HomeMy WebLinkAboutLot 01I
Lot I
¢ 051-042
-95
MUNICIPALITY OF ANCHORAGE
r~,
DEI'-.~TMENT OF HEALTH AND HUMAN SER~..S
Environmental Health Division
,, 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name ,, DISTANCES
Address ' TANK FIELD WELL
~Te(s) I Perm,t No, INo. of Bedrooms WELL /~ 3 //
3/t J , , ,.
LEGAL DESCRIPTIO. LOT LINE //~ +
J Block J Subdiwsion
Lot ] J~l~ ~J O/ ~ FOUNDATION ~ ~ /
wnship,~ange, SecLion
/ /~ AS-BUILT DIAGRAM (Show Jocahon of well, septic system, property lines, foundahon,
driveway, water boO~es,
~ /% / TANKS N
~ SEPTIC ~ HOLDING
Man~lacturer Capacity m gallons
Material No, ol Compa~ments
TYPE OF SYSTEM
~TRENCH ~ BED ~ W. DRAIN ~ OTHER
"~epth'to p~pe bottom from Total depth from odg~nal grade
Fill added above original grade Gravel depth beneath p~pe
~ '~ FT ~, ~ FT
Gravel length / Gravel w~dth
] otal a~sorpt~on area D~stance ~etween lines ~ __
~u'mb~r of hnes J S~,I rating P,pe materia~
~ J ~SOFT p~ ~0~ ~
Installer ~ Date Installed ~ -
~PRIVATE ~ OTHER{Identify) ,.,'~ ~ ~¢o'.~
Classlfication(A,B,C) 7otalDepth ~CaseOto ~'~. X .~ ~/~
Installe~ Date Installed: ~ ~ ~
REMARKS:
Inspections Pedormed by: ~ ~ '~" f~'~" ~ ' ~"~
I .:.;~ ,G~E ~JV~D. ¢~[ ;:~::~'& ,.~??, cedily that this inspeaion was pedormed according to all
Municipal and State guidelines-in eliecl.on, this date: / ~ ~ /
Health Depa~menl Approval: Date: / / ' L- ..
/ / ,,
72-013 (3/85)
DEPARTME]',IT OF i"IE. ALTH AN]E) E~NVIR[]NMENTAL I::'ROTECTION
8~'~5 L STREET, ANCHGRAGE, AK 995()1
264-'4720
F:'ERM I T NO ~
DAT'E ISSLJEI}~
85()64.8
1 () / 02 / 85
AF:'F:'I_ I CANT:
A D D R I.E S S:
CONTACT PI-IOI',IEE:
DOUBL['~ "M" CONST.
P.O. BOX 67()095
[.;HUG I Al':::., Al'::] 9956'7
6 8 8...- 2!; 1 13
I....EGAI .... DIESCRIP: SUBDIVISION, DIGEL LOT: 1
SECTION: 4 TC,)WNSHIP: 15N RANGE: 1W
LOT SIZliE: 4900C) (SQ. FrT. OR ACRE]S)
MAX BI~ZDIROOMS: 4
BLOCK: TRACT A
L..isted bel(::)w are the options available 'Lo you in designing youp septic
system. Choose the opt. ion that best £its youp site.
DEPTH TC) F:'IPE BC)T'I"OM (FT.)
GRAVEl... DE]:::'TH (FT.)
TO'T'AL DEPTH (FT.)
GF;,'AVE!]....WIDTI-.', (FT.)
GRAVE&.. LI!i']NGTH (FT.)
GRAVl.EL. VOLUME (CU. YDS. )
TANK SIZE (GAL. E;)
SOIl .... RATII'4G (SQ. FT. /BR)
4.0 4.5 4.0
5.0 0.5 3.5
9.0 5.0 .'7 .'~;.
2.5 26.0 5,, 0
90.0 *% 50.0 97.0 ~
45.9 48.2 7:L.'9
1,250.0 ** . 1,250.0 ** 1,250.0 .~.~
225 2 13 225
.~.x,- (3RAVEL. LENGTH > '75 Fl". REJ2UIRES MULTIPL. E RUNS
%% 'FANK MUST HAVE AT LE:AST TI,dC') CGMF:'AR'I'T'IENTS
(NOT EXCE:EDING 75 F"T.
I.E A C H )
I c:ert:i.f'y that:
I am fam:i].iap with the requiremen'Ls For' on-.site seweps and wells as set
f'or'th by the Municipality of AnchoPmge (MOA) arid the State oF Alaska.
2. I will. install the system in accopdance with all MOA codes and regula'Lions,
and in comp].J, ance with tine design cpiter, ia of' th:Es permit.
3.. I will adhePe to all MGA and State of Alaska requirements for the set bat:l<
distances Fr'om any existing well, wastewateP disposal system or public
sewePage system on this or any adjacent oe nearby lot.
Zl.. I understand that this pePmit zs valid fop a maximum of 4 bedrooms and
any enlaPgement will r'equir'e an additional pepmi'L.
IF A LIFT STA"I"ION IS INSTAL. LED IN AN AREA COVERED BY MOA BUILDING CODES,
'1"HEN (1) 'AN EL.ECTI::~ICAL F:'ERMIT AN]E) INSPECTION MUST BE OBTAINED; (2) AS-.BUIL. TS
WILl_ NO"I" BE APF:'ROVEI) WI'T'-iOLJT AN E:LE:CTRICAI_ INSPE:CTION REPORT; AND (3) THE
~':;~:.E~:LECTI"R I CAI_]. ........... (:',NED~W(~L'ST '~ ~~.BE DONE BY A .L" I CEIqSE:D, ELE:CTIR I C I AN.. '. DATE:
"~ COI~ ~
API:::'I.... I CANT: D[~BI..~[ "i'"', T,
..........
DEI:::'(4R'H'q[:2NT OF:' HEAI_..TH AND ENVIROI',IME]",ITAL PRO'I"ECTION
8.?.5 L STREI.'.CT, ANCH[IRAGE, AK 99501
~64.-47~o
C) ~'",4t ........ E-i; I -l- EZ $ ES W E F( .,I~.¢ W E:" [_ L. F" E R M I 'T'
.'ERMIT N0:
.~ A'T'IE t S S LJ E D:
85()648
1 C) *'(')'-'
/. ~
iPPL_ I cANT:
{ D D F=< E S S:
:ONTA[)T F'HONE:
DC.)UBL_E "M" CONST.
F'. 0. BOX 67JL}9,~
CHUGIAI'.::, AK 99567
6 El 8- 31.1. 3
.EGAL DESCRIP: SUBDIVISION: DIGEL LOT: I BLOCK: 'TRACT A
SECTION: 4. TOWNSHIP: 15N RANGE: 1W
.0]" SIZE]: 490(')0 LSD~FT./]OR ACRES)
.isted be].ow are i. he options available to you in designing your septic
iRAVE1 .... DEPTH (FT.
iI::;:AVEI,.~ WIDTH (FT.) ~ { 2. ~ ~ ~ 22~)~ 5.0 '
'ANX SZZE m L.S **
~OIL RATING (SQ. F]". /BR)~)~
· ~-~ T~NK MUST HAVE AT'
cer~ti{'~ that~ ~ '
1,; I am familiar with the~rements for on-site sewepS and wells as set .
¢cmth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I w:i. ll install the system in accordance with all MOA codes and regulations,
anti in compliance with the design cr. ite~ia o[ this per'mit.
3. I will adhePe to all:MOA and State of Alaska r'equirements fop t. he set. back'
distances from any existing well, wastewatep disposal system op publi'c
sewer~age system on this o~ .any adjacent o~ nearby' lot.
4.. I under'stand that this pepmit is valid [o~ a maximum oF 3 bedrooms and
any enlaPgement will require an additional per'mit.
F A L..IF:'T STA'I"ION IS INSTALL..ED IN AN AREA COVERED BY MOA BLJILDING
HEN (1) Ahl ELIEC'I'RICAt_, PLERM]:T AND INSF'ECTION MUST BE'] OBTAINED; (2) AS-BUIL. TS
}ILL NO1" ~E: APF'ROVED NI'THOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE
],...E:CTF;tI CAL, NL~MUST BE DONE BYJ.~ LICENSED ELECTRI CI AN.
MUNICIPALITY OF ANCHORAGE
DEPARTI~IENT OF HEALTH ,~,ND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG -- PERCOLATION TEST
/-/;74
SOILS LOG
PERCOLATION
TEST
DATE PERFORMED:
SLOPE SITE PLAN
I0
11
12
13
WAS GROUND WATER
ENCOUNTEI~ED? ~0 SL
P
E
IF YES, AT WHAT
DEPTH?
14
15
16
17
18
19
20
COMMENTS
PERFORMED BY:
72-008 (6/79)
Gross
Reading Date
Time
I~b~ A. S~4'f% .'
No. 1457-E
Net Depth to Net
Time Water Drop
PERCOLATION RATE '~'~' '~
TEST RUN BETWEEN ~ FT AND '~'""~ FT
(minutes/inch)
MUNICIPALITY OF ANCHORAGE
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
GENERAL INFORMATION
(a)
(b)
(c)
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Name [~:)L)I~L..~ ~.l~ ~-4¢~,.~._.~ Telephone: Home Bus, ness _~D~_'"~"
Applicant Address '~,<~::>, ~------~ f.~'"]rs/)<°l~ -'- ~---t-~-tS(~l,~,'t~ i ' -
Applicant is (check one): Lending Institution []; Ownerlbuilder~; Buyer []; Other [] (explain);
(d) Lending Institution Ol~: ."~c:~ ?~ .J~,-, Telephone
Address ¢, ~C'). ~ t~d"Z.~C-~
(e) Real Estate Company and Agent
(f)
Address
ne
IVCal'rthe HAA to the following address:
Engineering
196×
¸3.
TYPE OF RESIDENCE
Single-Family¢ Multi-Family
Number of Bedrooms
Other
WATER SUPPLY
Individual Well'~ Community [] Public []
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 wr tten conf rmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 01/84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DA m A 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 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 __
S & S Engineering
Address
Date Ear~le tHver, Alaska 99577
Telephone
g
~:rPrm~V:~condi~p prova~iSapproved ./~ / ~c~'t"'~'C-~' ~ate
/ /
CAUTION
·
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authonty
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)
WELL DATA
MUNICIPALITY OF ANCHORAGE (MO~/
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: L----~>I'-
MUNICIPALITY OF
DEPT. OF HEALTh
ENVIRONMENTAL PROTLC,.
JAN
R~
._ ECEIVED
Well Classification ~ i¢' If A, B, C, D.E.C. Approved (Y/N)
Well Log Present ~N) Date Completed { ~)" ~ --' ~' Yield
Total Depth L~' Cased to ~ Depth of Grouting
Static Water Level ~ ~
Pump Set At
Casing Height Above Ground '2'~:~ Sanitary Seal on Casingd~N)
Electrical Wiring in conduit~i~:TN) Depression Around Wellhead (Y~;)
Separation Distances from Well:
To SePtic/~ldi.~g Tank on Lot ~ ~"~ ' · On Adjoining Lots
Field on, Lot !~ ~::~' Adjoining
To Nearest Edge of Absorption ; On Lots
To Nearest Public Sewer Line ,~/f~' To Nearest Public Sewer
Cleanout/Manhole t.-3]~ To Nearest Sewer Service Line on Lot
Water Sample Collected by '~----~--~ ~:::~lN.-~'~'~--Ji--4~'-'-~z''' ; Date ~.--'-
Water Sample Test Results ~,~--r-I '5
Comments
B. SEPTIC/I=I&)L-I~I~G TANK DATA
Date Installed ~C>- I (z:>-~l~'Size ~'Z.-~:~'~:::) No. of Compartments ~-.
Standpipes(~9/N) Air-tight Caps (~'N) Foundation Cleanout{~N)
Depression over Tank (Y/~ Date Last Pumped
Pumping/Maintenance Contract on File (Y/N)r.3 l ; for
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Hofdm~ Tank:
!
To Water-Supply Well I ~"~
To Property Line I ~Ot -'~
To Water Main/Servic~..~L~; ~ CD ~
Course
Temporary Holding Tank Permit (Y/N)
To Building Foundation ~-~ '
To Disposal Field ~' ~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed [ ~ ,--- ~ tp
Width of Field ~ ~
Square Feet of Absorption Area
Depression over Field (Y/~.
Results of Last Adequacy Test
Separation Distance from Absorption Field:
I
To Water-Supply Well
To Building Foundation ,
Lot
To Water Main/Service Line ~ ~-~ 1 .~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design ~-,-,~ ~...~-'1~:1,.~:~
I
Length of Field t. c:>¢~
Depth of Field ~, ~
Gravel Bed Thickness '~'~, ~'
Standpipes Present(~l)
JDate of Last Adequacy Test
To Property Line ~ /
To Existir~g or Abandoned System on
· On Adjoining Lots ~ "~
To Cultbank (if present) /'~
Comments
D. LIFT STATION
Date Installed
Dimensions
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Manhole/Access (Y/N)
.!"Pump Off" Level at
/ /~ Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MO/), and H,~,A guidelines in effect on the date of this inspection·
'g ...... Date
S~ ned s&$Engin~ring ___ .
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
CHEMICAL & GEOLOGICAL LABORATORIES Ok ALASKA, INC.
TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER 5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
I.D. NO.
Water System Name
Mailing Address
Phone No.
Zip ~
C~ State
Mo. ~Dly Year
SAMPLE TYPE:
~ Routine
[3 Check Sample (for routine sample
with lab ref, no.
[3 Special Purpose
Treated Water
Untreated Water
SAMPLE
NO. LOCATION
Time Collected
Collected
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[] Sample too long in transit; sample should
not be over 30 hours old at examination to
indicate reliable results. Please send new
sample via special delivery mail.
Date Received ...~___.~"* ~
Time Received
O
Analytical Method:
ID Fermentation Tube
Membrane Filter
Lab Ref. No. Result* Analyst
I
*No. OI colomel/100 mi. Of NO. of Polltlve I~ortlofli.
\
o~-122o
Rev. 1983
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
Membrane Filter:. Direct Count
Verification: LTB
Final Membrane Filter Results /~)
BGB.,,
r)ate.
Time:
Too Numerous To Count
Collformll00ml
Coilformll00ml
~-lO-g4
Domo
COLLECTING SAMPLE TNTC =
Municipality of Anchorage
Development Services Department ,.~_~'~
Building Safety Division
On-Site Water & Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 ~.~
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: OSP1 1 1 21 0 PID Number: 051 --042--95
Name:
GARY & DANA GONDERZICK WastewaterSystem: [] New · Upgrade
Address:
22156 MAYTAG STREET *CHUGIAK, AK 99567 ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 552-0481 4 · Deep Trench [] Shallow Trench [] Bed E3Mound []Other
LEGAL DESCRIPTION so,,Rating: Tote, Depth f .... rigina, grade:
0.8 GPO/ScI, Ft. 9.0 MAX
Block: Lot: Subdivimon: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
- 1 DIGEL 4.85 MAX Ft. 4.17/4.09 Pt.
Township: _ Range: Section: Fill added above original grade: Gr~vel length:
- SEE DWG. Pt. (2 @ 48) = 96 Pt.
Gravel width: Number of lines: Distance between lines:
WELL: []New [] Upgrade 2.5 Pt. 2 10+ Ft.
Classification (Private, A,B,C): Total Dept~/ Cased To:(BEDROCK) Total absorption area: Pipe material:
¢_u~/~~.~-~ Pt. Ft. 793 se. Pt., D 3034/ F-810
Ft. WILCO CONTRACTORS 8/31/11
Pump Set At: Casing Height Above Ground:
Ft. Ft. TANK
GPM
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other*
T~o Septic Absorption Lift Holding =ublic/PrivateManufacturer: Capacity in gallons:
Tank Field Station Tank Sewer Lines GREER 1250
Material: Number of comp~rtments:
Well 100'+ 100'+ - - 25'+ STEEL 2
Su,ooe Water 100'+ lO0'+ - - - LIFT STATION
!Lot Line 5'+ 10'+ _ _ _ Size in gallons: J Manufacturer:
I
Foundation 5'+ 10'+ _ _ _ "Pump on" level at: "Pump ~er alarm at:
Curtain Drain - NONE KNOWN ~ ~ical Inspections performed by:
I I
Remarks: OLD TANK WAS "DECOMISSIONED" PER MPC. BENCH MARK
Location and Description:
BOTTOM OF SIDING
Assumed Elevation: 100.00 Ft
ENGINEER'~ SE~
Inspections performed by: CEC, Ltd. Dates: 1st 8/51/11
2nd 8/51/11 _~=,~- OF ,z-~
~'~.. ...... :,~. h ~
Development Services Department Approval H_ ~, "..?,
Conditional approval: Date: ~!. ~,?~Z ~..
Reviewed and approved by: ~b/~ / - 1 / '" "' ,,
PERMIT NUMBER: AS BUILT DRAWING PARCEL ID NUMBER:
OSP111210 - 051-042-95
I A B
I fCO 6.83 19.67
I
I ~ ST1 25.28 48.08
I ST2 31.80 55.39
~ DBL1 35.38 59.04.
/ ~ / DBL2 36.29 61.03 59.95
//,~,/ BR '37.40
/ / FS 44-.07 61.36
\ // / C01 24.06 36.62
\ /~/ MT1 23.67 36.79
\ / ~ C02 65.60, 83.14
\ /? MT2 64-.0781.4-8
\ / /
%\ // / C03 33.17 32.69
%. MT3 34-.27 33.62
/~//
%' / ! C04- 64-.92 78.36
%' /
-~ ./ MT4- 62.23 75.87
/
SEWER LINE FROM HOUSE ./ ~'""/
TO SEPTIC TANK INSULATED // .~..~.;~.c~.o4- J ,
WITH 4" OF BLUEBOARD. ×/ ~H;i'~/T~c02
/ C~MT 1 ~ / ~/ I
/ DIGEL LOT ' //' / / -- 'JX
/ /~ I?~LS~..I S~PT~C~ TA~
/ ---- / ~
. / I I.: ...~ ~ ~ x I .
/ //
~ ~~: I//////
~ I I I
= ,,
I
~..'
PREPARED FOR: I PHONE NUMBER: I PAGE NUMBER: k~'"
LEGAL DESCRIPTION: DRAWN BY:
DIgEL LOT 1 PNB
~PE OF WORK: DATE'
AS-BUILT DRAWING 9/6/11
A B
FCO 6.83 19.67
ST1 25.28 48.08
ST2 31.80 55.39
DBL1 35.38 59.04-
DBL2 36.29 59.95
BR 37.40 61.03
FS 44.07 61.36
C01 24.06 36.62
MT1 23.67 36.79
C02 65.60 83.14-
MT2 64-.07 81.4-8
C03 33.17 32.69
MT3 34-.27 33.62
C04 64.92 78.36
MT4 62.23 75.87
AS - BUILT DRAWING ,Oo --042--95NUMBER:
FINSULATION
ST1 / /FINALsTiRADE : 100'81
TOP OF TANK -"X ~ / I ~ /- TOP OF TANK
AT INLET = 97.90 ~ / -- ~ AT OUTLET = 97.90
AI~VI~ItTETO[ B9U7N. 4G1J I I SEPTICTANK II ~-,NVERT oF BUNG
ISOUTH TRENCH [
ORIGINAL GRADE = 101.16
TH HIGHEST POINT
· RELATIVE ELEVATION OF BOTTOM
ORIGINAL GRADE = 100.56
HIGHEST POINT
GRADE = 100.17+
20' OF TRENCH
' FILTER FABRIC
OF PIPE = 96.25
9' -- - -- -10'+' -
OF TRENCH = 92.16
Of TESTHOLE=86.16 (DRY)
INORTH TRENCH[
GRADE = 99.44+
LAST 20' OF TRENCH
-FILTER FABRIC
OF PIPE = 96.55
-BOTTOM Of TRENCH = 92.16
GAR'NESS ENG. IiNEiERING GROUP, Ltd.
CONSULTANTS & GENERAL CO
5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 * PHONE (907)357-6179 * FAX (907)338-,324.6 * WEBSITE: wve~.gomessengineering.com
PREPARED FOR:
GARY & DANA GONDERZlK
LEGAL DESCRIPTION:
DIGEL LOT 1
IPHONE NUMBER:
552-0481
PAGE NUMBER:
20F3
IDRAWN BY:
DATE:
9/6/11
TYPE OF WORK:
AS-BUILT DRAWING
Permit Number:
Tax Code Number:
Work Type:
On-Site Wastewater Disposal System
OSPl11210
05104295000
Septic
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 EImore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Upgrade
Permit Effective Dates: August 24, 2011 to August 23, 2012
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: DIGEL
Site Legal Address: DIGEL LT 1 G:1558
Owner/Address: GONDERZIK GARY A & DANA
22136 MAYTAG ST CHUGIAK AK 995670000
Permit
Site Mailing Address: 22136 MAYTAG ST, Chugiak
Lot Size in Sq Ft: 49557
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y SepticTank N Holding Tank N Privy N Private Well N Water Storage
All construction must be in accordance with: 1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: r
Issued By:
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services
On-Site Water & Wastewater Program
~ Phone:907-343-7904
Fax:907-343-7997
Mayor Dan Sullivan
On-Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. ~.-/ - ~;-: '~-- -~
Property owner(s) GARY & DANA GONDERZIK
Mailing address 22156 MAYTAG STREET *CHUGIAK, AK
Day phone 552-0481
Site address 22156 MAYTAG STREET *CHUGIAK, AK
Legal description (Sub'd, Block & Lot) DIGEL LOT 1
Legal description (Township, Section & Range)
Lot Size ~-[ct 7 ,~',-~--~ Sq. Ft. Number of Bedrooms
4
THIS APPLICATION IS FOR:
( [] all that apply)
Absorption Field []
Septic Tank []
Holding Tank []
Privy []
Private Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR:
N/A
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.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Rush Fees:
Date of Payment:
Receipt Number:
Permit No. '~J .
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
(Rev. 01/11)
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
August5,2011
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Elmore Rd.
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Proposed Septic Upgrade for Digel Lot 1
To whom it may concern:
The existing 4 bedroom house is served by a private well and septic system. Due to the age of the system
and concerns expressed by the new property owners regarding the performance of the septic system, they
have elected to upgrade the septic system. We are proposing to install a new 1250 gallon septic tank and a
dual deep trench type drainfield. One test hole was excavated on the property. The drainfield will be
designed around the 30 foot radius of the test hole. Comments regarding the design are summarized as
follows:
1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the topography around the
drainfield is 1-5%. In short, there are no slope concerns.
We are unaware of
If you have any
~3n~'e~/~ ly,
~. Gfimess, P.E~3 M.S.
Preside ii i'? ~.~
NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
this septic system. (Contact G. E.G. Ltd. for 7 page construction specification letter.)
adverse impacts this installation would have on adjacent wells or septic systems.
please contact us at 33 7-6179. Thank you for your assistance.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
T15N RlW SEC 4, S2NW4SW4NW4
/ X C'~SEPTiC
/ ~ AR..~..~
/
/ ~ MG LOT 1
X X / PROPOSED SEPTIC
~ ~ / SYSTEM
DIGEL LOT 4
/ / EXISTING ~ ~' I
/ / 4 BEDROOM ~ -, ~__
/ HOUSE ~ ~ ~ J ~ ~ '~ --~'1 ~ J
/ / %/ / ~
~PTIC / ~ I ./ ~~~I : JENNIFERS LOT
DIGEL LOT 3 J ~1 '~ ~ / / /I
~PTIC ~ ~ ~ / ~PTIC
AR~ AR~ J
DIGEL LOT 2 J
SC~E:
I I
G~NESS ENGINEERING GROUP, Ltd~ /~
~:de~f~ey A. Garn e,~..
~,RY · D,N* ~O~DERZ~K I SS2-O~8~ I ~ Or 2
LEGAL DESORIPTION: D~WN BY:
DIGEL
LOT
1
PNB
SITE P~N 8/5/11
DESIGN CRITERIA:
NUMBER OF BEDROOMS: 4 I NOTE: THE CONTRACTOR
SHALL HAVE THE NORTH LOT
GALLONS PER DAY (GPD): 600+ ~"'"'~100-,,,~. I LINE, AND ALL WELL RADII
PERCOLATION RATE/S: 12 MIN./INCH~ I FLAGGED BY A REGISTERED
PROPOSED APPLICATION RATE: O.B
MINIMUM DRAINFIELD SQ.FT.: 750 GPD '"'""'""-~/ LAND SURVEYOR PRIOR TO
CONSTRUCTION.
DRAINFIELD DESIGN: !
II
MAXIMUM DEPTH: 9'
WIDTH: 2'
~LENGTH: 2 O 47.5'= 95' ~ /
M.O.A. APPROVED SAND FILTER: N/A /
EFFECTIVE: 4' .
REDUCTION FACTOR: N/A / ~
ACTUAL SQ.FF.: 760
/
GEG, Ltd. HAS A 7 PAGE SPECIFICATION.,,~_ / /
LETTER THAT PERTAINS TO THIS DESIGN. ~<,,~ ,/~
TO OBTAIN A COPY Of THE LEl-FER~ /~
CONTACT GEG. BY PROCEEDING FORWARD /
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND ~-~ /
- PROPERTY OWNER AGREE THAT THEY j /
HAVE READ THESE SPECIFICATIONS AND -- ~ ~ ---- / PLm PROPOSED DUAL DEEP
/ I
I
SHALL RAISE SEWER LINE ~ /'x,~,_ ~,~
~o. ~.~ .ous~ TO .~w / ~ ~*~o
SEPTIC TANK SO AS TO . / /~' ~,..~
ALLOW FOR NEW TANK TO BE ~ .~---~---,¢------_. MT /~ ~/~
INSTALLED WITH 2' MINIMUM ~/ ~ ~ C~~'// ./..,~'~FS = 1-5'/** ///~'.× I
COVER. . /' , "< ~.,.~- X /~ ' '
,/ J----/ / ~---._ ', --.-z_.-_--'"~-'-"~l
/ / /EXISTING / ~"
/ / × / E'~)_~-oo~/ x '
/ , ! HUUbl:. /,..._ ~-EXISTING SEPTic TANK TO BE
.' ./ / /~O~,M,SSIONL~" PER uPc. .
,', ," L_
, ! ~') ~ ~o,u~ ~:i.:'?.?~..::i:!.:.~.."..?.:!/
x ~ X / ~'--~-~~'"":~!
\ \, SCALE: I ' ~ '
\ \ ,- = .o' / /!1
\ \ I / ·
/ ~ I ~-----_=oo. /
............ ~ '']'/r'z/: ......... "':"'~ 1
,~,, ,~sc,,~,,o,: ' ' ~RAw. ,~: k~O~.:::.:,'.. :',./~-~-' ...' ~/
DIGEL LOT1 .NB X~°'~
SEPTIC SYSTEM UPGRADE 8/5/2011
GARNESS .ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
,3701 F_.. TUDOR ROAD, SUITE 101 * ANCHORAGE, A.K. 99507 * PHONE.: (907)5,37-6179 * FAX: (907)5~8-5246 * WEBSI/E: gome~mengtneerlng.com
ISOIL LOG - PERCOLATION TESTI
LEGAL DESCRIPTION: DIGEL LOT
PERFORMED FOR: GARY & DANA GONDERZIK
ORGANICS
SOILS LOGGED BY:
COMMENTS:
GM TO SM
TEST HOLE #1I
SOIL CLASSIFICATIONS
'nA....
Garn ss."
GW ~ ORG
GP HL
GH CL
GC OL
SW HH
SP CH
SH OH
SC
DEPTH TO
GROUNDWATER DATE
DRY 7/29/11
DRY 7/51/11
DRY 8/5/11
DATE READING CLOCK NET TIHE WATER LEVEL NET DROP
TIHE (PIlNUTES) READING (INCHES)
7/29/11 1 5:03 - 6.00" -
2 5:33 30 3.50" 2.50"
3 3:33 - 6.00" -
4 4:03 30 3.50" 2.50"
5 4:03 - 6.00" -
6 4:35 50 '5.50" 2.50"
PERCOLATION RATE 12 (MIN./INCH) PERC. HOLE DIA. 6
TEST RUN BETWEEN 4.5 FT. AND 5.5 FT.
A FOUR HOUR PRESOAK WAS PERFORMED: [~YES ~]NO
JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS
(INCHES
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS,~DE, RF_OF)MED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
EOR
Parcel I.D. ~
1. GENERAL INFORMATION
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program _
4700 E!mo~e Road / / ~l
P.O. Box ,96650 / /'~///// //] (/
Anchorage, AK 99519-6650
www.muni.org/onsi~:e /-/ // /,' ]il// (907) 343-7904
CERTIFICATE OF ON-SITE SYSTEI S APPROVAL A SINGLE FAMILY DWELLI 0
Expiration Date: 9
Complete legal description DIGEL LOT 1
Location (site address) 22156 MAYTAG STREET *CHUGIAK, AK
Current Property owner(s) ANTHONY LORENZO Day phone 688-5088
Mailing address 22156 MAYTAG STREET *CHUGIAK, AK
Lending agency Day phone
Mailing address
Real Estate Agent KATHY FERNANDEZ W/ PRUDENTIAL Day phone 441-9000
¢' Mailing address 5801 CENTERPOINT DR. #200 *ANCHORAGE, AK 99505
Unless otherwise requested, COSA will be held by DSD for pickup.
NUMBER'OF BEDROOMS: 4-
TYPE OFWATER 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 On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems
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 samples. (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. STATEI~ENT OF !NSPECTtON 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,
t,,~ the . water supply and/or wastewater disposal vz ......
shows ~ .... u,~-s,~e~' o,,o,~m ,~;o (are) safe, functional and arteq,a~e_
for the number of bedrooms and type of structure indicated herein. I ~jrther verify that based on the
information obtained from the Municipality of Anchorage files and from ,my invest/gat/on and inspection, t,~e
on-site water supply and/or wastewater disposal system is(are) in compfiance with all appficable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name ef~Fi~r~' "GARNESS: ENGINEERING GROUP, Ltd. Phone
Address 3701 Eo TUDOR ROAD, SUITE 101 *
ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
537-6179
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MQA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide ~'E
DSD SIGNATURE ~.o ,o ,~?...
_ ~ Approved for ~ bedrooms.
.
D~sapproved.
..
Conditional approval for bedrooms, with the following stipulations~
~, .'~: ~ ~, ,,,~
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 1
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Legal Description:
WELL DATA
Well type PRIVATE
Date completed
Total depth 60
DIGEL LOT 1
CHECKLIST
*BASED UPON SURROUNDING WELL LOGS
If A, B, or C provide PWSID# N/,A
10/7/85 Sanitary seal (Y/N) YES
ff. Cased to *40+ ft.
Parcel ID: 015-042-95
Date of test
Static water level
Well production 25
WATER SAMPLE RESULTS:
Coliform O colonieS/100 mi.
Arsenic: ~ J~ ug./L.
SEPTIC/HOLDING TANK DATA
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 12+
FROM WELL LOG
10/,7/,85
5
g.p.m.
AT INSPECTION
4/,26/,11
25
.ft.
4.07 g.p.m.
Nitrate 0o"~r ?~mg./L.
Date of sample: 4/27/11
COllected by: GEG, Ltd.
Co
Tank Type/Material
Tank size 1250 gal.
Foundation cleanout (Y/N) YES
Date of pumping 4/,25/,11
ABSORPTION FIELD DATA
Date installed 10/16/85
Length 54&51=105 ft.
SEPTIC/,STEEL
Numberof Compartments 2
Depression over tank (Y/N) NO
Pumper.
I'BELOW EXISTING GRADEI
Soil rating (g.p.d./ft2o~ 225
Width 5 .ft.
Date installed" 10/,16/,85
Cleanouts (Y/N) YES
High water alarm (Y/N) N/,A
SANITARY PUMPERS
in.
New depth 29/,28in.
600+ g.p.d.
If yes, give date -
Depression over field NO
For 4 bedrooms
Total depth 7.9/7.75ft. Eft. absorption area 755 ft2 Monitoring tube YES
Date of adequacy test *'4/26/11 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 25/2,3 in. Water added 550/205 gal.
Elapsed Time: ** min. Final fluid depth?-5/,26in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN **SEE ATTACHED LETTER
System type DUAL TRENCH
Gravel below pipe ,3.5 .ft.
D. LIFT STATION
Date installed
"Pump. on" level at__in.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Size in gallons
"Pump off" level__~,
Cycles tested.
100'+
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas. 50'+
Manhole/Access ~ ~
High water alarm level at
Meets alarm & circuit requirements~
in.
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main N/A Water service line 10'+
Wells on adjacent lots 100'+
Absorption field
Surface water
5'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation. 10'+
Water service line 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
Water main N/A
Driveway, parking/vehicle storage
10'+
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 COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date
COSAFee$ L{
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
SGS Ref.# 1111567001
Client Name Gamess Engineering Group, Ltd Printed Date/Time 0.5/0.3/201 I 10:32
Project Name/# DIGEL LOT I Collected Date/Time 04/27/2011 8:l0
Client Sample ID DIGEL LOT 1 Received Date/Time 04/27/201 I 1 l:00
Matrix Drinking Water Technical Director Stephen C. Ede
PWSID 0
Sample Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<10) 04/28/11 05/02/I 1 NRB
Waters Department
Total Nitrate/Nitrite-N 0.748 0.100 mg/L SM20 4500NO3-F B (<10) 04/28/11 AYC
Microbiology Laboratory
E. Coli Nep. ative 1 100mL SM20 9223B A 04/27/11 DLC
Total Coliform Nep. ative 1 100mL SM20 9223B A 04/27/11 DLC
Nov-19-04 03:36A
SULLIVAN WATER WELLS
g
XTTENTION: It Is the ~ty d the ~ owner to mJbmR a ~ of the well log to the i~oper ~, Mur~
Page 1 of 1
Sonja Blewett
From: Jim Sullivan [apw@gci.net]
Sent: Friday, April 29, 2011 12:44 PM
To: Sonja Blewett
Subject: 22136 Maytag
Sonja
On 4-27-11 I installed a MOA well seal and conduit at this property
Thanks
Jim Sullivan, CPI
Arctic Pump & Well, Inc.
PO Box 770197
Eagle River, AK 99577
(907) 688-25'10
(907) 258-2570
(907) 745-25'10
4/29/2011
G.ARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
April 29, 2011
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Digel Subdivision, Lot 1, Septic Test
To whom it may concern:
The septic system on the subject property was installed on 10/16/1985 and consists of a 1250 gallon tank
and a dual 5-wide trenches with 3.5 feet of effective. The trenches each contain one sump located at the
end of each trench. The septic adequacy test was performed on 4/26/2011. The liquid levels were checked
prior to the start of the test and sump 1 (north trench) had 25 inches of liquid in it and sump 2 (south
trench) had 23 inches of liquid in it prior to the start of the test. The test began by introducing the liquid
into sump 1o A total of 275 gallons was introduced over a 66 minute period, which caused a rise of 4
inches in the sump. Flow was then switched to sump 2 where 205 gallons was introduced over a 50
minute period, causing a rise of 5 inches. During that 50 minute period sump 1 liquid level had dropped 3
inches° After checking the liquid levels in sump 1, an additional 255 gallons was introduced over a 65
minute period. The total amount of liquid introduced into the north trench was 530 gallons, and the total
rise was 4 inches. Both trenches were inspected the following morning (1045 & 1110 minutes later) and
the north trench had subsided back to its original liquid level and the south trench had only dropped 1
inch. In short, the north trench meets the MOA absorption requirements for a 4 bedroom home of 600
GPD.
It was also noted on the pump receipt that there was rock and dirt pumped from the tank on 4/25/11. The
owner informed us that he had a separation at the inlet of his tank last year causing his front yard to flood
and needing a repair. He stated that the rock and dirt had came from the separation.
If you have
y~.
an~estions, please contact us at 337-6179.
~M.S.
Thank you for your assistance.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 33%6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
N. 00' 08' W;
165.3