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HomeMy WebLinkAboutCROMWELL HEIGHTS BLK 1 LT 10 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221410 Work Type: SepticTank Upgrade Tax Code Number: 01533209000 Site Legal Address: CROMWELL HEIGHTS BLK 1 LT 10 G:2639 Site Mailing Address: 10970 MOUNTAIN LAKE DR, Anchorage Owner: COUNCELL BRENDA 50% & Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: ,�111CI7(- ON llepartmerit 10/27/2022 10/27/2023 ::11 ❑ Disposal Field 2 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Well radius is to be staked prior to tank installation Received By: / Issued By: !>I Date: Date: MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 015-332-09 ON-SITE SEPTIC/WELL PERMIT APPLICATION Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) BRENDA COUNCELL... Day phone Mailinq address 10970 MOUNTAIN LAKE DRIVE, ANCHORAGE, AK 99516 Site address 10970 MOUNTAIN LAKE DRIVE, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) CROMWELL HEIGHTS B1, L10 Legal description (Township, Range & Section) Lot Size 28,800 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank Upgrade M Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. re of property owner or authorized agent) Permit/Rush Fees: oqj Waiver Fees: Date of Payment: UZ 5 as Date of Payment: Receipt Number: JC Cal5 GU Receipt Number: y Permit No.S P2 IU 10 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc October 5, 2022 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: CROMWELL HEIGHTS BLOCK 1, LOT 10 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COIV PLJANi OSP221410, Tim Ec,Vuno, 10127122 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank and lift station on the above referenced lot. We propose to install a 1500 -gallon epoxy coated steel STEP tank per the attached design to serve the existing 4 -bedroom residence. The lot and area are served by private wells. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffinan, P.E. F( -r 5 t W C D N I U 1! 1 N IN f'q v� Id, ,e.cr arxnipr Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CACOMJF OSP221410, Tim 7/.' DESIGN DETAILS: INSTALL NEW 1500—GAL EPDXY COATED STEEL STEP TANK. MAINTAIN 10'+ FROM FOUNDATION, 100' TO WELLS, 100' TO SURFACE WATER, 5' TO FIELD & DECK SUPPORTS WITH 4' OF COVER OR INSULATION. INSTALL PER AMC 15.65, 15.55, & MASS... TANK BEDDING, SEPARATIONS, MATERIALS,... APPROX. 100' WELL RADIUS EXISTING SEPTIC AREA STAKEALL WELL RADII, PROPERTY APPROX. LOC. LINES, ETC... PRIOR TO CONSTRUCTION DECOMMISSION EXISTING CONNECT TO MT EXISTING FIELD S.T. & INSTALL NEW I E FlELD G MT 1500–GAL EPDXY COATED STEEL STEP SEPTIC TANK CO ® –5– WITH NEW FDCO. E� MT MH FDCO MT 100' WELL Ranu is I STAKE WELL RADIUS MINIMUM SEPARATIONS o PRIOR TO CONSTRUCTION TYPICAL... — I 0 DRIVEWAY FCO EXISTING 4 BED HOUSE WELL DESIGN BASED FROM WALATKA DIGITIZED ASB & MOA DOCS, NO WELLS WITHIN 10 ' OF PROPOSED SE DTIC TANK. VERFY & E TAKE ANY WELL RAM PRIOR TO CONSTRUCTION. CROMWELL HEIGHTS BLOCK 1, LOT 10 SUPPORT®SERVICES: ®®® PREPARED FOR: ®��� OF Aj<QVA XXX F WIC. 5 10970 MOUNTAIN LAKE DR 411�z� ®01 9 TH ANCHORAGE, AK 99516 FIRST WATER CONSULTING DATE: 10/5/2022 a SURVEY: JAG 2003 rtis Huffman 13030 SUES WAY DRAWN: FWCS �' 10 5/202 �w 10/5/2022 � Af ANCHORAGE, AK 99516 SCALE: 1" = 30' 1 A' 907-350-9566 FirstWaterAK@gmail.com PAGE: 1 of 1 Air 907-350-9566 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAL TH & HUMAN SERVICES Or,-Site Services Transmittal Sheet TO: ~OH~' ~/MrYo/v LEGAL: L I0 The attached paperwork has been reviewed and is being returned for the following reason(s): Discrepancy in legal description and/or owner name. Discrepancy in number of bedrooms. Signature and/or stamp missing on Show measured distances to sewers/wells, curtain drains and streams within 200 feet of proposed system. __ Replacement disposal site not shown and/or tested. Calculation error in design. Show locations of all soils, percolation or water table tests. Proposed system too deep for soil test submitted. Topographic information missing or inadequate. Narrative missing or inadequate. Additional soil/perc test needed. Sand filter requirements not satisfied. Water monitoring results missing or inadequate because Incomplete; missing Well log required. Water sample unacceptable because. Please supply the necessary information and re-submit your request. Your cooperation is appreciated. Reviewer.~,~/[/ Date/2 LEA VE THIS FORM ATTACHED TO PAPERWORK /203-rev. 4/93 Municipality of Anchorage ,,: ._ Page 1 of DEPARTMENT OF HEALTH AND HUMAN SERV~-''-~ ENVIRONMENTAL SERVICES DIVISION P.O. BOX 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~l .t.~ c~¢'~C) L't~"l PID Number: 01533209 Name: Steven Taylor Wastewater SyStem: [] New {~ Upgrade Address: ABSORPTION FIELD 10970 Nountain La~e Drr Anchoraqe, AK 99516 Phone: I No, ~ Bedrooms: f-I Deep Trench [] Shallow Trench ](~] Bed [] Mound [] Other Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION Design: 1 GPD/Sq. Ft. 0.16 ft. Lot: Block: Subdivieion: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe 10 1 Crc~ell Heiohts (].3q ~[~c)v~ c~1-~c]6= Ft. f~_~ Ft. Township: Range: Section: Fill added above original grade: Gravel length: T12N R3W 23 90 ~ Ft. 40 Ft. WELL: N/A ~ New [] Upgrade Gravelwidth: Number of lines: Distance bet~een lines: 15 Ft. 4 3 Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: .,~ Ft. Ft. 600 Se. Ft. 4" perforated PVC Driller: Date Drilled: Static Water Level:Installer:. Date installed: Ft. Pacific Rehab Const. July-Auqust Yield: GPM I Pump Set at: Ft. I Casing Height Above Ground:Ft. TANK SEPARATION DISTANCES =septic [] Holding [] S.T.E.P. TO Sel:)tic Al~orption Lift Holding aublic/Privete Manufacturer: Capacity in gallons: From Tank ~ Field Station Tank Sewer Lines G:eer 1,250  Material: Number of Compartments: We~. ~ 110' 111 ' 100' N/A Steel s. ~ace L I FT S TAT I O N Water N/A N/A N/A N/A N/i~ Lot Size in gallons: I Manufacturer:. Line 19' 11 ' 16' 19 ' N/A ~'49d)I Orenco Svste/ns, Inc. "Pump on" level at: ~ "Pump off' level at: I High water a. larm at: Curtain Pum~ Make & .M~et [ Electdc~ Inspe~;tionspedormed by; Remarks: BENCH MARK /~ --- ~ Location and Description: Z-~ ~ /~f~/~,~ ~ /~/~'~ ~;'~~/ TOD of qas valve on north side of house. Department of Health and Human Services approv,a,~/;/ .. ~,_-, · .<,~-:, Reviewed and approved by: Date: ?'2-013 (Rev. 9/91) MOA 25 '-- ~ z _~ MOUNTAIN LAKE DRIVE ' ~ ~ Z z ~ ~ ~m ~ 0 ~ m ~ ~ ~m ~VIROH}IE~ iNCORPORATED RECEIVED August 8, 1996 Jim Cross Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 AUG 1 2 1996 Municipality ut Anchorage Dept. Health & Human Services Subject: Septic System Installation at 10970 Mountain Lake Drive, Lot 10, Block 10, Cromwell Heights Subdivision Dear Mr. Cross: This letter, along with the attached as-built drawings, serves as our notification that the referenced system has been installed in accordance with our drawings and specifications. The following dates include key milestones for system design approyal, site inspection, and system acceptance: September 22, 1994 October 28, 1994 November 7, 1994 July 19, 1995 August 1, 1995 August 17, 1995 August 8, 1996 1st Percoloation Test Conducted 2nd Percoloation Test Conducted Septic System Design Approved by MOA First Site Inspection Conducted by EMI Second Site Inspection Conducted by EMI Third Site Inspection Conducted by EMI Final Site Inspection Conducted by EMI Inspection of the on site watewater disposal system installation was conducted by EMI in accordance with the Muncipality of Anchorage Waste Water Disposal Regulations (Section 1.65.150). The first inspection was conducted after the excavation of the ditches and bed, and before the placement of gravel. Construction materials were verified during the second and third inspections. During the third inspection, the placement of gravel, distribution lines, monitoring tube, and cleanouts were inspected before the placement of any fill. Elevations and grades were vedfied by EMI during this third inspection. Dudng the final inspection, EMI verified placement of final fill. The owner reports that the system was completed in the fall of 1995 and was in service through the winter. During our inspections, EMI verified that the installed leach field system is more than 100 ft from the well, as designed and as required. Please refer to our attached as- built drawings for system piping elevations. 6301 Closure Letter/cmr 8/8/96 Page 1 of 2 206 E. FIREWEED LANE, SUITE 201 * ANCHORAGE, AK 99503-2703 CONSULTING (907) 272-9336 · FAX (907) 272-4159 · TRAINING (907) 272-8852 · FAX (907) 272-0319 If you have any questions regarding this project, please feel free to call me at 272- 9336. Thank you. Respectfully, cc: Mr. Steve Taylor, House Owner Attachments: 1. As-Built Drawings 2. On-Site Wastewater Disposal System an/or Well Inspection Repor~ 6301 Closure Letter/cmr 8/8/96 Page 2 of 2 ENVIRONMENT,~ MANAGEMN~,rl~ INCORPORATED _I~UNICIPALITY OF HOV 0 1 1996 RECEIVED October 29, 1996 Dan Roth Municipality of Anchorage Department of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519 Subject: Septic System Installation at 10970 Mountain Lake Drive, Lot 10 Block 1 Cromwell Heights Subdivision. Dear Mr. Roth, This' letter is being prepared to provide the information requested on the attached transmittal sheet dated 9-10-96. 1 ) What type of pipe used (i.e. D3034, F-810, ect.)? All four inch pipe used on this project was ASTM D3034. The 1 1/4' pipe used for pressure pipe was schedule 40 ASTM D2672 PVC. 2) MOA Electrical inspection? A MOA Electrical inspection has not been done yet. The MOA Electrical department said that a Department of Health & Human Services building permit was required prior to issuing a electrical permit which is required prior to an inspection. Since this upgrade is completed, your department said a permit was not required. You suggested that we do everything required for approval except the electrical inspection and then you would provide your approval contingent on the electrical inspection being completed. Lets try that ! 3) Swing ties to dwelling? The as-builts have been updated to provide a table of distances. drawing I of 1. Please see 4) Was the septic tank integrity verified? The integrity of the septic tank was visual vedfied by a engineer dudng the drain field and pump station installation. 206 E. FIREWEED LANE, SUITE 201 · ANCHORAGE, AK 99503-2703 CONSULTING (907) 272-9336 · FAX (907) 272-4159 · TRAINING (907) 272-8852 * FAX (907) 272-0319 5) Separation distance between well and septic tank appears less then 100'? A survey was done to verify the separation distance and it was found that the well is 98.2' from the septic tank. A application for separation distance waver between well and septic tank is attached. Respectfuly, /~ EV~;~ONMEN L M GEMENT, ~J~Shn Simpson, P.E.~/ attachments: waiver application INC. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES On-Site Servicee Transmittal Sheet TO: 3-01-1~' LEGAL: L ,~r IO Bz,~ / C,~p,~w~z L H~/6,~,Ts The attached paperwork has been reviewed and is being returned for the following reason(s): Discrepancy in legal description and/or owner name. Discrepancy in number of bedrooms. Signature and/or stamp missing on Show measured distances to sewers/wells, curtain drains and streams within 200 feet of proposed system. Replacement disposal site not shown and/or tested. Calculation error in design. Show locations of all soils, percolation or water table tests. Proposed/system too deep for soil test submitted. Topographic information missing or inadequate. Narrative missing or inadequate. Additional soil/perc test needed. Sand filter requirements not satisfied. Water monitoring results missing or inadequate because Incomplete; missing. Well log required. Water sample unacceptable because Reviewer Date LEA VE THIS FORM ATTACHED TO PAPERWORK /203-rev. 4/93 MUNICIPALITY OF ANCHORAGE ON-SITE WA TER/WASTEWA TEll DISPOSAL SYSTEM FIELD AUDIT Date ~- ~ - ~4 Document Type Legal Description / o i- /0 ~R / C~ O~ ~L ~/~ Site Address /0970 ~u~/~ ~ ~,~[ Engineer/Firm ~ON~ T~Rz ~ /~ ~ Excavator Follow-up Notes Time //'/i~ /~63-5-92 XI.&N..\GE~IENT I\('ORPOR.~TEI) August 14, 1995 Bob Griffin Pacific Rehab Construction P.O. Box 230628 Anchorage, AK 99523-0628 Subject: Septic Design at 10970 Mountain Lake Cromwell Heights Subdivision RECEIVED AUG 1 8 1995 Municipality of Anchorage Dept. Health & Human Services Drive, Lot 10, Block 1~ Dear Mr. Griffin: Environmental Management, Inc. (EMI) has fulfilled their contract with Pacific Rehab Construction. Our contract included a percolation test, an MOA-approved septic system design, and two site inspections. The percolation test was conducted on September 22, 1994. The septic system design was completed, approved by MOA, and submitted to you by November 8, 1994. Our first site inspection was conducted on July 19, 1995 and our second inspection on August 1, 1995. Our site inspections were conducted upon your request and in accordance with our contract. During our first site visit and inspection, we noted that all system appurtenances and materials were not on site for our inspection. In addition, the existing grade (upon which the leach field would be installed) was not level and should be leveled prior to system installation. These deficiencies were identified to you verbally on that date. During our second site visit and inspection, we noted a number of potential system installation deficiencies that should be corrected prior to system acceptance by MOA: 1) The distance from the water well to the edge of the leach field must be a minimum of 100 FT. According to our swing ties and the system design site map, this requirement may be out of compliance. 2) The drainage system piping was not level. 3) The monitoring tube as per our design drawings was not in place in the leach field. 4) As noted in our first inspection, all system appurtenances and materials were not on site for inspection. These materials require inspection prior to installation per MOA specifications. In our August 1, 1995 facsimile from Stephen Hammond, we notified you of these second site visit deficiencies. 206 E. FIREWEED LANE, SUITE 201 · ANCHORAGE, AK 99503-2703 CONSULTING (907) 272-9336 · FAX (907) 272-4159 · TRAINING (907) 272-8852 · FAX (907) 272-0319 Additional inspections are required to verify the system is properly installed. Any further work by EMI on this project, to include, but not limited to consultation or inspection services, will be completed on a time and materials basis with payment required in advance. If you have any questions regarding this project, please feel free to call Chris Riggio or me at 272-9336. Thank you. Respectfully, Envi~ment~ Mana~. ment, Inc. /?tce President cc: Mr. Jim Cross, Municipality of Anchorage /~ Mr. Steve Taylor, House Owner 206 E. FIREWEED LANE, SUITE 201 · ANCHORAGE, AK 99503-2703 CONSULTING (907) 272-9336 * FAX (907) 272-4159 * TRAINING (907) 272-8852 ,, FAX (907) 272-0319 Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 December 19, 1996 John Simpson, P.E. Environmental Management, Inc. 206 East Fireweed Lane, Suite 201 Anchorage, Alaska 99503 2703 Subject: Waiver Request for Lot 10 Block 1 Cromwell Heights Subdivision Waiver Request #WR960062, PID 015-332-09 Dear Mr. Simpson: Your request for a waiver of the required 100 foot horizontal separation of an on-site wastewater disposal system to a private well has been approved. The approved separation distance is 98 feet from the private well to the septic tank. This waiver approval applies to the existing on-site wastewater disposal system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. If you have questions or further concerns reg.arding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-site Services DllUljm:Taylor .~UNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ WR960062 PID~ 015-332-09 HA# Date Received: November 1, 1996 Legal Description: Lot 10 Block 1 Cromwell Heights Subdivision Engineer: John Simpson, P.E., Enviromental Management Inc. Permit ~ SW940424 206 East Fireweed Lane, Suite 201, Anchorage, Alaska 99503 2703 Applicant: Steven Taylor Waiver Requested: Private well to the septic tank of 98./ feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: e 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: Name of Reviewer Rec ~: 02294/3249 A/nount: $ 625.00 Date Paid: 11-1-96 x--.?~- 2 T~ TR I.. 2.3 EN~qRONME~?,& MANAGEMEN~ INCORPORATED Date: October 10, 1996 To: From: Municipality of Anchorage Department of Health & Human Services Environmental Services Division 825 "L" Street, Room 502 Anchorage, Alaska 99501 John Simpson, P.E. Environmental Management, Inc. 206 East Fireweed lane, Suite 2q~/ Anchorage, Alaska 99516 Subject: Application for Separation Distance Waiver -Well to Septic Tank, For 10970 Mountain Lake Drive, Lot 10, Block 1, Cromwell Heights Subdivision. This waiver application is organized per Municipality of Anchorage ordinanCe chapter 15.65 section 15.65.1450-B 1 through B 5. B1. We are requesting a Separation Distance Waiver to the requirement that an on site Well be 100 feet from an on site Septic Tank. This Waiver is being requested because the existing septic tank is 98.20' from the existing well. Please see drawing 1 of 1 attached. B2. Site and soil information: The lot size is 28,800 square feet and is located in the Hillside Road and O'Mailey Road area of Municipality of Anchorage. The site is sloping in a westedy direction at a approximate 7% to 12% slope across the site. The well is slightly up slope from the septic tank. There is no standing surface water on site and all surface water drains away from the septic in a westerly to northwesterly direction. It can be assumed that the ground water gradient is in the same direction as the surface water. In the event any possible leakage from the septic tank did happen, it would flow away (down gradient ) from the well. On site soil conditions as per the Anchorage area soil survey is as follows "This rolling, well-drained soil formed in 5 to 10 inches of loess over very gravely till of moraines. Slopes are short and choppy. A representative profile has a layer of grayish brown silt loam about 1 inch thick. The subsoil is dark brown silt loam about 7 inches thick. The substratum, to depths greater than 48 inches, is brown or grayish brown very gravelly sandy loam till. The till varies in compactness; in some areas it is very firm. Permeability is moderate in the upper 7 inches and moderate to moderately rapid below. Runoff is rapid and erosion hazard is severe. The available water Page 1 206 E. F1REWEED LANE, SUITE 201 · ANCHORAGE, AK 99503-2703 CONSULTING (907) 272-9336 · FAX (907) 272-4159 * TRAINING (907) 272-8852 * FAX (907) 272-0319 capacity is Iow." From the 1983 on site well log, the subsurface soil conditions are as follows; "0' to 2' Stickup, 2' to 17' gravel clay, 17' to 49' cemented gravel, 49' to 60' silty gravel, 60' to 87' gravely clay & cobbles, 87' to 91' water sand and gravel". B3. Mitigating measures: There are no mitigating measures proposed at this site because evidence indicated none are required. The owners of this property have lived on site since 1987 and over the last 10 years have indicated no noticeable ill effects due to the 1.8' less separation of the septic tank to their well. The adjacent down gradient residents are all serviced by a public water system which is in excess of 800' away from subjects on site waste water disposal system. This public system is tested for water quality on a routine bases and no adverse impact has been indicated. B4. B5. Engineers Statement: This on site water and waste water system is a fully functional system meeting all the requirements set out by the Municipality of Anchorage. The on site waste water disposal system has recently been upgraded and is adequate to service this 4 bedroom house. In general the site is neat and clean with no refuse or out buildings on the site. From a USGS water resources division data search we found that most of the wells in the area were over 100' deep with the water level averaging 73'. Please see drawing 2 of 2 for approximate well locations. This coupled with the on site soils information indicates that the aquifer being used for drinking water in this area is isolated from the near surface ground water. Therefore if a problem happened a very Iow probability exists that the drinking water would be affected. I foresee no adverse impact to approving a waiver of separation distance for the amount required, 01.8'. List of adjoining property owners: (From the Municipality assessors office these are adjoining property owners) · Cromwell Heights BIk 1, Lot 2 & BIk 1, Lot 11 & BIk 1, Lot 12 Hoffman Robert L. & Ethel · Cromwell Heights BIk 1, Lot 3 Samel Roberta L. · Cromwell Heights BIk 1, Lot 4 Vehrs Larry F. & Nadya A. · Cromwell Heights BIk 1, Lot 6 & BIk 1, Lot 7 Hoffsetz Robert F. Jr. & Sara Ann Page 2 Z UJ uJ 160.0' 10' UTILITY EASEMENT Zl.~l 0 ~ 9AIIdO 9NV-I NIV. LNnOI,V MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF0 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940424 DESIGN ENGINEER:ENVIRONMENTAL MANAGEMENT, INC. OWNER NAME:TAYLOR STEVEN DAVID & ~q~-~O~ OWNER ADDRESS:10970 PHILLIPS ST ANCHORAGE, ALASKA 99516 DATE ISSUED:il/07/94 EXPIRATION DATE:il/07/95 PARCEL ID:01533209 LEGAL DESCRIPTION: CROMWELL HEIGHTS BLK 0 i LT 1 LOT SIZE: 28800 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 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 PROVISIONS: RECEIVED BY:~ ISSUED BY:~ DATE c=~ ~ -~ MOUNTAIN LAKE DRIVE ~ ~ .o ~ .... ~ -i- ~ .. .. /' .. I ,~ m H£ADINF£ET Illllltlllllllll}llllllllll I 350.00 ? i ' I i" ! /' ' · I :: ' · :~ II SINGLE PHASE, 60HZ ~.' ' ] . i....] ................ i... [ ...................... '.........[.........:;..........i........].....'........ll 115/230 VOLT 200.00 150.00 100.00 0.00 0.00 OSI i0 HHF 7 stage OSI 05 HHF - 5 stag 'Refer to Price List page ............. : ................................ ].......L....Z...._...} ................. ; ........................................... ; .................. ;_......'.i ......................... i ................... i ....................... ~'. .................. i ......... 5.00 10.00 15.00 20.00 25.00 30.00 NET DISCHARGE, GPM (ORENCO SYSTEMS, INC )] ORENCO SYSTEMSTM ALAR oC©NT ©L PANEL ORENCO SYSTEMS" Alarm-Control Panel offers fine quality components for reliable automatic pump operation. Standard functions include circuit breaker, manual, off and automatic motor control operation, plus an audio/visual high-water alarm circuit with audio silence and automatic reset upon correction of the high-water condition. A selection of optional features offers flexibility for a variety of pumping applications. ORENCO SYSTEMS" alarm-control panels are specifically engineered for pressure sewer (STEP) systems, for controlling pumping into conventional gravity collection systems and for on-site systems such as intermittent sand filters, recirculating gravel filters, Iow pressure drainfields, as well as for simple uphill pumping to standard drainfields. ORENCO SYSTEMS" alarm-control panels are especially designed for use with mercury float switches capable of directly switching on & off pumps with high starting currents. The alarm-control panel is also compatible with other standard dry-contact switching methods. STANDARD FEATURES: Listing: Underwriters Laboratories. Rating: Model A-1 rated at 1/2 Hp/11.5 VAC, S~ngle Phase, 60 Model A-2 rated at 1 1/2 Hp/230 VAC, Single Phase, 60 Hz. Current Limiting Circuit Breaker: 20 amp, OFF/ON switch, DIN rail mounting with thermal magnetic tripping characteristics. (Single Pole/115 VAC; Double Pole/230 VAC) Toggle Switch: A SPDT HOA switch with a 15 amp motor rating. Fuse Disconnect: ® L 2 amp SLO-BLO fuse with DIN rail mount. Audible Alarm: Panel mount with a minimum of 80 db sound pressure at 24 inches, continuous sound. Visual Alarm: NEMA 4-rated, 7/8-inch diameter, red lens, oil-tight with push-to-silence feature. Audio-Alarm Silence Relay: 115 VAC, automatic reset, with DIN rail mount socket base. Alarm Circuit: Wired separately from the pump circuit, so that if the pump's internal overload switch or current-limiting circuit breaker is tripped the alarm system remains functional. Enclosure: NEMA 4X-rated, fiberglass with hinged cover. Noncorroding. Dimensions: 10" High X 8" Wide X 5-1/8" Deep, or 8" High x 6" Wide X 4-5/8" Deep. External mounting ears. Padlockable Latch: Constructed of noncorroding stainless steel. OPTIONAL FEATURES: Elapsed Time Meter: 115 VAC, 7-digit, nonresettable. Counter: 115 VAC, 6-digit, nonresettable, horizontal base mount. Redundant Off Relay: 115 VAC, 25 amps, automatic reset, provides Iow level alarm capability. Olher custom features can be provided. ORENCO SYSTEMS, INC. 2826 Colonial Road Roseburg, OR 97470 503/673-0165 Wiring Diagram Terminal Strip Alerm ~ On / Off Mercury Floats Neu~'al Pump 115 VAC / 1/2 Hp. 1 Ph-se / 60 Hz. 115 VAC, 1 Phase, 60 Hz. Terminal St~p AS Alarm ~ Neutral On / Off Mercury Floats I Wiring Diagram DF CB 20A 11 I~, Pump 230 VAC / 1 1/2 Hp. 1 Phase t 60 Hz. L~ JUNCTION BOX TIMES DRA WING NO. 1 LIFT $ TA TION COM-~ONENTS NOT SHOWN,) ELE¢ T~ICAL CONTROL BOX BOL TS (24 SWING JOINT 24" ~ MANWA Y WITH BOLTS FL OW INDUCER FLOAT ASSEMBLY PiPE PACKAGE AS IT IS PACKAGED BY THE FACTORY 4" X 1-1/4" BUSHING (SLIP X SLIP) 2" X 1-1/4" BUSHING MALE X FEMALE (2 EA.) 1--1//4" X I" BUSHING MALE X FEMALE (FOR PUMP) I-~/4" FLEX CONNECTOR OUTLET ELBOW EXTRA 24" LENGTHS OF I" PIPE FOR LONG MANWA YS (SEE STEP 14) CHECK VAL V~ PUMP VAULT BALL VAL UNION (DISASSEMBLED) J6" MALE X MALE (SEE STEP 141 ADO EXTRA PIPE SECTIONS AS NECESSARY (STEP I/8" WEEP HOSE FOR OUTLET LINE DRAINBACK GRAY PIPE. INS TALL ASSEMBLY IN TANK BEFORE BURIAL (SEE STEP 21 INSTALL BUSHING ON CRA Y PiPE (STEP 11 ~6" MALE X FEMALE SH~NG J(~NT STEP 141 CONDUIT ELBOW MUS T REMAIN BOVE GRADE) SEAL HERE (SEE STEP §1 12/.1 UF ~RE ELBOW COVER ~_ EL EC TRICA L CONDUIT S. 5. SCREI'V~ RETAINING NUT X~ ~O , LID ItOLI~ I)o, I~N TAI~$ 24" ~ MANWA Y F4TIt OOl IS (SEE STEP 71 RING INSERT ~IRE HERE (SEE STEP ~1 I-I/4" X I" BUSHING 500 GALLON LIFTSI'A TION PICrURED IIERE PUMPOU T BOLT RING 2" PIPE COUPLING 2" X ~-1/,I" BUSHING FERNCO COUPLING 4" PIPE TO BRtOGE EXCA VA TED AREA BE TI~EEN TANK ENO AND TRENCH TO DRAINFIELD ~4" FLEXlBLE CONNEC IOR -- SEE STEPS 4, 5. AND 6 !- I/'4" PIPE 10 C)RAINFII~ f) I-I/4" X 4" BUSHING VAULT RETAINING ANGLES WELDED IN THE TANK 1-I/4" PIPE FROM TANK -----/ INFII,'I ~ ANTI-S)'PlION / SLOPE SITE P~N Municipality ot Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O Organic material tO ~ilts(ML) (GP) Brown, Dense Poorly graded gravel with sand moist to saturated @9', L~tof ;ROUND WATER Excavation ENCOUNTERED? yes IF YES. AT WHAT / (~ ~4: 1,4e..I E Reading Oate Gross Net Death to _ Net-:-- Time · Time Water Drop '" 9/22/94 10: 43: 00 ~" 1 10;44:05 1 :hq m~n ~." 2" " 10:45:0~ 6" 2 10:46:04 1 _'~4 rolm 4" ?,, " 10:47;00 6" 3 10:48:08 1:08 min 4" 2" " 10:50:00 6" 4 10;51:08 1:08 min 4" ~,, " lO:=,~:nO 6" 5 10:53:08 1:08 min 4" 2" PERCOLATION RATE 0.57 [m,nutes,',ncn! PERC HOLE DIAMETER 6" TEST RUN BETWEEN 4 FT AND 4.5 FT COMMENTS PERFORMED 8Y: Stan Dolloff/EMI ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS OATI= ~2-~08 trey. CERTIFY THAT THIS 'iF_ST WAS PERFORMED IN DATE; Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: Steve Taylor LEGAL DESCRIPTION.LOt 10,Block 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 1, Cromwell Heights Subd. O_rg_ani. c material with..Peat (Pt) Poorly graded gravel with sand (GP) Brown, moist, medium to dense Limit of Excavation COMMENTS DATE/~! Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTER ED? yes SITE PLAN S IF YES, AT WHAT ~ --; / ~) DEPTH? / p E Oepth to Water After Monitoring? '7° Date:. N T( '#2. Gross Net D~th to Net Reading Date Time Time Water Drop 10~2'8/94 3:50:b0 6" 1 3:51:19 1:19 min 4" 2" " 3:52:00 6" 2 3:53:18 1:18 min 4" 2" " 3:54:00 6" 3 3:55:18 1:18 min 4" 2" " 3:56:00 6" 4 3:57:18 1:18 min 4" 2" PERCOLATION RATE 0.65 1 TEST RUN BETWEEN __ (minutes/inch) PERC HOLE DIAMETER __ ET AND 1 . 5 ET 11 PERFORMED BY: Start Dolloff/~4I ~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: SPECIFICATIONS FOR UPGRADE OF EXISTING ON SITE SEPTIC SYSTEM Legal Description: Lot 10, Block 1, Cromwell Heights Sub. Owner: Steve Taylor A._~. General Overview 10. The septic upgrade is for a single family residence only. The attached drawing and/or site plan shall be part of this specification. All materials and workmanship shall meet the Anchorage Department of Health and Human Services requirements. All soils tests are advisory to the design and are to be verified or modified in the field by the engineer. (Upon completion of the excavation, soil conditions present in the walls and floor of the bed/mound system should be logged). Additional percolation tests and groundwater monitoring will be required during system installation. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to meet Municipality of Anchorage requirements. It is the responsibility of the engineer to locate any adjacent wells. The installation and excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. It is prudent that a surveyor locate the nearest lot line position and the location of any easements. Inspection of on site wastewater disposal system installations are required, and shall be done by the engineer in accordance with the Municipality of Anchorage Waste Water Disposal Regulations Section 15.65.150. The first inspection must be conducted after the excavation of ditches and bed, and before any gravel is placed. At this time the construction materials will be verified by the engineer. The second inspection must be conducted after the placement of gravel, distribution lines, monitoring tube, and cleanouts, but before the placement of any other backfill. At this time elevations and grade will be verified by the engineer. The engineer will be on site for the placement of the remaining backfill and insulation. EMI requires a 24 hour notice to schedule inspection times. The installation of the bed/mound system and lift station shall be conducted by a certified excavator as required by AMC 15.65.035. EllensHD~MI Jobs\6301 Griffin Septic Design(10/6/94) Existing Septic Tank The existing septic tank is a 1,250 gallon, two compartment, steel tank installed May of 1983. The integrity of the septic tank will be verified by the engineer during the drain field installation. Existing Drain Field The existing on site septic system is a trench system. This system has failed and can no longer properly absorb the effluent coming from the septic tank. This existing system has been removed from the ground. Proposed Lift Station Due to the high water table, effluent from the existing septic tank shall be lifted approximately 5 ft. to the proposed bed/mound system. The lift station will be the MOA preapproved Anchorage Tank and Welding, Inc. lift station using a Orenco System, Inc. Septic Tank Effluent Pump (S.T.E.P.) rated for a four bedroom single family dwelling. Lift station specifications and pump curve are attached to this design submittal package. All electrical components shall be UL listed and installed by a licensed electrician in compliance with all applicable codes and regulations. ProPOSed Bed/Mound System The bottom of the bed shall be level, plus or minus 1 1/2 inches. The drain field pipe will be laid over a minimum of 6 inches of gravel with an additional 6 inch layer of gravel installed to provide a minimum of 2 inches of gravel over the drain field pipe. Piping materials use for drain field installation shall be 4 inch ASTM P3034 or ASTM F789 PVC pipe or approved MOA pipe. Piping material used to lift effluent from the lift station to the drain field shall be 1 1/4 inch Sch 40 ASTM D2672 PVC pipe or MOA approved. All pipe must be labeled with the ASTM designation on the side or show proof of ASTM equivalency. Gravel backfill material shall be 3/4 inches to 3 inches screened rock diameter with less than 3% passing #200 sieve residual. Cleanouts will be placed at the corners of the bed/mound system as shown in the attached drawing. A 4 inch PVC pipe will carry effluent from the septic tank to the lift station system. Effluent from the lift station shall be carried to the bed/mound EllensHD\EMI Jobs\6301 Griffin Septic Design(10/6/94) system with a 1 1/4 inch PVC pipe. A free standing monitoring perforated tube will be installed in the absorption area as shown in the plan drawings. Insulation material must be placed directly over the top of the final gravel layer and the top of the septic tank and all piping and appertances installed at depths of less than 3 feet below ground level. Insulation materials shall be at least 2 inches of extruded direct polystyrene (DOW Chemical Company Styrofoam HI or equivalent). The insulation will also serve as the silt barrier. Fill material over the bed shall be installed to no less than 2 feet in depth and shall be graded to prevent ponding of surface water. Side slopes are to be installed at a minimum of 2 feet horizontal to 1 foot vertical as shown in the plans. Drain Field Bed Dimensions 1. Proposed Bed: 40' long X 15' wide--600 sq. ft. Calculations: Percolation Rate = 0.57 min./inch (see attached Municipality of Anchorage Soil Log - Percolation Test for Lot 10, Block 1, Cromwell Heights Sub., Attachment A.) (4 bedroom) (150 gallon .Der day .Der bedroom) = 600 sq. ft. 1.0 gpd/sq, ft. EllensHD\EMI Jobs~6301 Griffin Septic Design(10/6/94) MUNICIPALITY OF ANCHORAGE 1. 0 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 ��jj ;� /7 01 C -les ,% 3 � C)s. PHONE 6 33?? NEW ( ❑ UPGRADE MAI LIN� ADDRESS LEGAL DESCRIPTION C_ / a /3,/ Clz dry cu E_ c LOCATION o r -F 5 C N C�/S 2 0 �' lC d 1/IJaL C i O. OF BEDROOMS DISTANCE TO: Well �,�� Absorption area r Dwelling7 l / PERMIT NO. -SUS U .L J Y3 w Q Manufacturer G �� 7 Mat rial No. of co artments � N Liq. capacit��,gallons �n IF HOMEMADE: Inside length Width Liquid depth Y DISTANCE TO: Well Dwelling PERMIT NO. JOZ 0zH Manufacturer Material Liquid capacity in gallons w= 0 DISTANCE TO: Well �-/OO F undation y�l��) Nearest lot line �p PER IT NO. 3 Lu LL Z w No. of lines Len the k cls line g Total I n,9 h of lines Trench width Distance between lines H z 7A 6 U inches F Top of tile to finish grade r U Material beneath tile Total effective abso'r ptjQp area 0 >� inches w Length Width Depth PERMIT NO. (D < F wa Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. � � w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS C,45 r /iZ 0 io SOIL TEST RATING INSTALLER d REMARKS � s �r�+ 140-173Ze fltQ1� 47i"Y�� O� APPROVED DATE LEGAL �i 12 /2-U13 (Hev_ 3/7X) ///—"/,/1, ////, , /07 Q T -R T41 1 K2 lw I" i? I_ 1 7_ um' kll T=7 H=O �����Fl-�' 0::-: FE DEPARTMENT ( HEALTH AND ENYIRONMENTHL` OTECTION 825 'L- STREET, ANCHORAGE, HK 99b01 264-4720 L4 E= L. L. ��F-.:- CH 0-4 --- "On 1 7- E07 �F="9_-A E-7 F--:: ���V-1 I -F PERMIT NO. ( 830205 ) APPLICANT ANDERSON BROS. PO.BOX 129, E.R. 694-]]77 LOCATION LEGAL LOT 10 BLK 1 CROMWELL HTS LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRHINFIELD MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: Ell ���� �����0-1= "I Qa ������ ����1-1= W THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). Y_ 1-1 E=7 _V_ In? E= VA CV 01 �I E:-- -F " T —"=. !f --' �FQ�d C -:-u F=_ E: E= -�F' THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). �CA, 9_0 T 0::�?_ E= E> On E= I-- _r T lc_ _v_ 1? 10 F< "05 Im 07" E=E= - 0 ;2!f- C-0 9:3 F-ij L_R CH 0­4� PERMIT APPLICANTHAS 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. ___ -F&.Aco < _2E_1 _-_- I I 9=�F?E= F?E=0-0-9 I����� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 10 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS NAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ���T-1 I -TF ��F, I F? EE On �ERE IC- ���F=- I--' " ���� I CERTIFY THAT 1: I HM 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 THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS SIGNED:_ ___________ nrr��� ANDERSON BROS. APS 7 - ISSUED BY ___DHTE owho_ Y4. 0 �� C') LY SOILS LOG MUNICIPALITY OF ANCHORAGE �.e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - � & ..A PERCOLATION ON TEST 1'21 l PERFORMED FOR: Afj1)e Z5C-k1j 13'ZCI � L 7t DATE PERFORMED: LEGAL DESCRIPTION: � RC1 - (13 C��� `��G �� G `f r DEPTH SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ;���� a po co9aa eo6eo C:lrm� xr.. CP ��cey��e�¢f Oflseaoas`e� 9 i� + se esoo�n-g ae nao aec ya ec ono nn �' V� =e ="�, r:0. 1732-F , y.; June 22, 1968 a ; o" SITE PLAN WAS GROUND WATER ��S S ENCOUNTERED? L O L P IF YES, AT WHAT lig E DEPTH? / [ Reading Date Gross Time Net Time Depth to Water Net Drop It � J � x, WAS GROUND WATER ��S S ENCOUNTERED? L O L P IF YES, AT WHAT lig E DEPTH? / [ Reading Date Gross Time Net Time Depth to Water Net Drop 20 ]PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS GIS L! C L' 41 4 PERFORMED BY: C0 i •� C" CERTIFIED BY: r" DATE: �N� l� // • l 72-008 (6/79) WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological & Geophysical Surveys Drilling Permit No. LOCATION OF WELL (Please complete either to, Ib or Ic.) A.D.L. No. la. Borough Subdivision; Lot I Block Ib. 1/4gtrs. Section No. Township N� Range E❑ Meridian —of—of—of _ S❑ W❑ Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL .. 6 it /�."..... �JQ L��{�+ic'L4lfi► Address: Street Address and Area of Well Location 2. WELL LOG Feet Below Surface 4. WELL DEPTH: (final) 5. DATE OF COMPLETION Material Type Top Bottom ft. 6. ❑ Cable tool ❑ Rotary Driven Dug El Jetted ❑ Bored Other: :. 7.USE: 0 Domestic Public Supply Industry Irrigation Recharge Commerical ❑ Test Well ❑ Other: r, f` 8. CASIN,G;• ❑ Threaded ❑ Welded diam. `=r in. to ft. Depth Weight Ibs./ft. diam. in. to ft. Depth Stickup ft. 9. FINISH OF WELL: Type: Diameter: Slot/Mesh Size: Length: Set between ft. and ft. Backfilling Gravel pack 10. STATIC WATER LEVEL: ft. Above or ❑ Below land surface Date Equipment used: I I . PUMPING LEVEL below land surface and YIELD ft. after hrs. pumping g. p. m. ft. after hrs. pumping g. p.m. 12.GROUTING Well Grouted: Yes Q No Material Neat Cement Other: 13. PUMP: (if available) HP Length of Drop Pipe ft. capacity g.p.m. Q' Subm. Jet ❑ Centrifical Other 14. REMARKS: 16. WATER WELL CONTRACTORS CERTIFICATION: 15. Water Temperature ° F C This well was drilled under.,my jurisdiction and this report is true to the best,of my knowledge and belief; Registered Business" Name Contract License Number ... , Address: _ Signed: Date: Authorized Representative Form 02-WWR (11/81) Copy Distribution: WHITE -State DGGS, PINK -Driller, CANARY -Customer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~J ,~_ ~'~'c-~ / OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Prope~y Owner I~N~,/'~AY~o~ Telephone: Home Mailing Address Lending Institution Mailing Address Real Estate Company and Agent Address Telephone (C) FI'¢'-~ L I~ M S, ~'e'-'l['~'- Telephone (e) Mail the HAA to the followino address: or: Check here ~ if hold for pick up. List contact person and day phone number below. Business TYPE OF RESIDENCE Single-Familyx Number of Bedrooms 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. 4o 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. Page I of 2 72-025 fRev 8/861 Front . '~ $S,~/~C/'/Op. CHECKLIST- FEBRUARY 1984 II,//~1/ _ '~'£S O/,'"~e6 264-4720 --[j~ Z', .,. '/' "~ ~q~,,), ~'tS/o'~' Legal Description: WELL DATA Well Classification Well Log Present (Y/N) Total Depth Static Water Level Cased to If A, B, C, D.E.C. Approved (Y/N) Date Completed ~, .,,9_~. ~ ~ Yield 9! Depth of Grouting /N/C:)/Vl--~ Casing Height Above Ground I ~ Electrical Wiring in Conduit (Y/N) ~ Separation Distances from Well: To Septic/Holding Tank on Lot ~ ~ To Nearest Edge of Absorption Field on Lot l',i o N ~ To Nearest Public Sewer Line Cleanout/Manhote Water Sample Collected by Water Sample Test Results Comments Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) · On Adjoining Lots J ~.C) ' On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ;Date B. SEPTIC/HOLDING TANK DATA Date Installed ~//~/4~ Standpipes (Y/N) o Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: Size /2 -.~ No. of Compartments '7' Air-tight Caps (Y/N) ?/ Foundation Cleanout (Y/N) Date Last Pumped '~,~.~ Temporary Holding Tank Permit (Y/N) To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation To Disposal Field J , To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Daie of Last Adequacy Test · To Property Line To Existing or Abandoned System on · On Adjoining Lots TO Cutbank (if present) To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Square Feet of Absorption Area ~ ~ ~-' Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified,.qr conformed to all MOA and HAA guidelines in effect on the date of this inspection· Signed -~f'"~~ Date ~//~' 7 MOA No. / Company Receipt No. //~.~::~/ E:~ ,~ 4~'E::::) Date of Payment · c~//'7_.//~'.~ Amount: $ ./ ~-"~ ~ Page 2 of 2 72-026 (11/84) Engineer's Seal CONSULTING ENGINEER !03 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 10, BLOCK 1, CROMWELL HEIGHTS LOCATION: OWNER: TYPE OF. WELL: WELL LOG AVAILABLE: INSTALLATION REQUIREMENTS MET: WELL YIELD FROM WELL LOG: · 10970 MOUNTAIN LAKE DRIVE IRELAND SINGLE FAMILY ~*:.49~ 4 GALLONS PER MIN~,., PUMP YIELD: 7.5 GALLONS PER MINUTE DATE OF INSPECTION: MAY 6, 1987 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 7.5 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. STATIC WATER LEVEL WAS FOUND AT 24 FEET BELOW TOP OF CASING. AFTER 20 MINUTES AND 150 GALLONS THE WELL PUMP STOPPED DUE TO 100 % DRAWDOWN. RECOVERY WAS MONITORED FOR 30 MINUTES. RECOVERY RATE STARTED AT 1.5 GALLON PER MINUTE, AFTER 30 MINUTES ( 40% RECOVERY) RATE WAS .95 GALLONS PER MINUTE. 100% RECOVERY PLOTTED TO 90 MINUTES GIVING AN AVERAGE RECOVERY RATE OF 1.1 GALLON PER MINUTE. TEST FOR COLIFORMS: NEGATIVE. WATER WAS TESTED FOR COLIFORM BACTERIA AND NITRATES ON MAY 7, 1987. TESTS WERE WAS TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. CONSULTING ENGINEER 203 W. 15th AVE "C- SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOT 10, BLOCK 1, CROMWELL HEIGHTS LOCATION: 10790 MOUNTAIN LAKE DRIVE OWNER: IRELAND RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WELL: PRIVATE, ON SITE SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1250 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 345 SQ. FT. SOIL RATING: 85 INSTALLATION DATE: MAY 1983 DATE OF PUMPING: MAY 11, 1987. ANCHORAGE CESSPOOL PUMPING. DATE OF TEST: MAY 8, 1987. TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 1.5 FEET OF COVER AND 49 INCHES OF LIQUID. CLEAN OUT TO TRENCH WAS THREE FEET DEEP AND HAD THREE INCHES OF LIQUID. SUMP WAS 5.5 FEET DEEP AND DRY. A FAIR AMOUNT OF SLUDGE IN SUMP. 1000 GALLONS OF CLEAN WATER WAS ADDED TO THE CLEANOUT. SLUDGE WAS WASHED OUT TO SUMP. WATER LEVEL IN SUMP ROSE TO 33 INCHES WITH THE ADDITION OF ~THIS AMOUNT OF WATER. NEXT DAY SUMP WAS DRY, BUT FULL OF SLUDGE. ON MAY 11 SLUDGE WAS REMOVED FROM SUMP AND TANK.PUMPED. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. ',l C~', JUNE 25. [971 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date /~-~ ~, Z Z /~/ (a) Legal Description (include lot, block, Location (adck~ess or directions) subdivision, section, tc~._ship, range) (b) Applicants Name /<! ~ _Y_ ~..eCf~ L) ~ Applicants Address I'd 3 / tAD ~ ~- <~ /~' U'~, (c) Applicant is (check cfm) Lending Institution ~--] ; Buyer ~ ; Other ~ (explain); (d) Lending Institution /$-g/~j~ C-~2/~:~//L;~/L) flsa_- (e) Telephone 57~ ~ ~ Owner/builder ~ ; 2. Type of Fesidenee Single-Family ~ Number of ~edrooms Multi-Family Other (describe) 3. Water Supply Individual W~ll ~ Ccnmunity ~ Public Note: If co~,unity ~11 system, must have written confirmation f-rcm the State Depar~unent of Environmental Conservation attesting to t~ legality and status. Is the ~11 adequate for the number of bedr .cx~s specified in this HAA (Y/N) Y(~5 4. Sewage Disposal Onsite ~ Public ~-] C=:munity ~ Holding Ta~k ~ Is the wastewater disposal system adequate for t~he numb~_r of b~drocms (Y/N} ~.)~u3 $ y' S T~,'m. P~P. ,'~ , T1 g '3 o'z.o% , [Page 1 of 2] 2-15-84 5. Engineerinq Firm Providing Inspections, Tests, Data and Information I certify that I have checked, verified, or conforn~d to all MgA HAA ~uidelings i~ effect on the date. of this inspectiorl. Signed .~ ~ ( ~GINEER S~) Date ~ le p hone 6. DHEP Approval Appro%gd fo~ Approved ~ Disapproved ~-~ Conditional ~-~ Terms of Conditional Approval 5he Municipality of Anchomage Department of Health and Enviror~ntal Protection not guarantee the continued satisfactory performance of the water supply and/ct wastewate~ disposal system. This approval indicates that, as of the validation shown above, based on the data and information furnished by an engineer registere, the State cf Alaska, the water supply and wastewater disposal system is safe and tional for the r~mber of bedrocms and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the followi~ng address: q J°° ,"g 3~ KB2/d5/s [Page 2 of 2] As MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUI~ORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 NOI-LD~]IO~d -I¥1N?,WNO~IAN3 WELL II,%.TA ~ H±]V]H 4O fl~DV'dONDNV JO ~nVdlDINn~ Well Classification ~11 ~ ~esent (Y~) Total ~p~ ~/ ' Card to Static ~ter ~1 Casing ~ight ~ Gr~nd Elec~ical Wiring in ~n~it (Y~) ~p~ation Distan~s f~ ~11: To ~ptic~oldi~ Ta~ ~ ~t /~/ To ~a~est ~ of ~so~ption Field on ~t To Newest ~blic ~ Line Lot 10 · bck 1 Com~ell Heights S/D If A, B, C~ C, D.E.C. Approved(Y/N) Date Completed (~- Z..~- ~..~ Yield Depth of G~outing AJo~ $9' Sanitary Seal on Casing Depression A~ound Well~,e.ad J r Pump Set At (Y/N) (y/N) /~O ; On Adjoining Lots ; On Adjoining Lots To Nea~est Public Se~r B. SEPTIC/HOLDING TANK DATA Date Installed 5--/?- Size /'~ ~--0~ No. of Ccmpa~tments Standpipes (Y~) ~J Air-tight Caps (Y~)~J F~ndation Clean~t (Y~) ~pression o~ TaDR (Y~) ~O ~te ~st P~d ~'/~ -- ~~ ~ ~, P~ing~inte~n~ ~n~a~ ~ File (Y~) ~ O; for Holding Ta~ High-Wate~ ~a~ (Y~) ~/~ ~ra~y Holdi~ Tank ~t (Y~) Sep~ation Distan~s ~ ~ptic~olding Ta~: To ~ter-Supply ~11 ~/ ' ~o ~ilding F~ndati~ To ~o~rty Li~ ~ ~' To Dis~al Field ~ To ~ter ~in/~rvi~ Li~ ~ ~ / To S~e~, ~nd, ~e, ~ ~jor ~aina~ Co~ ~ / D 0 [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 5- - / ~ ~ ~ ~ Width of Field ~- ' Square Feet of Absorption Area .3 ~) / Depression over Field (Y/N) L30 Date of Last Adequacy Test Results of Last Adequacy Test ~//¢ Separation Distanoe from Absorption Field: To Water-Supply Well //5- ' To P~operty Lir~ ~/~P To Building Foundation L/d) ~ To Existing or Abandoned System cn Lot /t~ O~ ~-- ; On Adjoining Lots ¢- / OO ' To Water Main/Service Line ¢~ ?--3- ' To Cutbark( if present) /L//~ / TO Stream/Pond/Lake/or Major Drainage Course + /00 To Driveway, Parking Area, or Vehicle Storage Area ~ ~/O ' Con-u-ents Type of System Desi9n Length of Field %/f Depth cf Field 7 ' Gravel Bed Thickness ~ ' Standpipes Present (Y/N) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested fo= Electrical Codes(Y/N) Dime ns ions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Continents ~-/¢~ ~/~ ~ /3' ** Check Permitted Bedroom Rating Against HAA t~quest ** I certify that I have checked, verified, Or conformed to all MOA HAA C~idelines in effect on the date of this inspection. :, ,,,,/? ~t '/ Sioned ~//'¢'' ~3'~ ''~''-'* Date Company C ¢,~f/~ MOA NO. ! KB1/d5/s [Page 2 of 2] 2-_,,-84 :Il %:I! :Il i -i MOUNTAIN (Phelps St.) LAKE i Drive