. R OF RESIDENCES THRT THE WELL WILL SERVE.
T'b,.lC) ,:.' ~.". ':, I ~".,~ .... i EL-W X E."~ ["-I :..=.. RF~-:E RE~.T...,L! ][ RE"][)
BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R 14ELL RND RNY ON-SITE SEI4RGE DISPOSRL SYSTEM IS
100 FEET FOR R PRIVRTE WELt_ OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBL. IC NELL.
MINIMUM DISTBNCE FROM R PRIVRTE WELL TO R:PRIVRTE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
F'EZRD1 X T E::-::F" X F-.'ES_.-; [:.,EC:ED'~E:EF-: g~_..
I CERTIFY THRT
t: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH B"r' THE MUNICIPRLIT'¢ OF 8NCHORRGE.
2: I WILL INSTRLL. THE ':;YSTEM IN RCCORDRNCE WITH THE CODES.
2:: I LINDERSTRND THRT THE ON-SITE SEWER SYSTEM MR"r' REQLIIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
","4.
PERFORMED FOR:
LEGAL DESCRIPTION:
SOILS LOG
MUNICIPALITY OF ANCli~I~I~Ty OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENI~r-~[.
825 L. Street, Anchorage, Alaska 9950J~NVI:~q-~0TM P,~OI'ECTION
SOILS LOG - PERCOLATION T~ 2 2 1981
PJ&S
PERCOLATION
TEST
REC£1 J MED:Apri] 10, 1981
Lot 2, Block. 5, Northwood Subdivision
1
2
3
4
5
6
7
9
10
11
12
13
14
15
16
17
18
2o
Organics and organic silt, dark
brown, top frozen.
Gravelly-sandy-silt, tan to
light brown, moist, stiff,
ns organics.
(GM-ME)
Silty-gravelly-sand, gray, dense
moist, rounded particels to
boulder size.
GM-SM)
SLOPE SITE PLAN
S0[L
TE ~T ~
I
PEI~C 'ES' ~
ROID
WAS GROUND WATER No s
ENCOUNTERED? L
O
P
IF YES, AT WHAT E
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
2 4-10-81 3:24 PM. 20 Min. ll 1/2 1/2
3 4-10-81 3:54 PM 30 Min. ll 3/4 1/4
4 4-10-81 3:44 PM 40 Min. 12- 1/4
'-~.. 4-10-81 3:54 PM 50 Min. 12 1/4 1/4
6 4-10-81 4:04 PM 60 Min. 12 1/2 1/4
PERCOLATION RATE 40 (minutes/inch)
TEST RUN BETWEEN 4½ FT AND 7 , FT
COMMENTS
PERFORMED BY: Howard Grey & Assoc., [nc. CERTIFIED BY:
DATE: April 11, 1981
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-47'44
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Io~.- HAA #
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent
· Address
~4 ~ -~...;.~..~,~.,., Day phone
Day phone
Day phone
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Unless otherwise requested, HAA will be held for pickup.
NOTE:
Individual well
Community well X'
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address 06o)
Engineer's signature
DHHS SIGNATURE
Approved for
Disapproved.
bed rooms.
Conditional approval for
Phone
Date
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anohorage Department of Health and Human Services (DHH$) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHH$ does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy aertain federal 8nd state requirements. Employees of DHH$ 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.
72~25 (Rev. 1/91) Back MOA
Legal Description:
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
L_~.I~ ~O;~'~b.)~L~ Parcel I.D. O51
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter.
Date completed
Cased to
ADEC water system number
Driller
Wires properly protected (Y/N)
FROM WELL LOG
ATINSPEC
Date of test
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line
WATER SAMPLE Ri~
Coliform Nitrate
Date of sample:
?
g.p.m.
On adjacent lots
; On adjacent lots
__ Public sewer manhole/cleanout
Petroleum tank
Collected by:
MUNICIPALITM OF ANCHORAGE
L SERVICES DIVISION
RECEIVED
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed z~'--- ~,~
Cleanouts (Y/N)
Tank size
Foundation cleanout (Y/N)
Compartments
Depression (Y/N)
High water alarm (Y/N)
Date of pumping '7- ~ ~r- ~) 7.- Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot /~/~'~ On adjacent lots .~ 'ZOO !
To property line 4-- t~ Absorption field
Surface water/drainage .~ Od'
Alarm tested (Y/N)
Foundation
Water main/service line
72-026 (Rev. 7/91) Front ' CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed M~,~--~t u re r
Size in gallons ~ole/Access (Y/N)
Vent (Y/N) : "Pump on" level atr~ -- "Pump off" level at
High water alarm level ~'~ r-\ Cycles tested
I'
Meets MOA electrical codes (Y/N).~
SEPARATION DISTANCE F~OM LIFT STATION TO:
Well on lot On adjacent lots Surface water
Date installed
Length ~1. /
Total absorption area
D. ABSORPTION FIELD DATA
Width
~o6~
Depression over field (Y/N)
Results (paSs/fail)
Peroxide treatment (past 12 months) (Y/N)
Soil rating ~:~c) System type
Gravel thickness ~'- ¢ ! Total depth
Cleanouts present (Y/N) ~'
Date of adequacy test ~-[ ~- .3~.
for -~E'~' ('~}
If yes, give date --
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
To building foundation
On adjacent lots -~ 7.~'
Surface water
Curtain drain
On adjacent lots + ~.oo' Property line
To existing or abandoned system on lot
Cutbank ~1 ~o' Water main/service line
· Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Engineer's Name
Date
HAA Fee $ / ?¢
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
A
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3-470
ANCHORAGE, ALASKA 99515
WALTER J. HICKEL, GOVERNOR
(907) 349-7755
September 21, 1992
Mr. Roger Shafer
S & S Engineering
SUBJECT: Northwood #2
Class "A" Public Water System, PWSID 213001
Dear Mr. Shafer:
I have completed a review of this office's files concerning the monitoring status of the
above-referenced Class "A" Public Water System and found the following:
The last satisfactory Total Coliform Bacteria Sample results was submitted
to this Department on September 10, 1992. This does meet the provisions
of 18 AAC 80.200(a), of the State Drinking Water Regulations.
The last inorganic Chemical Contaminants Sample results were submitted
to this Department on April 21, 1992. This does meet the provisions of 18
AAC 80.200(a), of the State Drinking Water Regulations.
The last Radioactive Contaminants Sample results were submitted to the
Department on August 9, 1990. This does not meet the provisions of 18
AAC 80.200(a), State Drinking Water Regulations; however, it is conditionally
acceptable at this time.
The last Organic Chemical Contaminants/Volatile Organic Chemicals were
submitted to this Department on June 2, 1992. This does meet the
provisions of 18 AAC 80.200(a), State Drinking Water Regulations.
Issuance of this letter does not imply that the above-referenced Class "A" Public Water
System is in compliance with other provisions of the State Drinking Regulations.
If you have any questions on the above information, please do not hesitate to contact this
office at 349-7755.
Sincerely,
Michael Lu
Enviornmental Eng. Ass~,lJ..~,~,;,.~ o~,ec¥ck, d paper
DATE RECEIVED
INSPECTION APPOINTMENTS
DATE DATE DATE
INSPECTOR INSPECTOR I NSP ECTOI~'x
NJUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMi~NTAL SANITATION DIVISION AUG 2 6 1981
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER
DIRECTIONS: Complete all parts on page 1. Incomplete requests will .ot be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER I PHONE
I
MAILING--ADDRES~
' ' PHONE
PRO-pi~-RTY RESIDENT (if different from above)
2. BUYER PHONE
MAILING ADDRESS
3. LENDING INSTITUTION J PHONE
I
MAI LING ADDRESS
4, REALTOR/AGENT J PHONE
I
MAILING ADDRESS
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE ~ SINGEE FAMILY
[] MULTIPLE FAMILY
7. WATER SUPPLY [] INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
NUMBER OF,BEDROOMS
[~] One [] Four [] Other
[] Two [] Five
[~ Three [] Six
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ NDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEIV WAS INSTALLED.
L,~sq 5- 1£-~t
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 [Rev. 6/79)
THIS SIDE FOR oFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LoG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
F-IPUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or f-'] Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABsoRPTIoN AREA MATERIAL
4. DISTANOESwELL TO: Septic/Holding Tank IAbsorption Area ISewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[Z~APPROVED FOR '~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
72-010 (Rev. 6/79)
;
- ~ ~ ~ , D, ~"RECEIVED
INSPECTION APPOINTMENTS -, .' -
TIME ' · · TIME TIME ,
I NSPECTOR,~,
INSPECTOR INS'PECTOR J~U' ["~'" '~'~ - F ANCHORAGE
U T, (~1~ HEALTH &
MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 LStreet-Anchorage, Alaska 99501 AUG :3 6 1981
ENVIRONMENTAL SANITATION DIVISION E J
Telephone 264-4720 R'EC VED
REOUEST'FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete request~ will not be processed. Please allow ten {10) days for processing.
1. PROPERTY OWNER PHONE
MAILING ADDRESS
PROPERTY REb'~rDEN'r'[If'~ifferent frown above)~ PHONE
2. BUYER PHONE
MAILING ADDRESS
3, LENDING INSTITUTION J PHONE
MAILING ADDRESS
4. REALTOR/AGENT I PHONE
I
MAILING ADDRESS
5. LEGAL DESCRIPTION
~TREET C-OdATI ON
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
[~ SINGLE FAMILY [~ Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
7. WATER SUPPLY
[] NDIVIDUAL*
COMMUNITY
[] PUBLIC UTILITY
ATTACH WE LL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** (~( YEAR ON-SITE SYSTEM WAS INSTALLED.
~ PUBLIC UTILITY /_./.~S~
NOTE: THE INSPECTION FEE MUST ACCOMPANY'EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 {Rev. 6/79)
THIS sIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMS='R OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL "
[] COMMUNITY , ,
[] PUBLIC UTILITY DATE DRILLED
Connection Verified LOG RECEIVED .....
3. SEWAGE DISPOSAL SYSTEM ' PERMIT NUMBER
[]INDiVIDUAL/ON -SITE DATE INSTALLED ·
[]PUBLIC UTILITY
Connection Verified , -~ INSTALLER '
I-"rSeptlc Tank or [] Holding Tank
Size: If Tank is homemade 'ROLLS RATING
give dimensions: r
~I'YPE OF TANK MANUFACTURERr
TOTAL ABSORPTION AREA MATERIAL '
W E L L TO: Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line '
5. COMMENTS
[Z~'~APPROV ED FOR ~'~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED