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 I 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 \I _• / H MT �__----MTS I 1 I 1I I IT / \ NEW DRAIN FIELD I I I I "2 N W � I II� i IIIA IXW LL I I / I t I � I I I t I ,DA7/18/2 003 fA _ol 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 , 1 I 1 I I I LAKE 0' THE HILLS EAST S/D; TRACT A. I I 1 I 1 I I -NOTE. THE PROPERTIESN I LAKE 0' THE HILLS EAST I ' I 1 I CROMWELL HEIGHTS S/D; 1 LAT s, BLOCK 1, SUBDIVISION ARE SERVED BY I I I I A COMMUNITY WATER SYSTEM. I I I a Wvyim � CROMWELL HEIGHTS S/D; LOT 9, BLOCK 1, 1 / �� \ I =m wr: 1 11 I CROMWELL HEIGHTS S/D; 1 b. / I I �'.. , ; LOT 4, BLOCK 1, wo NN` -SEPTIC I\ \ I , I / ��� I \ ' PROPOSED SEPTIC UPGRADE / �� \� I / �� (SEE DESIGN PAGE 2 OF 2) MOUNTAIN LAKE —' \\ -- -- _ -- _CIRCLE y 1 CROMWELL HEIGHTS S/D; LAT 3, BLACK 1, 1 \ w I Lj w^ I I EXISTING I / \ 4 BEDROOM I /�`•p\�>r SE I / AREAS WN tF '1' HOUSE wo w\ 0114 01 CROMWELL HEIGHTS S/D; I IICROMWELL HEIGHTS S/D; / i LOT 11, BLOCK 1, 1 I 1 LOT 2, BLOCK 1, Ld �• , g J I I \ , I I Z CROMWELL HEIGHTS S/D; I I CROMWELL HEIGHTS S/D; ' O I LOT 12, BLACK 1, 1 I I LOT 1, BLOCK 1, I DATE: 7/9/2003 �� il� �.'!/�� r >'` '•:7 �i�l 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 ....... ... .. .. ...... ..... .. . . .... ......... J fr y mess e 9 0 v4sf. .•' 4�ov 4� 00"o ro f e sio�aac 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 z � tj8= I I� 11 I i� II I� II I I� II I EXISTING I WELL I � I NOTE: THE CONTRACTOR SHALL HAVE THE NORTH LOT UNE FLAGGED BY A REGISTERED SURVEYOR PRIOR TO CONSTRUCTION. (/ � / nl 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 ....... ... .. .. ...... ..... .. . . .... ......... J fr y mess e 9 0 v4sf. .•' 4�ov 4� 00"o ro f e sio�aac 0400�00�0 N 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 tvA/vER SEgitESr Fold,_LOT /o 1640" / CIfONWELL yF/GyJ� 5u.FP. WArvER i?EePuESr NuMOFR WR, 60062 1ulilvFt? l?EQuEsr FdR OW -Lor wEI-c rO OF 98 FEET SF- PT► C 0/9 rA -- T14if OR/61A.14L S,EPr/G SYSTEM 6v&.1 COArST?ucTEO /& /qI3. TIME SEPT/c rPr,vK W +S f oufrR u e rEP To (L OSE re ELc * r r".1 r l ir.,E , 7wer NE (E/v r u P G)e,+cc ro r?yo oiof pr/aiv Arl zz-p Pxo/o"O rive olrnw sR Or- 'THF EAvCRvA'CHAfaAv G TkE S4w7/c rRuk CoosrIeucrop � /9101P POv6P /4r ri-w r/fitE lyn? ='NvER,-y TO PE F/7.Ep r ,,rA/ L14-T5+q 7-16H)- IDup41AA P, rRE rKE SEPric r79n/k /S Pow'v6RAP1,FA FROM 77{E W 6Lt ON It of-l°PROai 1mof-TE 4- - /O �0 fLvP,C, Z E R CH-I*AAGE OF r- FFt u F 1v M /GR 47-/.061 to 0A1 ri-tE S"JfF*CE rot-#+Rof rHC 7-9f qu,E:M0A1 carts PR/t c Ep IA. ,-KNE / 483. rH& %d r� L EFEr. T,(F sTRr,lc If * i 4S ,-Ar& - A,aV F_,vca4A rEfflE0 opr 8 % FCEr /,& n S*AA7 ' 6/Povel- /4 Y6/4. T Mrs I.volen res 7Ff*r TKE rurAL t' ntE ",4 rE.e to rA IlolF-L L / t e#A,F,'AolCo *0 aNY/6'R PREJSai4A. pit 70 ri-eF- SE/'rIL 77M rJ vauw H/cc. PROA4 wEa Qur ONE NORrA,r Pur!; T/ -/E i^. 1qF- s /°f -c r to rll E S $a° r/c rNivK DN TY�(F sr4,0"E ... U 7,2'. I HI IS VEC�u f 4—= T/YF TYRlfotL Al- 7i -f& A44-1-S,,jPC 15 r C OPE F R Oar r.�-res Errs r r a N -o -4w Tit E oao S. o.. 14. D. E, C, s. P. W. IV AMR TA91. E ¢s- 46 ,fit o OIL IrOI?e7'IOA1 04.3-tg1'0o -g �.o= rgmssR"&L o, r Y 0�2 t g� t .r- 80 ,00i�vrs 6.0 4..r 2.3 �vRrER r�e�E G�gD�ENr 0 % 2.9 �-/a�4� z ovr�� SFPRRRT/ oa Q8 61?#ti7- u.,qivFR G'Rr O 74 r.9 L /8.6 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 uj /I �\ , TEST PIT# 2 O uPR�OPO�3cD NE W Y � I � S \I I Q EXISTI G 19 HOUSE Z 100.0' I I o 0 I I m I � /EXISTINGELL li I ~ I OF LOT 10 , I ..:' GlNfifd John Earl SimpsonIt �Q CE -8061 �� PROFESS�0�1� ."te' 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. 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Price List page RefertoP ........ ....... ....................... ...... ....................... 5 .. ....... ....... ........ .. .... ........... . .......... . .. . .... . ....... ... . ........ ............... ..... ................... . .......... .................. . ...... .... ............ ............ 50.00 . ........... ......... ....... ............ ... .... . ...... .......... ......... .. - . . . .... ... ......... .... ....... .... ..... ........ ---*--Avaffable .... .... ...... 115v 10T -23s_.__......_..__..... . .. . ...... ....... ........... .................. ........... . ... .......... . - .. . ..... ... ................ ... . . ......... . .......... 0.00 ... . ............ ... ..... ... . .... ..... ........... ... ... ... . .............. .... . ... ............. ... ............. ..... ....... .............. ....... .... . ............. ............................. 0.00 5.00 10.00 15.00 20.00 25.00 30.00 L 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 �J 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'..�� 2-15-84 D IJ ra � 00 r a �O �g u urea eeMr,ev flat m w,pftwfaewasu ♦` S o46 _ r a S m N O A ( �r � O t� O � � Y 6 o C a � ND `" � o w]n•,n > efe p y a IJ j C z y p r r CO nearm.a,eao —� „eNPfSa,A > D m a S > C a c d i D i feuer,ns..e r O O Zm Cr enenwfafM * �� r new (Phllhpe St.) -19 r MOUNTAIN LAKE Drive aw.ar -� D�'o m o eLnr J Ct Z 3 z • Iy J1,tb Ot i m i— ..F E + t �80 0 �b a'P' � a uw M afueloeu�f,em ,ve ne,w iwae uses ,osee O