HomeMy WebLinkAboutNORTH WOODS PHASE 2 BLK 1 LT 5TIT
EiN
•
i�
#051-741-24
Municipality of Anchorage °�.,
Development Services Department
Building Safety Division •
On -Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW040378 PID Number. _ 051-741-24
Nemo:
Wastewater System: ❑ New ® U rad
Address:
P9 e
22226 Whi,cerim, Man 99567
ABSORPTION FIELD
Ph": Number of Bedrooms;
O Deep Trench ® Shallow Trench 13 Bad O Mound 0 other;
LEGAL DESCRIPTION
SOrI Rating.
Total Depth from Original grade:
Block: l=SubdMelon:
1 5
0.6 GPD
Deptlr to Pipe bodom from Original gads:
5.0 Ft.
Gravel depth beneelh pipe:
North Woods Phase 2
2.95/2.96 Ft.
2.05/2.04
Township: Flange: Section:
FB d ab onel grade:
addeove dPi
Ft.
GW -1 Lanpth:
0.57-1.78 Ft.
106 Ft.
Well: New ❑ Upgrade
Gnavalwidlh:
NumberofW«: Dhtenesbetaeenllrws:
classification (private, A, B, C): Tool Depth: Cased ro:
$,0 Fl.
Telal ebeorylion area:
2 1 0 FL
Pipe Marenel:
Pu lac Fl.
1060
D3034
t.
Fe
& F810
Driller. Date Dralotl: Static water Level:
Installer:
Dale Installed:
of
R.P.C.
10/13/04
Pump Bet K: Calling Helght Above Ground:
r�pu
TANK
Ft.1Yield;
GPM Ft. Ft.
SEPARATION DISTANCES
0 Septic O Holding ❑ S.T.E.P. 0 Other.
To Septic Absorption Lift Holdingu' idpriva
a^ nen apo
From Tank Field Station Tank Sewer Line
Anchorage Tank 1000 Gal.
well
200'+
200'+
NA
NA
25'+
MSteI
Numbs of Compe Manb:
Steel
2
Surface Water
100'+
100'+
NA
NA
LIFT STATION
Lot Las
5'+
10'+
NA
NA"
a "re"
Gal.
Foundation
a
5 +
r
10 +
NA
NA
l
' Pump on' eve at:
ump otr level at:
H Pin wale' slam at:
Cwlein Drain NA *50'+ NA NA
Pump Make & Model Electrical Inspections performed by:
Remarks:
*none known ftfiqf& C&nc yLt
BENCH MARK
Locallon and Description:
n Nb
Bottom of siding
u 10 13 K '• 10. (01
Assumed Elevation:
100
Ft.
Engineer's Stamp
�� OF Al. 11
"i1`.••••.......ati S ,1
. fn..•. oa �,9
Inspections performed by: KNO Engineering, Inc Dates: 1 at 10/13/04
2nd
,r
Developme t Services Department Approval 3'et 161soliliv
• •a« .a.. •....o
Kenneth M.
rnt
Reviewed and approved by: 0. Date: p
It�a Jt
�����
«�•xe.
�i�"90FESSIO
AS—BUILT SYSTEM DETAILS/SITE PLAN Permit# SW040378
NORTHWOODS S/D, PHASE 2, BLOCK 1, LOT 5 PID# 051-741-24
� L co S� t
K H
MT CO
MT TH04-1 5 G
K N D ZABE SPLITTER O
co I C
MT
CO F DIVERTER
MT CID O�
o p B Q4
EXIS G o C
1000 GAL NK Q
O
FCO C)
co ?0J�
O O O
A
SCALE: 1
A—C=29.8'
B—C=23.3' s.2 ss3�
A—D=35.9'
B—D=22.3' 8.18 FINISHED GRADE 7.49
A—E=58' aar
B—E=63.5' E w.o
A—F=56.9' 1000 GAL
B—F=58.3' SEPTIC 93.4 93,4
A—G=76.2' + TANK SEWER ROCK
B—G=50.7'
A—H=82' 94.3 94.1 91.40 91.4
B—H=54.5' 1
A-1=73.5'
q—� �6, 6 97.3 FINISHED GRADE 97.0 ' d"
8—J=72' Ro nrue
A—K=90.2'
B—K=66.3' 93.5 93.4
A—L=94.7' SEWER ROCK
B—L=69.4'
91.44 91.4 1
r
OF PREPARED FOR:
GARY BADGER wom uon now, ,,,, nr� anv�non
/ C:) 22226 WHISPERING BIRCH DR. "T�DTO1p
CHUGIAK, AK. 99567
SCALE: NTS
.rD US FlELD BOOKS COMM
CE -711 k MUNDAer JOHNSONDRAWN: END ENGINEERING
1 /If a�rT � WrAMM — cH'q"ED- KMD 20441 PTARMIGAN BLVD.
AW
tY w
931021 / Am" DAT -*HN ON D" 11/10'04 EAGLE RIVER, AK 99577-8736
owc. f0£:
M NW0954
...............................................................................
04064ASB.DWG 04064 907 898-8111 FAX (907)696-8111
04064ash.dwn
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program _
4700 South Bragaw St. S A e T Y
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.orglonsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: KNO b9ineerina
Legal description: North Woods Phase 2_ Block 1. Lot 5
The attached paperwork has been reviewed and Is being returned for the following reasons:
❑ Original signature or stamp missing on _
Calculation error in design.
❑ Additional soils information needed.
❑ Water monitoring results inadequate.
❑ Discrepancy in information submitted.'_
❑ Topographic information missing or inadequate.
❑ Incorriptete; missing _
❑ Incomplete; missing _
❑ Additional adequacy test information needed. _
❑ Water sample unacceptable.
❑ Measured/proposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well log required. _
❑ Omission in narrative. _
❑ Insufficirt fill over tank or field,_
® OtherKI) Please submit groundwater monitoring results through construction in
accordance with Rjrmit pry—vision; and 23 Please indicate final disposition of former septic
tank. C I'£T QP j t zY jo y
Name of reviewer: Julie Makela. P.E. Date: 11/19/2004
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Permit Number: SWO40378
Legal Description: ,'NORTH WOODS PHASE 2 BILK 1 LT 5
Design Engineer: 0070 KND Engineering
Owner Name: GARY BADGER
Owner Address: 22226 WHISPERING BIRCH DRIVE
CHUGIAK , AK 99567-5449
Date Issued: Sep 09, 2004
Expiration Date: Sep 09, 2005
Parcel ID: 051-741-24
Site Address: 022226 WHISPERING BIRCH DR
Lot Size: 35178 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
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.
5. The following special provisions.
NEED TO DO GROUNDWATER MONITORING THROUGH CONSTRUCTION. A NEW GROUNDWATER
MONITORING FORM NEEDS TO BE SUBMITTED WITH THE FINAL AS -BUILT.
Received By:
Date:
Issued By, Date: 5jiA 4 o
A 111 't If
Municipality of Anchorage
Development Services Department
;1011
1011 op'
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. Permit Number SW
Property owner(s) Gary 8a ger
Day phone 6
-1 117
Mailing address (1) 22226 Whispering birch
Drive, Ch giak, AK 9Q567
Mailing address (2)
Zip Code
Legal description (Lot, Block & Sub'd.) North
Woods Phase 2, block 1, Lnt S
Legal description (Section, Township & Range)
Lot Size 351 Acr /Sq.Ft
Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only ❑
Well Only
Sewer and Well ❑
Water Storage
Sewer Upgrade EK
THIS PROPERTY CONTAINS:
Hot Tub ❑
Jacuzzi
Swimming Pool ❑
Water Softening Unit
Therapy Pool ❑
I 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.
property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 1000)
0t3/oe
'V S %
Waiver Fees:
Date of Payment:
Receipt Number:
MDENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-8111
September 2, 2004
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Sewer Upgrade — North Woods, Phase 2, Block 1, Lot'5
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit to upgrade and
replace the existing septic system and tank for the subject lot. The existing septic tank
will be abandoned in place and in accordance with municipal standards. On August 19,
2004 one testhole was excavated for the proposed system. The result of this test is
attached. The general slope of this lot is from east to the west at a grade of
approximately 3-10%.
We have designed our system utilizing the testhole we excavated for the existing 3 -
bedroom house. The lot is served by public water. We propose to install two 5' wide
shallow trenches. Water was not encountered during the excavation or monitoring,
however it is expected that groundwater will rise at the seasonal peaks and the system
has been designed to account for this occurrence.
There are no public or private wells within 200' of our proposed system location except
as noted. 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 696-6111 / FAX 696-8111.
Respectfully submitted,
XHD Engineering, Inc.
Kenneth M. Lluffus,I.E.
Attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/ Site Plan
Soils Log/Percolation Test
Owner:&xcavators Specs
WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN
NORTHWOODS S/D, PH.2, BLOCK 1, LOT 5
�A
NO PUBl1C NEUS NnHR 200' OF
PROPOSED SYSTEM.
NO PRIVATE MU wTHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS wTMN 200' OF
PROPOSED WELL EXCEPT AS NOTED.
1 � .
\ �'bFES310N�'
DESIGN DETAILS
3 BDRM X 150 GPD s 450 GPD
450 GPD/0.6 GPD PER SO. FT. (23 MIN AN.)— 750 SO. FT
(750/5'(W)) X 0.70(RF) (2' GRAVEL) - 105 FT. TRENCH
USE 2 TRENCHES — 53'(L) X 5' (W) X 2'(D)
Total depth of system is 5' from original grade.
Total depth of gravel below distribution pipe is 2'.
NOTES:
1. USE 1000 GALLON SEPTIC TANK. INSULATE TANK IF 0' COVER.
2. INSULATE TRENCHES WITH 2" HD BURIAL FOAM.
3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK.
4. CONTRACTOR WALL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS & SEPTICS, ESMTS, PROPERTY LINES, WATER LINES, ETC.
PREPARED FOR:
GARY BADGER
22226 WHISPERING BIRCH DR.
CHUGIAK, AK. 99567
FIELD BOOKS
DOUNDARM
STMNQ
As's" JOHNS
ONQ EXE`
ACAs PLE.n,nn^
COMPUTED:
DRAM: WAC
CHECKED' KMD
DATE 09-01
MD` NW155
ODD "e.: 04009
61
Scale: 1"= 100'
PAGE 1 OF 2
=11 W ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
WASTEWATER DISPOSAL SYSTEM DETAILS
NORTHWOODS S/D, PH.2, BLOCK 1, LOT 5
or
OF AZ 14
4*
;0 /
\ SSIOtt�'
PREPARED FOR:
GARY BADGER
22226 WHISPERING BIRCH DR.
CHUGIAK, AK. 99567
FIELD BOOKS
COMPUT o:
BOUNDARY:
DRAW: wAc
STAMM
O1EO"D` KMD
ABr JOHNSON
DAA —01
pN FXE.
am. NW155
AUD `04009—DR
JOB N&: 04009
Scale: 1"= 20'
PAGE 2 OF 2
MUNI W ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
1
11
MD ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
SOILS PERCOLATION TEST
Performed for: Gary Badger Date Performed:
Project: North Woods Phase 2, Block 1, Lot 5 TEST HOLE # 04-1
Depth
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20 -
SEE ATTACHED SITE PLAN
Org/OL FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? NO Date?, 8126/04
GM - sand, cobbles & density
increasing w/ depth
B.O.H.
Dry fall - use water monitoring
Sr of e)dsting TH 4/28/83
HOLE PRESOAKED
PRIOR TO TEST
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
8/26/04
1:00
6"
-
2
1:30
30 min
48/16"
18/16-
3
1:30
48/16"
-
4
2:00
30 min
34/16"
14/16"
5
2:01
48/16"
-
6
2:31
30 min
33/16"
15/16"
"
Water
Added
Percolation Rate 23 (min/ in) Perc Hole Diameter 6"
Test Run Between 4 feet and 5 feet
L Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
K D ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
FAX (907) 696-8111
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES AND MATERIAL SPECIFICATIONS
LEGAL DESCRIPTION: NORTH WOODS PHASE 2, BLOCK 1, LOT 5
GENERAL:
1. The scope of this project includes the installation of a septic tank and/or drainfield to serve a
single-family residence on the referenced property as delineated on the attached Municipality of
Anchorage (MOA) permit and site plan.
2. Consiruction shall be in accordance with the approved site plan and design drawings; MOA
permit with any special provisions or conditions, and all applicable State and Municipal
Wastewater Disposal Regulations.
3. KND Engineering Inc (KND) assumes no responsibility of the accuracy of the as -built survey
provided by the owner or owner's representative.
4. The owner or contractor is responsible to notify the engineer of any discrepancies noted on the
design plans or drawings prior to commencing work. These discrepancies could be, but not
limited to, possible encroachments, surface water, varying soils, unplatted easements, types or
use of dwellings on or adjacent to property, nearby public wells, etc.
5. The contractor shall be responsible for locating any necessary underground utilities, easements,
property lines and surface water. The owner and/or contractor shall ensure, if deemed
appropriate, that a registered land surveyor prior to construction flags all setbacks.
6. The contractor shall be responsible for verifying all pertinent separation distances and
component layout.
7. Unless specifically agreed otherwise, the property owner shall be responsible for final grading
areas subsequently depressed from soil settling. On all leachfield mound systems, the property
owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded
area.
8. The MOA Development Services Department On -Site Water & Wastewater Program must
certify contractors installing wastewater disposal systems. Owners installing their own systems
must also receive prior approval from said MOA Department.
SEPTIC TANK / HOLDING TANK / LIFT STATION INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall
include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded with proper material and compacting to prevent
damaging, settling or shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches above the final grade.
4. Septic tanks installed with less than 4 foot of cover shall be insulated. The contractor will
ensure that the fill over the tank does not exceed the burial depth rating.
5. A foundation cleanout shall be installed one to four feet from the building foundation. In the
line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent
pumping system exists within the septic tank). These cleanouts shall be located on undisturbed
soil not more than 10 feet from the tank. The second cleanout, in line, shall be to clean toward
the septic tank.
6. Final grading over the septic tank shall be such that a positive slope exists away from the septic
tank.
Pant 1 of R
Reference: N. Woods #2 Bl, LS
Date: 09/02/04
Page: 2 of 3
7. All H.D.P.E. tanks shall have a vertical length of 4 -inch perforated drainpipe besides the tank
extending to the bottom of the tank to above grade to monitor ground water.
8. All tanks shall be anchored when there is not enough adequate soil cover to resist buoyancy
forces in high -groundwater areas.
9. All holding tanks and lift stations shall have an audible and visual alarm inside the residence.
10. All lift stations shall be wired in compliance with the Uniform Electrical Code and all MOA
guidelines.
11. The contractor shall remove the old tank, or abandon it in compliance with the Uniform
Plumbing Code. The contractor is solely responsible for the abandonment procedure.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavaction become smeared,
they must be raked or scratched (roughed -up) before gravel (sewer rock) placement.
2. Once the sewer rock is installed, the distribution pipe is installed level with the perforations
facing downward. Gravel is then to be placed over the distribution pipe to provide a minimum
of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure
the silt barrier covers the entire gravel surface before placing backfill.
4. Monitoring tubes shall be four- (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. The portion of the
monitoring tube extending through the gravel shall be perforated from the bottom of the trench
to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as
noted on the design.
5. Backfill over the final gravel layer must not be less than twenty-four inches. Insulation must be
installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the
trench must be mounded to prevent the formation of a depression after settling.
6. All advanced technology waste water disposal systems (Advantex, Biocycle, Intermittent
Dosing Sand Filter, etc...) shall be constructed, installed, maintained and monitored per
manufacturer's specifications and MOA requirements.
MINIMUM MATERIAL SPECIFICATIONS:
1. A MOA approved septic tank manufacturer must construct any septic tank proposed for
installation.
2. The following pipe materials are MOA approved for use in septic system installations:
Type of Pine Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company
Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or
equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between
the final lea¢hfield gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing
the #200 sieve. If deemed necessary, a sieve analysis should be performed.
7. When sand is being used as a filter material, its gradation specification must conform to current
MOA or DEC requirements.
Reference: N. Woods #2 B1, L5
Date: 09/OVO4
Page: 3 of 3
INSPECTIONS:
Typically there will be three (3) inspections required during the installation of the wastewater
disposal system. These inspections will occur as follows:
1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds
and before the installation of any gravel. A septic tank may be set, in place, but may not be
backfilled before this inspection.
2. The second inspection must be conducted after the placement of the sewer rock, distribution
lines, standpipes, and cleanouts, but before the placement of the silt barrier, insulation, or any
other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required, especially with the installation of multiple
trenches, sand filters, pressurized distribution systems, etc. The inspecting engineer is to be contacted
at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take
place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's
activities.
The owner shall contract with the contractor to perform the work outlined in these specifications and
attached plans and in accordance with the attached MOA permit. All materials, components, and
construction practices shall comply with the MOA's and the State of Alaska's latest ordinances,
regulations, or policies regarding wells and septic systems. The failure of the inspecting engineer to
notice a material or construction non-compliance does not relieve the contractor of his/her
responsibility to correct such deficiency. There will be no contractual arrangement existing between
the contractor and KND Engineering Inc. KND shall be the owner's representative and will inspect the
work as stated above to document the contractor's activities. Final acceptance of the contractor's work
rests with the owner and the MOA.
KND shall have no liability to the owner or to others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the contractor to carry out the work in
accordance with these construction documents. KND's inspecting engineer will not be responsible for
the construction means, methods, and techniques, sequence, procedures or the safety precautions
incident to this project.
BY PROCEEDING FORWARD WITH THE INSTALLATION OF THE WATER AND/OR
WASTEWATER SYSTEM (S), THE PROPERTY OWNER, CONTRACTOR, AND WELL DRILLER
ACKNOWLEDGES HAVING READ AND ACCEPTED THESE SPECIFICATIONS.
A
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
NEW
1.11.
F-1UPGRADE
MAI LING ADDR SS
5f ikrcCe-IN L R 6 A 6:7. c 9 -7.
LEGAL DESCRIPTION AA4
A /�/ - �0
LOCATION
N0. OF BEDROOM
Well
Absorption area
Dwelling r
PERMIT NO.
V Y
DISTANCE TO:
�i
`-} Z 0
'
_
a Q
W<
Manufacturer
0
Material
No. of compartments 2.
rn
Liq. capacity in gallons
1
Inside len gth
Width
Liquid depth
-
090,-
IF HOMEMADE:
,.----"�"'
-
G Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
J (DZ
O Z Q
0 Z Fl
Manufacturer
Material
Liquid capacity in gallons
O
Well
Foundation
Nearest lot line
PERMIT NO.
W =
DISTANCE TO:
J LL Z
No, of lines
Length of each line
T t length of lines
Trench width
Distance between lines
P Z W
44A
Iinches
I-
Top of tile to finish grade
Material beneath tile
Total effective absorption area
p
inches
W
a
Length
Width /
Depth I d7 aa 7¢
ry tJi YJi t�2 l� o Vv''
PERMIT NO.
.
wType
of crib
Crib diameter
Crib dept,
Total effective absorption area %sn
LLI
w
WellNIP
Building fr � tionv
Nearest lot line
DISTANCE TO:
Y
+ 67 0
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
3:DISTANCE
it in fodation
'u
e li a
Septic tank
Absorption area(s)
TO:
OTHER
I
PIPE MATERIALS
SOI L TESTRARATI Nfi,
INSTALLER
I E3 R J -X C'11 y FAII t41,
REMARKS
Y
a
v
r'E
f �
f f
APP V DATE LEGAL¢
egg=n All
72-Ul3 rev. 3/78) 11 Vill.'604-297,9 .. -...•...n.
LMUNICIPALITY OF ANCHORAGF'r—�
Department/_')f Health and Environment& trotectiio '-
825 L Street, Anchorage, AK. 99501
264-4720
cc # # # HANDWRITTEN PERMIT # # #
Permit Gl�. OR ON-SITE SEWER PERMIT
Applicant: ('"/�}Mailing Address: Vo .S'
Location: Phone Number:
Legal Description: s / /�/ 02 /r��llD01i Sl� o� Size:
Type of Soil Absorption System Is:
Trench: Drainfield: _ Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH `� LENGTH �'2" _ GRAVEL DEPTH L WIDTH �0'
The length dimension is the length(in feet) of t eUt ehchor drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE GALLONS # #
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* # * TWO(Z) INSPECTIONS ARE REQUIRED # #
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
# # # PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) _ I understand that the on-site sewer system may require enlarge nt if
the residence is remodeled to include more tha 3 b 00 S.
Signed: Issued by:
Applican
Date:
SWP/024(1/81)
PERFORMED FOR:
LEGAL DESCRIPTI
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
❑ SOILS LOG
MUNICIPALITY OF ANCHORAGE(
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION \ PERCOLATION
TEST
825 L. street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
r
SLOPE
— ---7
DATE PERFORMED:
,,, :y
Z e ;2,
SITE PLAN
WAS GROUND WATER r L
ENCOUNTERED? J O
P
i E
IF YES, AT WHAT
DEPTH?
-P
- Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
k,
630
--2
_7
h
S-6
to
16 1,q
3
� ne t
20LJZ
u PERCOLATION RATE (minutes/inch)
li T RUN BETWEEN FT AND t—�=FT
COMMENTS -
PERFORMED BY: ` r, A "–MW', CERTIFIE DATE
r t' -as ���� -
Zas, f9' R, A1,A51 . 55577
72-008 (6/79)
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Zar k/a
Parcel I.D. Q-511-7411-24 HAA # OU old
Expiration Date:.. �-r—"T�`�
1. GENERAL INFORMATION
Complete legal description North Woods Phase 2, Rloe 1, Lot S
Location (site address or directions 22226 Whisoerinfl Birch Dr Chuglak AK 99567
Current Property owner(s) Gary Badaer Day phone 769-11112
Mailing address
Lending'agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD
for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
®
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional
civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the
transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal
and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health
Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well
and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one
year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or
a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
4. 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 Health Authority 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 ..r . .Inc-oner
Address0' Ptarmigan
Engineer's Printed Na Date 11110/04
Engineer's Comments:
This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the
condition of the well and septic applies only to the
conditions as of the day tested. The flow and absorption
rates may change due to subsurface conditions that
may not be observed from the surface, changes in
land use, local soil characteristics, groundwater levels
that may fluctuate during the year and the water usage
of the family being served by the system. The operational
life of all well and septic systems are subject to these
various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system.
Therefore, KND can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can KND guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
5. DSD SIGNATURE
Approved for 2S bedrooms.
Disapproved.
Conditional approval for bedrooms, with the
ON-sve .�
pu��i6�:AA ER
v9PsiEW nee
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineers Report
Well Flow Advisory Other
By: Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
3 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: North Woods Phase 2. Block 1, Lot 5 Parcel ID: 051-741-2
4
A. WELL DATA
Well type_PILWLG if A, B, or C provide PWSID #_ Well Log (Y/N)
F Date completed Sanitary seal (Y/N.)_ Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height (above ground)
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production 9-p.m g.p.m.
WATER SAMPLE RESULTS:
F Coliform __--colonies/100 mi. Nitrate __ung./1. Other bacteria _colonies/100 mi.
Arsenic: __fng•/l. Date of sample: Collected by:
' B. SEPTICIHOLDING TANK DATA
p
Tank Type/Material septic/steel (Anch. Tanks Date installed 10/13/04
Tank size 1000 gal. Number of Compartments2_ Cleanouts (Y/N) Y
Foundation cleanout (YIN) Y_Depression over tank (Y/N) )SLHigh water alar (Y/N) J9
j;
Date of pumping NA-new tank Pumper
r C. ABSORPTION FIELD DATA
= Date installed 10/13/04 Soil rating (g.p.d./ftZ or ftZ/bdrm)Qf System type Trench
Length 106 (2 x 53) ft. Width 5 ft. Gravel below pipe 2.05 / 2.04 ft.
Total depth .4 ft. Eff. absorptionarea 1060 ftZ Monitoring tube Y Depression over field N
Date of adequacy test NA-new field Results (Pass/Fail) For e bedrooms
Fluid depth in absorption field before test in. _ Water added— gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date -----
k
Date installed NA Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off" level at_ in. High water alarm level at
Datum Cycles tested Meets alarm & circuit requirements4,
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer /septic service line
On adjacent
On adjacent
Public sewer manhole/cleanout
Holding
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5 ' + Absorption field 5 1+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 10 0 ' + Driveway, parking/vehicle storage 10' +
Curtain drain 50'+ Wells on adjacent lots 2001+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Kenneth M. Duff us
Date 11 /10/04
HAA Fee $430.OQ
Date of Payment /, I A l°4
T
Receipt Number _.Le) 77 Jh
(Rev. 12101) 1
VV 0
Waiver Fee $
Date of Payment
Receipt Number
!r
in.
ply `
i
{
RAF : YJ
V ~ L.J T#`'
t 1
tR U/(�11114
mm fA
vas♦4 y. °+ <, ri: <�*
RAW
l��'d `,0
u:4 b
i }
r�
3
�d
wo
a
DnteQ .at;,
71
*.
c . a
ly
+ {� i 4✓'+ t... r
1 } a
s»
ply `
i
{
RAF : YJ
V ~ L.J T#`'
t 1
tR U/(�11114
mm fA
vas♦4 y. °+ <, ri: <�*
RAW
l��'d `,0
u:4 b
i }
r�
3
�d
ply `
i
{
RAF : YJ
V ~ L.J T#`'
t 1
tR U/(�11114
mm fA
vas♦4 y. °+ <, ri: <�*
RAW
l��'d `,0
u:4 b
i }
r�
�d
wo
a
DnteQ .at;,
a nerOM
�y nMw at •w it y i
--AAY oL,tyN— X
i.
�''" � � f t , � ` �,F ♦ ,ktd78�Rx, G:' JptIN50N ,�R ,,'.
R®gtstpaadi,nndstlr9k9dl
i08g0 Ira,
i" 30 azr
.- �. � :'. _ Phseie (947) 994-354 •c >;` r_
MUNICIPALITY OF ANCHORAGE Y
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date (,, Z- 07
1, GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township,
04
P
Location (address or directions) I
&�'r�r 1 S 1�1 �G Ta i9_c t l -
(b) Applicant Nam e�ru— Sk.�-A Telephone: Home � f3 -iCcs�o Business
Applicant Address -L1 IS
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder Buyer ❑ ; Other ❑ (explain); -
(d) Lending Institution �lL ��-�a�si t-�G Telephone
Address
(e) Real Estate Company and Agent t✓
Address
Telephone
(f) Mail the HAA to the following address:
S & S ENGINEERING
17034 Eagle River Loop Road No. 204
Eagle River Alaska 99577
TYPE OF RESIDENCE
Single -Family 5r, Multi -Family p
Number of Bedrooms
Other
3. WATER SUPPLY
Individual Well ❑ Community ❑ PublicJ
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
72-025 (11/84)
Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site watersupply 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 in ypf ctj
ZMGINEERING
Name of Firm 17014 E2gle River Looe Road No. 204 Telephone
Address Eagle River, Alaska 99577
Date
6. DHEP APPROVAL / , q
Approved for%�&.bedrooms by Date ���n� 9 /v
Approved Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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.
Page 2 of 2
72-025 (11/84)
f�NICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE (MGMRONMENTAL SERVICES DIVISION
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1884 JUN 8 lg%,
264-4720 (�'
Legal Description: — �_PC 6W. v
A. WELL DATA
Well Classification
If A, B, C, D.E.C. Approved(�Si'N)
Well Log Present (Y/N) Date ompleted " Yield
Total Depth Cased 4
Depth of Grouting
Static Water Level
Pump Set At
Casing Height Above Ground
Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N)
Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic Ing Tank on Lot Z
t
; On Adjoining Lots
t
Zoe `�
To Nearest Edge of Absorption Field on Lot
; On Adjoining Lots
To Nearest Public Sewer Line
To Nearest Public Sewer
Cleanout/Manhole
To Nearest Sewer Service Line on Lot
Water Sample Collected by
; Date
Water Sample Test Results
'�PwS
Comments N C>
B. SEPTIC/TANK DATA
Date Installed ' '-'V2--62j Size ( No. of Compartments 2
Standpipes445TJ) Air -tight Caps 4%N) Foundation Cleanout ON)
Depression over Tank (YA? Date Last Pumped
Pumping/Maintenance Contract on File (Y/N)fli; for
Holding Tank High -Water Alarm (Y/N) I` Temporary Holding Tank Permit (Y/N) _PJ 1A
Separation Distances fromSeptic/ Tank:
,
To Water -Supply Well 2-='p t To Building Foundation
To Property Line -i- To Disposal Field
To Water Main/Service Line It> 114- To Stream, Pond, Lake, or Major Drainage
Course - r
Comments V l'S t�JMp'1►�U S�1G� �JQ g� C%'Z
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed —83
r
Width of Field 16
ZSd�a3Zv Type of System Design
r
Length of Field 4-L
Depth of Field
99
Gravel Bed Thickness rryADe2 4CW16Y—
Square Feet of Absorption Area 7sb 7S� Standpipes Present(DN)
Depression over Field (Y j Date of Last Adequacy Test b __7 -10-7
v
Results of Last Adequacy Test
Separation Distance from Absorption Field:
(
To Water -Supply Well 1_wv 14, To Property Line 1 O +
To Building Foundra�tign is To Existin or Abandoned S stem on
Lot 7
To Water Main/Service Line
9 Y
On Adjoining Lots
tJ
To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course 14u
To Driveway, Parking Area, or Vehicle Storage Area J;;76 1+
Comments {AV2�120,-_f(7sr.lk� O o L -E_* sis. ,
19 63 �1 K�-� 'f LkE, M0L.:;V �-t �w r� rp_ na 14>F
aS
D. LIFT STATION ------
Date Installed
Dimensions
Size in Gallons Manhole/Access (Y/N)
"Pump On" Level at "Pump Off' Level at
High Water Alarm Level at Vent (Y/N)
Tested for
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I have checked, verified, or conformed to all MOAand HAA guidelines in effect on the date of this inspection.
Signed & S ENGINEERING Date �/ �7
J,
Comp Eagle Rlver Loop Road No. 2 b 3
No. �7��
agle ver, a e .� �d
C� %i
Receipt No. cam- OC1 �— aC� Y,b � ai1b�.
Date of Payment 7 orea.%
Amount: $ p2) cp OF ....
*n. sa ri
1S. �.4
.>.' q
Page 2 of 2
72-026 (11/64)
A
0
ANCHORAGE/WESTERN DISTRICT OFFICE_
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
DATE: May 1S, 1987
PWS I.D.# 21300].
STEVE COWPER, GOVERNOR
Telephone: (907)
Address:
274-2533
To Whom it May Concern:
According to records on file in this office the C11UGIA K UTILITIES
(Northwoods) Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
Michael P. Lewis
Environmental Engineer
JJpp
jj(( rJ
} r
5
DEPT. OF ENVIRONMENTAL
CONSERVATION
F
"
�9
ANCHORAGE/WESTERN DISTRICT OFFICE_
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
DATE: May 1S, 1987
PWS I.D.# 21300].
STEVE COWPER, GOVERNOR
Telephone: (907)
Address:
274-2533
To Whom it May Concern:
According to records on file in this office the C11UGIA K UTILITIES
(Northwoods) Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
Michael P. Lewis
Environmental Engineer
