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HomeMy WebLinkAboutCROMWELL HEIGHTS BLK 1 LT 10NA aelojwvA \% -Al
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: OSP251058
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: STEENMEYER TINA B & STEVEN M
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
3/21/2025
3/21/2026
28800
❑ Disposal Field Q 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 a osed on the same day, or
b. Cover ,sealed, and heated to prevent freezing
Special Provisions: This property recently sold without the benefit of a COSA. A COSA is now required to be
applied for in order to close out this septic tank permit.
ye
Issued By:
Date:
Date: S
4
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section
ON-SITE SEPTICIWELL PERMIT APPLICATION
Parcel I.D. 015-332-09
Property owner(s) TINA & STEVEN STEENMEYER Day phone
Mailing address 10970 MOUNTAIN LAKE DRIVE, ANCHORAGE, AK 99516
Site address 10970 MOUNTAIN LAKE DRIVE, ANCHORAGE, AK 99516
Legal description CROMWELL HEIGHTS BLOCK 1, LOT 10
Number of Bedrooms 4
Engineering Firm FIRST WATER CONSULTING
Building Permit Number
Not Applicable RN
APPLICATION IS FOR:
APPLICATION IS AN:
(_M all that apply)
Absorption Field
❑
Initial ❑
Septic Tank
Upgrade
Holding Tank
❑
Renewal ❑
Privy
❑
Well
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
Permit/Rush Fees: Waiver Fees:
Date of Payment: 70? Date of Payment:
Permit No. 0 Waiver No.
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
!
!!
March 15, 2025
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: RENEWAL SEPTIC SYSTEM PERMIT #OSP221410
LEGAL: CROMWELL HEIGHTS BLOCK 1, LOT 10
The property owner has requested we renew the septic permit OSP221410 for the above
referenced lot. Nothing has changed on the lot or adjacent lots that would affect the design as
previously permitted. The lot and area are served by private water. The design will not impact
any of the neighboring properties.
Groundwater was noted in the MOA on-site file and if deemed necessary at installation, the
proposed epoxy coated steel septic STEP tank will be anchored to prevent possible buoyancy
issues or other action may be required.
The lot and area are served by private water and any encroaching wells, easements, … must be
staked prior to construction. The design will not impact any of the neighboring properties.
Please contact us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251058, Deb Wockenfuss, 03/21/25
FIRST WATER CONSULTING
CROMWELL HEIGHTS BLOCK 1, LOT 10
DESIGN DETAILS:
NO WELLS WITHIN
100' OF PROPOSED
SEPTIC TANK. VERFY
& STAKE ANY WELL
RADII PRIOR TO
CONSTRUCTION.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251058, Deb Wockenfuss, 03/21/25
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:
l)epartmefit
10/27/2022
10/27/2023
28800
❑ Disposal Field Q 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 prio to tank ins'tal'lation
Received By: /
Issued By: rl� �,�a`t rV"cavtg U
4
Date: _10 -
Date:
Municipality of Anchorage
• Development Services Department •='�
Building Safety Division _. —:-':
On-Site Water & Wastewater Program, 4700 South 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. SW030243 PID Number. 015-332-09
NaTe7
STEVEN TAYLOR &JUDITH HULL
Wastewater System: O New ■ Upgrade
Y P9
10970 MOUNTIAN LAKE ROAD * ANCHORAGE, AK 99516
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 346-2809 4
D Deep Trench D Shollow Trench ■ Bed O Mound D Other
LEGAL DESCRIPTION
Son Rating:
0.8
Total Depth from orgind grade.
**SEE
CPD/Sq.
R BELOW R
Block: Lot: Subdivision:
Depth to pipe bottom from oe4nal grade:
Gravel depth beneath pipe:
10 1 CROMWELL HEIGHTS
SEE DWG
R 0.55 FL
Township: Range: Section:
Iw added above alginol grade:
Gravel length:
— — —
SEE DWG
R 50 R
WELL: O New [] Upgrod
tree« Width: 15
Number 3 m..
Dwo 5�"" R
FL
CbeNlkotion Private, A8.0 . Cased To:
Total obsonptlon area:
750
pipe ma eriab
D 3034/ F-810/SCH.40
R R
so.
R
Dote Drilled: Stotlo Water tivel:
Installer Date Installed-
A+ HOME SERVICES 7/14-16/2003
FL
6YWI01.
TAN
Pump Set At
Coming Height Above �vana:
GPN
R
R
DSeptic 0Holding C)�\ DOther
Manufacturer. ��\ ✓ C°p°cly M galbn�
SEPARATION
DISTANCES
To
Septic
Absorrpption
Lift
Holding
ubec/PrlvaG
From
Tank
FII
Station
Tank
Sewer llnw
`\
Well
"989+
100'+
100'+
—
25'+
Material;
Number of Comportments:
Surface Water
100'+
100'+
100'+
—
—
LIFT STATION
Lot Line
5'+
10'+
5'+
—
—
(^
Sue In gallons ` \� \ \ '1 Manufacturer.
Hqh water slam at•
Foundation
5 +
10 +
r
5 +
—
—
Curtain Drain
NONE KNOW
Pump Yalu
Eleo"fed Yupectlons performed by:
Remarks: *WAIVER EXISTING
BENCH MARK
Uootlon and Deeerilmon:
**EXCAVATION WAS LIMITED TO THE
TOP OF GAS METER DIAPHRAGM
REMOVAL OF ALL CONTAMINATED MATERAL 0.5-2.64
OF M.O.A..OAPPROVED SAND FILTER ADDED.
100.00 R
ENGINEER
EXISTING SEPTIC TANK & LIFT STATION TO BE OF GOOD INTEGRITY ON
�o
7/15/2003
Inspections performed by: AKWWC, INC. Dates: 1st 7/14/2003
:... ...
2nd 7/15/2003
3rd 7/16/2003
e r A • G' "ass:' •
E— eo��
Development Service Department Approval
Re viewed and approved by: Dote:? 2 3-D3rofesstaaq�
40p000
% A B t
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EXMT1 103.86 56.35
(5_02=0 N
LIFT STATION MT2 125.45 87.74 I
I
EXISTING 1250 GALLON INTEGRITY /
SEPTIC TANK. INTEGRITY ON 7�1 �200a MT3 92.41 46.57 I
VERIFIED ON 7/152003
MT4 1114.921 80.1 I
DBLI DBSTI t
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DRAWN BY:
ALASKA NVATER & WASTEWATER
N.C.H.
4.1
SCALE. 1 „ = 30,
CONSULTANTS, INC.
, ..... „�PODr7
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (9072337.6179 • FAX (907)338-5246
n
(✓i'I
PREPARED FOR: PHONE NUMBER:
PAGE NUMBER:
JUDITH HULL & DAVID TAYLOR AGENT 273-7766
2 OF 3of
A. 0 ess:• 0
O�� n
LEGAL DESCRIPTION:
CROMWELL HEIGHTS SUBDIVISION; LOT 10, BLOCK 1,
C —795 eap�
0���e •., A�appG
professSon
OOppp0000�'
TYPE OF WORK:
PROFILE OF
DRAWING SEPTIC SYSTEM UPGRADE
PERMIT NUMBER: PARCEL ID NUMBER:
SWO30243 AS -BUILT DRAWING 015-332-09
%FINAL CRADE-
MONITORING TUBE---, / 98.97 (AVG) r -MONITORING TUBE
FABRIC
:a...``.. .�..r. �. J:w ��� ^r Vii........:` .
TOP SAND
94.644 (AVG) 15 FEET WIDE
INVERT OF PIPE- 95.19(AVG)
THE DISTRIBUTION LINES ARE 1.25 INCH
SHEDULE 40 PVC WITH 1/4 INCH HOLES SPACED
48 INCHES ON CENTER. 11 HOLES PER LATERAL BOTTOM OF BED
33 HOLES TOTAL IN ENTIRE SYSTEM. 92.01-94.14
EXCAVATION LIMITED
TO THE REMOVAL OF
THE CONTAMINATED
MATERIAL
DATE opo DO4
7/21 00
1<< T.
WASTE
DRAWN BY:
> N.C.H.
ALASKA AVATER & �jAST NVATER
SCALE*• 4
.... 0
CONSULTANTS, INC. 1" 40, * ;..... . "• ........
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337.6179 • FAX (907)338.3246
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
STEVEN TAYLOR & JUDITH HULL (907) 346-2809 3 OF 3 • r -.
PO 1 r A. rness:
LEGAL DESCRIPTION: oA o - 3 0
CROMWELL HEIGHTS SUBDIVISION; LOT 1. BLOCK 10 01%• •. •• N��
TYPEProf
rcteaelcoa
PROFILE AS—BUILT OF SEPTIC SYSTEM ��°�^eo��ct v
400000
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW030243
Legal Description: (CROMWELL HEIGHTS BLK :::1 LTAO
O
Design Engineer: 0041 AK Water & Wastewater Consultant!
Owner Name: Judith Hull & David Taylor
Owner Address: 10970 MOUNTAIN LAKE DRIVE
ANCHORAGE, AK 99516-1876
'l, 1CQ- lZp�
Date Issued: Jul 14, 2003
Expiration Date: Jul 13, 2004
Parcel ID: 015-332-09
Site Address: 010970 MOUNTAIN LAKE DR
Lot Size: 28800 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy
All construction must be in accordance with:
1. The attached approved design.
❑ Private Well ❑ Water Storage
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3• The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Date: zkho
Issued By/n Date:r�
Municipality of Anchorage
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ff
ON-SITE SEWER/WELL
a IR
t 1-.riY.
PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-332-09 Permit Number
Property owner(s) JUDffH HULL & DAVID TAYLOR Day phone
Mailing address (2)
Zip Code 99516
Legal description (Lot, Block & Sub'd.) LOT 10 BLOCK 1: CROMWELL HEIGHTS SUBDIVISION
Legal description (Section, Township & Range) _ N/A
Lot Size v� Acres/Sq.Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade
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.
ALASKA WATER do WASTEWATER CONSULTANTS, INC.
Permit Fees: �100 t \SO
Date of Payment: 7'
Receipt Number:
0
Waiver Fees*
Date of Payment:
Receipt Number:
ALASKA. WATER & WASTEWATER
^"'�'"CONSULTANTS, INC.
July 9, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragraw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic System Upgrade for Lot 10, Block 1, Cromwell Heights Subdivision.
To whom it may concern:
The existing 4 bedroom house is served by a private well and septic system. The septic system
consists of a 1250 gallon septic tank that was installed in 1983 and a 500 gallon lift station and
bed type drainfield that were installed in 1995. The drainfield is surcharged and must be
upgraded prior to the sale of the house. We are proposing to inspect the existing septic tank and
lift station to verify its structural integrity. If it is in good condition, it is our intent to reuse the
tank and lift station We are proposing to excavate the contaminated material from the existing
bed and then re -build it to its current elevation and dimensions. Comments regarding the design
are summarized as follows:
1. SOILS: Attached is the soil log prepared by John Simpson, P.E. On the inspection report it
states that the soil rating was 1.0 gallons/day/ft2. We are proposing to use the maximum
allowable absorption rate for a bed, which is 0.8 gallons/day/ft2.
2. DRAINFIELD DESIGN: Rebuilding existing Bed
a. Percolation Rate: 0.57 & 0.65 minutes/inch
b. Application Rate: 0.8 gallons/day/ft2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 750 fie
f. Sand Filter: 1 foot minimum
g. Effective Depth: 0.5 feet
h. Width: 15 feet
i. Length: 50 feet
j. Effective absorption area = 750 ft2
3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507
Ph: (907) 337-6179 " Fax: (907) 338-3246' Website: akwwc.com
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: There are no slope concerns.
5. CLOSING: I am open to any suggestions from your department, which would be an
improvement to the proposed design. I am unaware of any adverse impacts this installation
would have on adjacent wells or septic systems. If you have any questions, please contact me at
337-6179. Than*ou for your assistance.
P.E., M.S. -
NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, two soils logs,
and a 7 page construction specification letter which are all part of the design package for this
septic system.
3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: akwwe.com
,
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1 LAT s, BLOCK 1,
SUBDIVISION ARE SERVED BY I
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CROMWELL HEIGHTS S/D;
LOT 9, BLOCK 1, 1
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(SEE DESIGN PAGE 2 OF 2)
MOUNTAIN
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1 CROMWELL HEIGHTS S/D;
LAT 3, BLACK 1,
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CROMWELL HEIGHTS S/D; I
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LOT 12, BLACK 1, 1
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DATE:
7/9/2003
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DRAWN BY:
Q..._ ... -_._... _...._..___..._
ALASKA
_
«'XrE4 R R
_
IVASTE AVATE?R
C.J.G.
> •,. T y*�,,�,
SALE
1 " =
100'
CONSULTANTS, INC.
3701 F. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONF (907)337.6179 • FAX (907)338-3746
' " ........ ...... • •'
It •^
vs
PREPARED FOR PHONE NUMBER:
PAGE NUMBER:
JUDITH HULL
& DAVID TAYLOR
273-7766
(AGENT)
1 OF 2
'•.J f rness:
C 7 3 •' a �'
'+
LEGAL DESCRIPTION:
CROMWELL HEIGHTS SUBDIVISION;
LOT
10, BLOCK 1,
o
4�+ped o\��-•
�•..p•;;;;;; ='
TYPE OF WORK:
SITE PLAN FOR SEPTIC SYSTEM UPGRADE
7/9/2003
DRAWN BY.
ALASKA NVATKR & WASTENVATKR C.J.G.
CONSULTANTS, INC. Ste.
3701 E. TUDOR ROAD, SUITE IOI • ANCHORAGE. AK 99507 •PHONE (907)337-6179 • FAX (907)338-3I46
1" = 30'
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JUDITH HULL & DAVID TAYLOR AGENT 273-7766 2 OF 2
LEGAL DESCRIPTION:
CROMWELL HEIGHTS SUBDIVISION; LOT 10, BLOCK 1,
TYPE OF WORK:
DESIGN DRAWING OF SEPTIC SYSTEM UPGRADE
04 F p
40
C T
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.. . . .... .........
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0400�00�0
PROPOSED REBUILDING OF EXISTING BEb. THE EXISTING BED IS A
15 FEET WIDE BY 40 FEET LONG BED TYPE DRAINFIELD WITH 0.5
FEET OF EFFECTIVE. WE ARE PROPOSING THAT THE BED BE
EXCAVATED AND THAT ALL CONTAMINATED MATERIAL BE REMOVED.
THE BED IS TO BE 50 FEET LONG. AFTER ALL CONTAMINATED
MATERIA. IS REMOVED, INSTALL A MINIMUM OF 1+ FEET OF
M.OA APPROVED SAND FILTER TO BE AT OR ABOVE THE BOTTOM
EXISTING ABANDONED OF THE EXISTING DRAINROCK. THEN ADD 0.5 FEET OF NEW
DRAINFIELD. CLEAN, WASHED SEWER DRAINROCK. THE DISTRIBUTION UNE IS TO
BE 1.25 INCH PVC WITH i INCH HOLES SPACED 23 INCHES ON
CENTER. (24 HOLES PER LATERA02 HOLES TOTAL)
� I
C0 I
EXISTING 1250 GALLON SEPTIC 0-----------.�
TANK AND 500 GALLON UFT
STATION. THE TANKS ARE TO BE '
EXPOSED AND THE INTEGRITY \
VERIFIED. IF OF POOR INTEGRITY
\
REPLACE WITH A NEW 1500
+ \
GALLON S.T.E.P. TANK PLACED
100'+ FROM THE WELL. %` \
INSTALL FOUNDATION
/ CLEANOUT
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EXISTING
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NOTE: THE CONTRACTOR SHALL HAVE THE
NORTH LOT UNE FLAGGED BY A REGISTERED
SURVEYOR PRIOR TO CONSTRUCTION.
(/
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7/9/2003
DRAWN BY.
ALASKA NVATKR & WASTENVATKR C.J.G.
CONSULTANTS, INC. Ste.
3701 E. TUDOR ROAD, SUITE IOI • ANCHORAGE. AK 99507 •PHONE (907)337-6179 • FAX (907)338-3I46
1" = 30'
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JUDITH HULL & DAVID TAYLOR AGENT 273-7766 2 OF 2
LEGAL DESCRIPTION:
CROMWELL HEIGHTS SUBDIVISION; LOT 10, BLOCK 1,
TYPE OF WORK:
DESIGN DRAWING OF SEPTIC SYSTEM UPGRADE
04 F p
40
C T
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J fr y mess
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
On -Site Services Transmittal Sheet
TO: %-af/N S/rlf,SDry LEGAL; L /0 B l C90MWel- L HF/CkTJ
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
u other wN97' TYPE OF PVC Pi PF usro TA e., fro-V0Pi'or ' L4MRA L
.)CHAMZ
a phe4rlayollrany-rE
FROM
Lv6LL re
Seerle rt7uk0.v
P6.
/ aF
/
3 FIL t 1W
01-/9uKf
ON L /Fr s
r ArfO.v A4
rA,
Please supply the necessary information and re -submit your
request. Your cooperation is appreciated.
Reviewer 01�Al Date/2 -If-&
LEAVE TMS FORMA TTACHED TO PAPERWORK
/203 -rev. 4/93
Lr
Municipality of Anchorage Page 1 of j
DEPARTMENT OF HEALTH AND HUMAN SERVI``—''
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: C I = ��� LIi� PID Number: 01533209
Name:
Steven Taylor
Wastewater System: ❑ New C3 Upgrade
y
Address:
ABSORPTION FIELD
10970 Mountain Lake Dr Anchorage, AK 99516
Phone:
No. of Bedrooms:
4
❑Deep Trench ❑Shallow Trench] Bed 0 Mound ❑Other
LEGAL DESCRIPTION
Soil
ign. 1
Total Depth from original grade:
0.16 ft.
GPDis . Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
10 1
Ft.
Ft.
Township:
Range: Section:
Fill added above original grade:
Gravel length:
T12N
RN 23
Ft.
40 Ft.
WELL: N/A ❑ New ❑ Upgrade
•
Gravel width: 15
Numb of lines:
Distance between
Ft.
Ft.
Classification (Private. A,B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe material: _7ec fdrO*S
Ft.
Ft.
600 SQ. Ft.
4" rforated PVC
Driller:
Date Drilled:
Static Water Level:
Installer.
Date installed:
Ft.
Pacific Rehab Const.
July-Aucrust 1995
Yield:
Pump Set at:
I
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
XXSeptic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
HoldingPublic/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
Greer
1,250
Material:
Number of Compartments:
Well
Jif
110'
111'
100'
N/A
Steel
Surface
LIFT STATION
Water
N/A
N/A
N/A
N/A
N
Lot
Size in gallons:
Manufacturer.
Line
19'
ill
16'
19'
N/A
dU
Foundation"Pump
'
on" level at:
"Pump off' level at:
lcg I/
High water alarm at:
31
50'
45'
31'
N/A
:9
Curtain
Pump Make & Madel
Electric Insp tions e_ rformed by*
Drain
NA
NA
NA
NA
NA
Remarks:
BENCH MARK
fl,0 Yale, 4(
Location and Description:
2%nom
To of cras valve
Assumed Elevation:
100.0 Ft
E�NGI�I�
,SEAL
E OF At
�
r
"'�
Inspections performed by: IIKI Dates: 1st 8/l/95
"" •• �••�•
2nd 8/17/95
3rd
............. ,:.:.. .... ..,.,ti
1 D,k John Earl Sim
Health Human Services
r�'�.'f °'�
Department of and ap r v
P
,•..����`�,:
,l�i�
Reviewed and approved by: Date:
72-013 (Rev. 9/91) MOA 25
LIFT STATION
FOR DETAILS SEE ATTACHED LIFT
STATION SPECIFICATIONS
x— SEPTIC TANK
LEGEND
© WATER WELL (D TEST PIT 0 CLEANOUT
SQ SEWER STANDPIPE ® MONITORING TUBE
FOR DESIGN PURPOSES ONLY. DRAWINGS SHOULD NOT B£ USED
FOR THE ESTABLISHING OF PPOPERT' LINES, EASEMENTS, ETC.
LOT 10, BLOCK 1
CROMWELL HEIGHTS S/D
SEPTIC SYSTEM AS -BUILT
DRAWING
DESIGN: SOD
DRAWN: CMR
CHECKED: JES
EMI NO.: 6301
BED SYSTEM
SEE SHEET 2
FOR DETAILS
TOE OF SLOPE
TEST PIT# 2
SCALE
V=40'
DATE:
AUGUST 17, 1995
SHEET 1 OF 2
John Earl Simpson
ABANDONED DRAINFIELDe
CE -8061
��5,
I'
•�•�y fit
ELECTRIC
LINE
®
I
I
TEST PIT# t © -I"' , — -�
I
I
` '. 30 . 0. I
c
uj
GAS METER
O
BENCH MARK
I
I
W
I
\I
I
Z
I
Q
EXISTING
HOUSE
I
I
is
0
Z100.0'
I
o
O
I
Z
I
m
I
/EXISTINGLL
i
12
I
y
LOT 10
I
LEGEND
© WATER WELL (D TEST PIT 0 CLEANOUT
SQ SEWER STANDPIPE ® MONITORING TUBE
FOR DESIGN PURPOSES ONLY. DRAWINGS SHOULD NOT B£ USED
FOR THE ESTABLISHING OF PPOPERT' LINES, EASEMENTS, ETC.
LOT 10, BLOCK 1
CROMWELL HEIGHTS S/D
SEPTIC SYSTEM AS -BUILT
DRAWING
DESIGN: SOD
DRAWN: CMR
CHECKED: JES
EMI NO.: 6301
BED SYSTEM
SEE SHEET 2
FOR DETAILS
TOE OF SLOPE
TEST PIT# 2
SCALE
V=40'
DATE:
AUGUST 17, 1995
SHEET 1 OF 2
John Earl Simpson
CE -8061
��5,
4-.'
•�•�y fit
"" ru
WMMRM
206 WEST FIREWEED LANE, SUITE 201
ANCHORAGE, ALASKA 99503
(907) 272-9336 -FAX 272-4159
"VV""W
To Lift Station
2" OF INSULATION
1.25" SCHEDULE
40 PVC PIPE
4"PERFORA
PVC PIPE
MONITORING TUBE
II
II
CID CO
NATIVE SOIL
SEWER ROCK
A'
v
laaALL22
L11YAti2a
Bench Mork
100.00.
Top of
go. Motor
A
96.58,
Top of
filter g—el
B
95.94,
Top of
pip.
C
95.92'
1 Top of
pip.
D
95.89.
Top of
pip.
8
95A1,
Top of
pipe
Lift Station
96.32'
Top of
Cover
Monitoring TUb,
94.52-
Bottom
of Pip, a XT
11
98.98.
PSniah
Ground L.v.l BMT
TOE OF SLOPE
MIN SLOPE 2:1
rA2__
OU GRND
IOULEVEL
_L1,01
wl
Z
John Earl Simpson
`.`,r
x\ CE -8001
.1.0 AW
Aw
I
LEGEND
LOT 10, BLOCK 1
SCALE
MONITORING TUBE • CLEANOUT
CROMWELL HEIGHTS S/D
DESIGN: SOD
DRAWN: CMR
N. T. S.
RMSOREffAL
CHECKED: JES
4
DATE:
August 9, 1996
FOP. DE, iGN PURPOISES ONLY, DRAWINGS SHOULD NOT BE USED
SEPTIC SYSTEM AS -BUILT
EN! I NO.: 6300
206 WEST FIREWEED LANE, SUITE 201
Fs.E; 2 OF 2
FOR THE ESTABLISHING OF PROPERTY LINES, EASEMENTSJET' C.
DETAILS
ANCHORAGE, ALASKA 99503
a
(907) 272-9336 -FAX 272-4159
ENVIRONNIEN'IAI.
N4ANAGBIENT
INCORPORATED
August 8, 1996
Jim Cross
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
RECEIVED
AUG 12 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 approval, site
inspection, and system acceptance:
September 22, 1994
1st Percoloation Test Conducted
October 28, 1994
2nd Percoloation Test Conducted
November 7, 1994
Septic System Design Approved by MOA
July 19, 1995
First Site Inspection Conducted by EMI
August 1, 1995
Second Site Inspection Conducted by EMI
August 17, 1995
Third Site Inspection Conducted by EMI
August 8, 1996
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 verified by EMI during
this third inspection. During 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,
Envirwrnental
Aan ment,
Simpson, P.E.
ct Engineer
Inc.
cc: Mr. Steve Taylor, House Owner
Attachments: 1. As -Built Drawings
2. On -Site Wastewater Disposal System an/or Well Inspection Report
6301 Closure Letter/cmr 8/8/96 Page 2 of 2
AAENVIRONMENTAL
MANAGEMENT
INCORPORATED
October 29, 1996
Dan Roth
Municipality of Anchorage
Department of Health & Human Services
P.O. Box 196650
Anchorage, Alaska 99519
U NiCIPAUTY OF ANCHoRAOE
NOV 01 1996
RECEIVED
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. Please see
drawing 1 of 1.
4) Was the septic tank integrity verified?
The integrity of the septic tank was visual verified by a engineer during the drain
field and pump station installation.
206 E. FIREWEED LANE, SUITE 201 • ANCHORAGE, AK 99503-2703
CONSULTING (907) 272-9336 9 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, INC.
J n Simpson, P.E.
attachments: waiver application
jA)3\/e(F
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
On -Site Services Transmittal Sheet
TO: JOHN EARL S 10 Ps0,0v LEGAL: L OT /O O' k / CRDs w El L HE IGH%S
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 becaus
X_ Other %/ WHAT TYPE Of P/R4E USED IIe. ETc�
,E1-EL'T,?1CA/ INSPE„T/oAv ? 51-1N6 T/,rr To DwEZ41u6.
i'rvrE RWY
59pr/c ” V EPYI FIW ? 5•� /�/°/'E/!RS 1Nf LL /S IPPI°�'?oXi�r.�rEL�' �'/a'
F?OM SEPT/ c TANK CGEANOu T l�/fC /y,►Y QF AApPROWMeATIE Lr
Please supply the necessary information and re -submit your
request. Your cooperation is appreciated.
Reviewer A&Z Date/0 - %6
LEAVE THIS FORM ATTACHED TO PAPERWORK
/203 -rev. 4/93
MUNICIPALITY OF ANCHORAGE
ON-SITE WATER/WASTEWATER DISPOSAL SYSTEM
FIELD AUDIT
Date 9-6- 9� Document Type 19,5 - Qu T
Legal Description L °T /y %3L -k / C Mo,4lwE1-z- f/EiG,yrf
Site Address /0970 tioUAl76/Av L 4*- E Ple i L, E
Engineer/Firm 30% El"a-pi s /ter Ps ON Excavator PVe'lf'/e, Rf'ielP/3
Inspection Findings 11oAllroi? Tuve iN geo wa7' spec, lob R1'40 To supyr-'gC
FNK r 0 CL OSF t0 Lv,ELj , WILL ba fOLL/w Ur cy/rV TOPCOAl ra LIERIAY
1U `96 Gvtt-LG i0 CLF
�vowrg� ca 7g w61Vb'R kPd uIRED.
Initials
Follow-up Notes
Time / He
/463-5-92
AAE_\t IRON\IE AL
t 1.1\aGE11E\T
IWORPOR.ATEI)
August 14, 1995
Bob Griffin
Pacific Rehab Construction
P.O. Box 230628
Anchorage, AK 99523-0628
RECEIVED
AUG 18 1995
Municipality of Anchorage
Dept. Health & Human Services
1
Subject: Septic Design at 10970 Mountain Lake Drive, Lot 10, Block 10;
Cromwell Heights Subdivision
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,
Envir me:h,
Mana "ment, Inc.
i
Jo E. Sim PE
Vice 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
• Municipality of Anchorage
Department of Health and Human Services
825 "L" Street 44
Rick Mysrrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
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 regarding this waiver, please call our office at
343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
DJR/ljm: Taylor
KUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR960062 PID# 015-332-09
Date Received: November 1, 1996
HA#
Permit # SW940424
Legal Description: Lot 10 Block 1 Cromwell Heights Subdivision
Engineer: John Simpson, P.E., Enviromenta.l Management Inc.
206 East Fireweed Lane, Suite 201, Anchorage, Alaska 99503 2703
Applicant: Steven Taylor
Waiver Requested: Private well to the septic tank of 98.i feet
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: x Waiver is NOT Granted:
List Conditions or Reasons for above: 5 FF
Date: By: PWA/
Name of Reviewer
Rec #: 02294/3249
Amount: $ 625.00 Date Paid: 11-1-96
aoo
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2
AAEMIRON jlENTAL
MANAGEMENT
INCORPORATED
Date: October 10, 1996
To: Municipality of Anchorage
Department of Health & Human Services
Environmental Services Division
825 "L" Street, Room 502
Anchorage, Alaska 99501
From: John Simpson, P.E.
Environmental Management, Inc. >
206 East Fireweed lane, Suite 2Qy'
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'Malley Road area of Municipality of Anchorage. The site is
sloping in a westerly direction at a approximate 71/o 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. FIREWEED 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 low."
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. 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 low 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'.
B5. List of adjoining property owners: (From the Municipality assessors office these
are adjoining property owners)
• Cromwell Heights Blk 1, Lot 2 & Blk 1, Lot 11 & Blk 1, Lot 12
Hoffman Robert L. & Ethel
Cromwell Heights Blk 1, Lot 3
Samel Roberta L.
• Cromwell Heights Blk 1, Lot 4
Vehrs Larry F. & Nadya A.
• Cromwell Heights Blk 1, Lot 6 & Blk 1, Lot 7
Hoffsetz Robert F. Jr. & Sara Ann
Page 2
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE e
DEPARTMENT OF HEALTH AND HUMAN SERVICES ��r�l�
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW940424 DATE ISSUED:11/07/94
DESIGN ENGINEER:ENVIRONMENTAL MANAGEMENT, INC. EXPIRATION DATE:11/07/95
OWNER NAME : TAYLOR STEVEN DAVID & 3x41-- Z 6 b GI
OWNER ADDRESS:10970 PHILLIPS ST
ANCHORAGE, ALASKA 99516
PARCEL ID:01533209
LEGAL DESCRIPTION: CROMWELL HEIGHTS BLK 1 LT 1
0
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:
DATE:
John Earl SimpsonIt
�Q
CE -8061
�� PROFESS�0�1� ."te'
LEGEND
LOT 10, BLOCK 1
LIFT STATION
SCALE
FOR DETAILS SEE ATTACHED
HEIGHTS S/D
cECKED: JES SHS
DRAWN:CROMWELL
ANCHORAGE TANK AND WELDING
'A
DATE:�Nw
NOVEMBER 1, 1994
INC. LIFT STATION SPECIFICATIONS
SEPTIC DESIGN SITE MAP
SEPTIC TANK
FOR DESIGN PURPOSES ONLY. DRAWINGS SHOULD NOT BE USED
EMI NO.: 6301
PROPOSED BED SYSTEM
FOR THE ESTABLISHING OF PROPERTY LINES, EASEMENTS, ETC.
SEE SHEET 2 FOR
EXISTING DRAINRELD
DETAILS
1
1-
TEST Ixrs i Q ' I
— ' ` . 30.0' 1'
TOE OF SLOPE
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John Earl SimpsonIt
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CE -8061
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LEGEND
LOT 10, BLOCK 1
DESIGN: SOD
SCALE
® WATER WELL 8 TEST PIT • CLEANOUT
HEIGHTS S/D
cECKED: JES SHS
DRAWN:CROMWELL
'
1'-40Aw.
'A
DATE:�Nw
NOVEMBER 1, 1994
® SEWER STANDPIPE ® MONITORING TUBE
SEPTIC DESIGN SITE MAP
206 WEST FIREWEED LANE, SUITE 201
FOR DESIGN PURPOSES ONLY. DRAWINGS SHOULD NOT BE USED
EMI NO.: 6301
srlEEr 1 of 2
FOR THE ESTABLISHING OF PROPERTY LINES, EASEMENTS, ETC.
ANCHORAGE, ALASKA 99503
(907) 272-9336 -FAX 272-4159
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(ORENCO SYSTEMS, INC L2826COLONIAL ROAD ROSEBURG, OR97470 (503)673-01
350-00
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EFFLUENT PUMPS I
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NET DISCHARGE, GPM
(ORENCO SYSTEMS, INC L2826COLONIAL ROAD ROSEBURG, OR97470 (503)673-01
ORENCO SYSTEMSTNI ALARM -CONTROL 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 TM
alarm-control panels are
specifically engineered for pressure sewer (STEP)
systems, for controlling pumping into conventional
gravity collection systems and foron-site systems such as
intermittent sand filters, recirculating gravel filters, low
pressure drainfields, as well as for simple uphill pumping
to standard drainfields.
ORENCO SYSTEMS TM
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/115 VAC, Single Phase, 60 Hz,
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: U
A SPDT HOA switch with a 15 amp motor rating.
Fuse Disconnect:
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 low level alarm capability.
Other custom features can be provided.
ORENCO SYSTEMS, INC. 2826 Colonial Road Roseburg, OR 97470 503/673-0165
Terminal
Strip
Alarm
sal +v-
is
SR
I 14 12
1 r—
Terminal
Strip
Pump
115 VAC/112 Hp.
1 Phase / 60 Hz.
Alarm Neutral I
On / Off
Mercury Floats
�p0 n(�GO�t�OGt��9 j m6a
Wiring Diagram
X&OM 4�,-I
on
20A
Ground
L,
115 VAC, 1 Phase, 60 Hz.
(0TGn@o sw@a0mt5 0 .
Wiring Diagram
mw(M 2A
Aub
a�■ �
Mriur
OF ca
2.255 __ 20A
i
Ground
tr«n
L, L2
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230 VAC, 1 Phase, 60 Hz.
Pump
230 VAC / 1 1/2 Hp.
1 Phase / 60 Hz.
DRAWING NO. 1
L1, --T STATION COM=ONENTS
TANK NOT SHOWN)
I
LID
O O O
O O
O O�
O0
0 0
O MANWAY TO TANK)o
GASKET
O 0
O 0
O O
JUNCTION BOX
TERMINAL STRIP
(3 TIMES SCALE)
0
0
's
PIPE PACKAGE AS
IT IS PACKAGED
BY THE FACTORY
OUT!
4 " X 1-1 /4 " BUSHING
(SLIP X SLIP)
X 1-1 BUSHING
2" 4' BUS / G
MALE X FEMALE (2 EA.)
1-114" X I- BUSHING
MALE X FEMALE
(FOR PUMP)
1-1/4" FLEX CONNECTOR
ELCCTRIC AL
ccWTROL
Box
0
4
Z
BOLTS (24 Eo.)
FLOW INDUCER
FLOAT ASSEMBLY --\
EXTRA 24" LENGTHS
OF 1 " PIPE FOR LONG
MAN WAYS (SEE STEP 14)
CHECK VAL VE
PUMP VAUL T
BALL VALVE
UNION (DISASSEMBLED)
36" MALE X MALE
(SEE STEP 141
ADD EXTRA PIPE SECTIONS
AS NECESSARY (STEP 141
1/8" WEEP HOSE FOR
OUTLET LINE ORAINBACK
GRAY PIPE. INSTALL
ASSEMBLY IN TANK BEFORE
BURIAL (SEE STEP 2)
INSTALL BUSHING ON
GRAY PIPE (STEP 11
36" MALE X FEMALE
500 G/
PUMP(
SWING JOINT
(SEE STEP 141
CONDUIT ELBOW
(MUST REMAIN
ABOVE GRADE)
SEAL HERE
ISEE STEP Bl
12/3 OF WIRE
ELBOW COVER
ELECTRICAL CONDUIT
S. S. SCREWS
RETAINING NUT
UD
LID IiOtl)
001M TAPS S
-= II01 1 RINr
l�
r
l;A';h 1. 1
iHIPJG
RING
?" PIPE COUPLING
?" X 1-1/4" BUSHING
FERNCO COUPLING — SEE STEPS 4, 5, AND 6
i" PIPE TO BRIDGE EXCAVATED
I REA BETWEEN TANK END
IND TRENCH TO DRAINFIELD
- 1/4" FLEXIBLE CONNECTOR
14" X 4" BU
TAINING AN
W THE TANK
ROM TANK
1- 1/4 " PIPE 10 ORAINFI£ I O
/Not, l l.,
�n
n
[:
24 P MANWA Y
=!
WTI/ /IOL 15
� 0
(SEE STEP 71
N
-= II01 1 RINr
l�
r
l;A';h 1. 1
iHIPJG
RING
?" PIPE COUPLING
?" X 1-1/4" BUSHING
FERNCO COUPLING — SEE STEPS 4, 5, AND 6
i" PIPE TO BRIDGE EXCAVATED
I REA BETWEEN TANK END
IND TRENCH TO DRAINFIELD
- 1/4" FLEXIBLE CONNECTOR
14" X 4" BU
TAINING AN
W THE TANK
ROM TANK
1- 1/4 " PIPE 10 ORAINFI£ I O
/Not, l l.,
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 -L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: Steve Taylor DA
Lot 10, Block 1, Cromwell
LEGAL DESCRIPTION: Heights_ Subdivision -Township, Range, Section:
SLOPE SITE PLAN
EP Organic material to silts(ML)
1
Q•0'
2
.O�
3-
Q•�
Poorly graded gravel with sand
4-
4
•D O
(GP)
5
Brown, moist to saturated @91,
D • Q
Dense
6
.0
0'0.
.0 D
8
• •D
—�
0 0'
1 1 11
s
10 O •.� --wAS GROUND WATER
Limit of Excavation COUNTERED? yes
S
11 IF YES. AT WHAT L
DEPTH? 7 P
12 E
DOM to Wuer Aftr
13 Nmrilorinq? '7."7 0aw �1
14A
18
19
20
a
PERCOLATION RATE 0.57 (minutes inch) PERC HOLE DIAMETER 6
11
TEST RUN BETWEEN 4 FT AND 4.5 FT
COMMENTS
PERFORMED BY: Stan Dolloff/W I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE.
'2-008 1 Rev. 41851
W-1 NI
1"I11 .
—�
1 1 11
—�
-U67AM
PERCOLATION RATE 0.57 (minutes inch) PERC HOLE DIAMETER 6
11
TEST RUN BETWEEN 4 FT AND 4.5 FT
COMMENTS
PERFORMED BY: Stan Dolloff/W I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE.
'2-008 1 Rev. 41851
t
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: Steve Taylor DA'
LEGAL DESCRIPTIONLot 10,Block 1, Cromwell Township, Range, Section:
DEPTH elg S SLOPE SITE PLAN
(FEET)
t Orgiaanic material with Peat (Pt)
—
0 �— — — — —
2 0
0
3 0 poorly graded gravel with
0 sand (GP)
4- 0 Brown, moist, medium to dense
0
5 0
0
6 0
7 0 0
8 0 0
0
9 0
0
10
11
12-
13-
14-
15-
16-
MU
213,4 1516MU
17 Dept.
18-
19
c
WAS GROUND WATER
Limit of Excavation ENCOUNTERED? yes
S
IF YES, AT WHAT +, --� i L
DEPTH? _� O L
P
E
Depth to Water After
Monitoring? .,7 • y& i Date: )
ECEIVED
1404 21994
a oi a ryaath &Hu S ces
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
10/28/94 3:50:00
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
11
11
20
PERCOLATION RATE 0.65 (minutes/inch) PERC HOLE DIAMETER 6
11
tt TEST RUN BETWEEN 1 FT AND 1 .5 FT
COMMENTS ?s h,jeerColgTj�,n 4es-�
PERFORMED BY: Stan D011off/EMI I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
SPECIFICATIONS FOR UPGRADE OF EXISTING ON SITE
SEPTIC SYSTEM
Legal Description: Lot 10, Block 1, Cromwell Heights Sub.
Owner: Steve Taylor
A. General Overview
1. The septic upgrade is for a single family residence only.
2. The attached drawing and/or site plan shall be part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of
Health and Human Services requirements.
4. 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.
5. 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.
6. It is the responsibility of the engineer to locate any adjacent wells.
7. The installation and excavation is to be exactly in the area shown on the
site plan, any deviation requires engineer approval.
8. It is prudent that a surveyor locate the nearest lot line position and the
location of any easements.
9. 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.
10. The installation of the bed/mound system and lift station shall be
conducted by a certified excavator as required by AMC 15.65.035.
EllensHMEMI Jobs16301 Griffin Septic Design(10/6/94)
1. The existing septic tank is a 1,250 gallon, two compartment, steel tank
installed May of 1983.
2. The integrity of the septic tank will be verified by the engineer during the
drain field installation.
C Existing Drain Field
1. 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.
2. This existing system has been removed from the ground.
D. Proposed Lift Station
1. Due to the high water table, effluent from the existing septic tank shall be
lifted approximately 5 ft. to the proposed bed/mound system.
2. 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.
3. All electrical components shall be UL listed and installed by a licensed
electrician in compliance with all applicable codes and regulations.
1. The bottom of the bed shall be level, plus or minus 1 1/2 inches.
2. 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.
3. 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.
4. Gravel backfill material shall be 3/4 inches to 3 inches screened rock
diameter with less than 3% passing #200 sieve residual.
5. Cleanouts will be placed at the corners of the bed/mound system as
shown in the attached drawing.
6. 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
EllensHDIEMI Jobs16301 Griffin Septic Design(10/6/94)
system with a 1 1/4 inch PVC pipe.
7. A free standing monitoring perforated tube will be installed in the
absorption area as shown in the plan drawings.
8. 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.
9. 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.
F. Drain Field Bed Dimensions
1. Proposed Bed: 40' long X 15' wide=600 sq. ft.
2. 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.)
UP
•e• •• 1 •_ • •: •. •: •-• •• .11 •
EllensHDIEMI 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
• '� Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
.. 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL Af
FOR A SINGLE FAMILY DWELLING 1r
Parcell.D. 015-332-09 HAA# SU�Wt
1. GENERAL INFORMATION
Expiration Date: I Q— .2 3— 03
Complete legal description CROMWELL HEIGHTS SUBDIVISION; LOT BLOCK I
Location (site address or directions) 10970 MOUNTAIN LAKE ROAD * ANCHORAGE, AK 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
STEVEN
TAYLOR &
JUDITH HULL
Day phone 346-2809
Community Class Well
❑
Public Water System
10970
MOUNTAIN
LAKE ROAD *
ANCHORAGE AK, 99516
Unless otherwise requested, .HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
III
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding tank
❑
Community On-site
❑
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 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 engineers
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 inspectiori 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 " ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
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. AKWWC, Inc. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for L -IL bedrooms.
Disapproved.
337-6179
Date — 1.z JICD
Conditional approval for bedrooms, with the filowing stipulations:
`J•�: • ON-SITE ••.'G-
warR Awn
WASTEWATER
Attachments:��•.,. • • _���\
HAA Checklist Manitenance Agreements J�'i/�0�1\\,
Septic System Advisory Supplemental Engineer's Reort
Well Flow Advisory Other
By:Original Certificate Date: !_ -.173 " 0" 3
(R". 12101)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 995196650
www.d.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
10
Legal Description: CROMWELL HEIGHTS SUBDIVISION: LOT 3G BLOCK a Parcel ID: 015-332-09
A. WELL DATA
Well typeMLA If A. 8, or C provide PWSID# N/A
Date completed 6/2911983 Sanitary seal (Y/N) YES
Total depth 91 ft. Cased to 91 ft.
FROM WELL LOG
Date of test 6/29/1983
Static water level 45 ft.
Well production 4 g.p.m.
WATER SAMPLE RESULTS:
Collform 0 colonies/100 ml. Nitrate 0.67 mg./L.
Well Log (Y/N) YES
Wires property protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
7/312003
22 fL
.67 9—
p.m-
Other bacteria 10 colonies/100 ml.
Arsenic. N/A mgJL. Date of sample: 713/2003 Collected by: AKWWC. INC.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material STEEL Date installed 5/1811983
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation deanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping 7/3/2003 Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA
Date crstalled 7Z1e/2003 Soil rating p.d r fttbdrm) 0-88
Length 50 ft. Width 15 ft.
System type BED
Gravel below pipe .55 ft.
Total depth s.2 ft. Eff. absorption area 750 fe Monitoring tube Y,� Depression over field NO
Date of adequacy test NEW Results (Pass/Fall) NEW
Fluid depth in absorption field before test _ in. Water added :� gal.
Elapsed Time: min. Final fluid depth — in
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
For 4 bedrooms
New depth _.._in.
Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION
Date installed 8/8/1996 Size in gallons 500 Manhole/Access (Y/N) YES
"Pump on' level at 41 in. "Pump off" level at 38 in. High water alarm level at 47 in.
Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements?'- YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot '98,
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100,+
On adjacent lots 1000+
Public sewer manhole/cleanout N/A
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 101+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
. wenvra rymnwa A* ASSvM>✓A
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and '•.Y*
review of Municipal records that the above systems are in """"' "" """"'
conformance with MOA MAA guidelines in effect on this date.
e A.••••ness� .••
Engineer's Printed Na a JEFFREY A. GARNESS Q4pa —7953
Date 4 Qe'v�Profesfa�`_�
IKUStUl
HAA Fee $ ma } i Sb Waiver Fee $
Date of Payment 7' 2.2 '03 Date of Payment
Receipt NumberS18,qQ r7 p. 9 Receipt Number
(Rev. 12/01)
Municipality of Anchorage
• Development Services DepartmentII'N s '
•..-moi'; - °
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Water Well Advisory
Health Authority Approval # 030345
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block 1, Lot 10 of Cromwell Heights
subdivision, the well's productivity was determined to be 0.67 gallons per
minute. The minimum well productivity required by this Department (AMC
15.55) for a 4 -bedroom residence is 0.42 gallons per minute. Although the
subject well currently exceeds this minimum requirement, all parties
concerned are advised that the production capacity of the well may fluctuate.
Restriction of non-critical water uses such as washing cars and watering
lawns and gardens may be required.
This advisory must be attached to all copies of the subject Health Authority
Approval.
JUL-21-03 09:23 AM �! P.01
a.,:(.:t
.14
SEP TIG ✓VENTS
•, � , � : it '-!
SAnj tin N«o
m. 141
A
IhwebyoeANythat 1
CA
dim tollOWk1Q
•J •rw• •r-r-�. •: BLAGk �
r., •. AnChOfaQe R
do not &Amp t11
{ qyN that no
_.....__ .. n •y.•! flQfa; 1 �fICtlOfa.:,'._t. t• tt
.�
T /L-_
32,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL r
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) l /
LOT !o a 8k r'12nP,aa>✓�L_L 4 i=IC.9T-s C, �� � r�'o�/U,�3lam/
Location (address or directions)
10970 o- OQr,FT,4rjN LAACG P12ty,
(b) Property Owner 424FLAND I TAYL-p& Telephone: Home VACA -Ot Business
Mailing Address t
(c) Lending Institution FAY S 1 `► +�c s la-�t Telephone �-� ��'/ %�'� L✓eG� a(v Y- l0 3 5
Mailing Address C C,
(d) Real Estate Company and Agent t— ` ' f
Address 3 20 r S
Telephone ±;-(o 3 - s s (s
(e) Mail the HAA to the followina address: or: Check here if hold for pick up.
List contact person and day phone number below.
2. TYPE OF RESIDENCE
Single -Family �f
Number of Bedrooms r
3. 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 Ja 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 1 of 2 72-025 (Rev B/M Front
MUNICIPALITY OF ANCHORAGE
FNkRoNM�%o HEALTH AUTHORITY APPROVAL (
PPROAL(
(HAA)
S" �ShO�c CHECKLIST - FEBRUARY 1984 )
'�'liC�r13 p,��s/OFN 264-4720
198j Legal Description: LO
r' a164 tfrS. C -A Tdlsl .�3 V
A. WELL DATA F0
Well Classification S If A, B, C, D.E.C. Approved (Y/N) KlA
Well Log Present (Y/N) � Date Completed i; ' A- 8 3 Yield - 95 9Dr'�'J 4-
Total Depth Cased to `�� Depth of Grouting No ME
Static Water Level --- V Pump Set At 9'a
tl
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/Holding Tank on Lot On Adjoining Lots
To Nearest Edge of Absorption Field on Lot 120 ; On Adjoining Lots
To Nearest Public Sewer Line No/Y& To Nearest Public Sewer
Cleanout/Manhole N D N L- To Nearest Sewer Service Line on//Lot >
Water Sample Collected by S ; Date /27
Water Sample Test Results ,le r
Comments * F,'U' Fz"e"- /
B. SEPTIC/HOLDING TANK DATA
Date Installed ! 3 Size f .2 �� No. of Compartments two
Standpipes (Y/N) i `� t] Air -tight Caps (Y/N) l Foundation Cleanout (Y/N)
Depression over Tank (Y/N) Date Last Pumped /l, %9g % !etc
Pumping/Maintenance Contract on File (Y/N) A ; fore
Holding Tank High -Water Alarm (Y/N) WIA Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank
To Water -Supply Well 00 To Building Foundation 3 y
To Property Line To Disposal Field 1 p
To Water Main/Service Line > 0 To Stream, Pond, Lake, or Major Drainage
Course l �50
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Type of System Design 4ir' . 7A44 -
Date Installed .5-/,a -a 3 Length of Field
Width of Field Depth of Field
Gravel Bed Thickness 3
Square Feet of Absorption Area 3 Standpipes Present (Y/N) i cXi o
Depression over Field (Y/N) I� // Date of Last Adequacy Test .7
Results of Last Adequacy Test SaL.� c�j�e rte/�^P' "7; 0 v Deco rd114145
y
Separation Distance from Absorption Field:
To Water -Supply Well To Property Line >
To Building Foundation rte' S� To Existing or Abandoned System on
Lot C> IN4L�f ; On Adjoining Lots }/°4D
To Water Main/Service Line >/0 To Cutbank (if present) 1NIOA1�
To Stream/Pond/Lake/or Major Drainage Course /70
To Driveway, Parking Area, or Vehicle Storage Area 3 D
Comments
D. LIFT STATION 0Nzt
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
— "Pump Off' Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, r conformed to all
/MOA and HAA guidelines in effect on the date of this inspection.
Signed Date s/ `�! g 7
Company MOA No.
Receipt No.
Date of Payment����
Amount: $ bV
Page 2 of 2
72-026 (11/84)
Engineer's Seal
3 W. 15th
"C" SUITE 203
70 �UV �U�r l G3dq 1D� po�v 70A CHORAGE,EALA KA 99501
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
R E S I D E N T I A L W E L L I N S P E C T I O N
- - - - - - - - - - - - - - - - - - - - - - - - -
LEGAL:
LOCATION:
OWNER:
TYPE OF.. WELL:
WELL LOG AVAILABLE:
LOT 10, BLOCK 1, CROMWELL HEIGHTS
10970 MOUNTAIN LAKE DRIVE -N%
IRELAND
INSTALLATION REQUIREMENTS MET:
WELL YIELD FROM WELL LOG:
PUMP YIELD:
DATE OF INSPECTION:
7.5 GALLONS PER MINUTE
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: WATER WAS TESTED FOR COLIFORM BACTERIA AND
NITRATES ON MAY 7, 1987. TESTS WERE WAS
NEGATIVE.
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.
SINGLE FAMILY
.4 9Lm-
YES
d•.:: • • • • ;�
P o. 2225-E " 1
YES
UNE 25.
4 GALLONS PER
MINU�F,, y.."
7.5 GALLONS PER MINUTE
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: WATER WAS TESTED FOR COLIFORM BACTERIA AND
NITRATES ON MAY 7, 1987. TESTS WERE WAS
NEGATIVE.
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
S E P T I C S Y S T E M A D E Q U A C Y T E S T
— — — — — — — — — — — — — — — — — — — — — — — —
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. ,•- $_,
�)r• AI
*-4,— T rI Vis'
No. 2225-E
tea'• JUNE 25, 1971 T
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PRO'T'ECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL. CERTIFICATE
1. General Information
Application Date /a. 2 % 19f4/
(a) Legal Description (include lot, block, subdivision, section, township, range)
LID /31 c; 204,A u_)GLL 14 1 s r lu t+e z 3, t L 12 3
J�
Location (address or directions)
(Ocf7o &1T, 1+)Z'E 72/UE
(b) Applicants Name Ki `V} 1 ?,-a Telephone `� `l 5 7 `�
Applicants Address 3 3 1 w Z c( A li e. � � ✓� (- 1-Y f ) U Z
(c) Applicant is (check ene) Lending Institution Owner/builder
Buyer KI ; Other � (explain);
(d) Lending Institution 11-&4_5,< ,,9 G'{'///t'E/-) /14 C_ /3 /j/_) eaephone 5 6 Zl AG
Address `�3� L f3, �. AAJC14, l �/ � D L- ;�
(e) Real Estate Co. & Agent �r7:3 eo t c- �C %� �/3✓ 817 l tit-5�✓t
Address 5-01 L r � `c4� l3 �' t_� ,
Telephone
2 . Tvoe of Pes ide nae
Single -Family CE�;j Multi -Family Other (describe)
Number of Bedrooms
3. Water Supply
Individual Well DKI Ccmmnity Public
Note: If ccrminity well system, must have written conf irmation frau the State
Depart7ent of Environmental Conservation attesting to the legality and status.
Is the well adequate for the number of bedrooms specified in this HAA WN) 1 L 5
4. Sewage Disposal
Onsite � Public F:::j Cxrmunity Holding Tank
Is the wastewater disposal system adequate fc,�r the number of bedrooms WN) L
,u c"-) S y Sic` ni . PC/z o r i
[Page 1 of 21
2-15-84
5. Engineering Firm Providing Inspections, Tests, Data and Information
I certify that I have checked, verified, or conformed to all MDA HAP, Guidelines is
effect on the date, of this inspection.
Signed Date
a Date
G 3a
Name of Firm
Address -5-AZ Z `* f3 �,, �W
o sa
a3y{�y{m�s,y3�yaaa�a ca s
Signed by
.. r---
_;=s ---
NO. 1732—H
Date
June 22, 1968 •'_
(ENGINEER SEAL)
6.DHEP Approval
Approved for bedrocos
Approved Disapproved
Terms of Conditional Approval
leohore X,2
3y Date
Conditional
The municipality of Anchorage Department of Health and Environmental Protection do
not guaractee the continued satisfactory performance of the water supply and/or t]
wastewater disposal system. This approval indicates that, as of the validation d, -
shown
-shown above, based on the data and information furnished by an engineer registere+
the State of Alaska, the water supply and wastewater disposal system is safe and
tional For the number of bedrooms and type of structure indicated.
(DHEP SEAL)
7. Mail the HAA to the following address:
x{300 6 .ST
KB2/d5/s
[Page 2 of 21
MUNICIPALITY OF ANCHORAGE ( MOA )
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
NCInAlOZid lb'1N",?,!NOMN3 Lot 10 B bck 1 Comwell Heights S/D
A. WELL DATA 'S H11d3H d0
@QV�OHDW d0 A111Vd101NnV4
Well Classification If A, B, cr C, D.E.C. Approved(YM) A-)14
Well Log Present (Y/N) XtNS Date Completed Co- L? - 83 Yield L/
Total Depth Cased to `%/ ` Depth of Grouting
Static Water Level Pump Set At
Casing Height Above Ground 2-1-0 Sanitary Seal on Casing (Y/N) 1C S
Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) N
Separation Distances frau Well:
To Septic/Holding Tank on Lot /©/ On Adjoining Lots -- /OL}
To Nearest Edge of Absorption Field on Lot 5 On Adjoining Lots f /OCA
To Nearest Public Sewer Line P✓e s`n t' To Nearest Public Sewer
Cleanout/Manhole IJo ,7 &- `.'e 5 c h f To Nearest Sewer Service Line on Lot `f
To "ou5dF Eif.v-v T.
Water Sample Collected By �575/'3 Date Z- - LY - �i 3
Water Sample Test ResultsSf�i 15 l-f�c r car �-- �3 A r1c y!;is 4141 c-
Ccmtrents W L L L 7 i /-� F /Zc' PiA
B. SEPTIC/HOLDING TANK DATA
Date Installed 5 -/y - 3 Size No. of Compartments Z
Standpipes (Y/N) %5 Air -tight Caps (Y/N)" /CF-) Foundation Cleanout (Y/N)
Depression over Tank (Y/N) NC) Date Last Pumped ti'1,4 — 1,)L 1<J $YS r cf01
Pumping/Maintenance Contract on File (Y/N) /U O ; for
Holding Tank High -Water Alarm (Y/N) N�j� Temporary Holding Tank Permit (Y/N) /4
Separation Distances from Septic/Holding Tank:
To Water -Supply Well lam/ To Building Foundation
To Property Line �` Z -y To Disposal Field �c
To Water Main/Service Line S To Stream, Pond, Lake, cr Major Drainage
Course 4 /DC7
Comments lJe `'y 5 JV.S 7-e-412, /��/�/2?/ T ;13CUS"-
[Page 1 of 21
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata �'s Type of System Design N4/4 (ti' F« 6�1)
Date Installed 5 / tsf �' 3 Length of Field C( f
Width of Field S ' Depth of Field % `
Gravel Bed Thickness 3 '
Square Feet of Absorption Area .3 Standpipes Present (Y/N) LSE's
Depression over Field (Y/N) A-) Date of Last Adequacy Test tiro
Results of Last Adequacy Test /UC= /S 7 /Y1
Separation Distance from Absorption Field:
To Water -Supply Wbll /� 5 ' To Property Line 4
To Building Foundation yL ` To Existing or Abandoned System cr.
Lot NQ&,":� On Adjoining Lots f / 00
i
To Water Main/Service Line t- Z S To Cutbank(if present) /L///l
To Stream/Pond/Lake/or Major Drainage Course -f- / U u
To Driveway, Parking Area, or Vehicle Storage Area 4 �/o
Comments /cJE w" . s /s E 61/1 %�E/ /7-� / ; 5' 3 0 Z- L� 5
D. LIFT STATION
Date Installed Dimensions
Size in. Gallons
"Pump On" Level at
Manhole/Access (Y/N)
"Pump Off" Level at
High Water Alarm 1.evel at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test. Meets MCA
Electrical Codes(YM)
Comments l /V 6F 12, C- / S /Li y G- / /= 7-
**
** Check Permitted Bedroom Rating Against HAA P_ -quest
I certify that I have checked, verified, or, conformed to all MOA HAA Guidelines in effect
on the date of this inspection. �.od
0 41 ill
Signed '/vJ-i�. Date`�,4'�,�•a•oaa,0R��,
Company `�. `� / �� MOA No.
KBl/d5/s
[Page 2 of 21 L /ZD,°YIwE Cc. C— 1475- .
W
NO. 1732-E G ''
�a �j•; June 22, 1968
`a.�t1.. •sagas a4,Y:n'..��
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