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HomeMy WebLinkAboutCONTOUR ACRES BLK 1 LT 4Contour Acres
Block 1
Lot 4
#017-451-05
r Municipality of Anchorage
Development Services Department
Building Safety DMsion
O on -Site Water and Wastewater Program. 4700 S. Bragaw St.
P.O. Boz 196050 Anchorage. AK 99519-8650 Page / of 4
www.d.anchorage.ek.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW060235 PID Number. 017-451-05
Rre. James R. & Beth A. Bysheim Wastewater System: ❑ New ❑ Upgrade
A""a 5301 Country Club Lane, Anchorage, AK ABSORPTION FIELD
Froar krnborao.noaes 4 ODs.PTnnch 7&W wTmm❑a.d ❑ta-4 ❑otos
W RWq Taal DOM tmtd apnal Vbd
LEGAL DESCRIPTION
5.0 DpPF
E=2.5/ W=2.45 Ft.
La
�mP"E=015
��W��s•IW=1.5
010 1 4 CONTOUR ACRES
W==0.95 Ft.
n
TV-av Range s.cean
Fr ad"d ae"e alp"I pe"
&V Lrgal
2 X 50
Absorption
E•1.8I yV11.1 Ft.
Ft.
darJPrMte
Gma aan
Mn.+ar a erre
Dutriu erw.an al
Well• El New ❑ Upgrade
E=5.0 / W=5.0 FI,
2
14 FT
Cwaa +aen(Pmre. A b. C).
Tar D.an
Ce"dn
Tar awaalwa.« 402•
Pq. Mates HDPE.PVC
236'
n,
a
FT
90
12 ga. steel
on.
Dnu.d
soot Wr.r ua
_.
arWMr
A+ Home Services
Date Mir.dad
1 812912006
r.M
Pu Sr r.
c"'n'H.,'"'m°'""
TANK
GPM
FL
FL
SEPARATION DISTANCES
❑Septic []Holding El S.T.E.P.❑dr.
To
Sa 1c
Absorption
Ldt
darJPrMte
'�"" Anchorage Tank & Welding
1500 O.t
Fmm
Tank
Field
Station
Tank
Tank
Sewer Lka
.—.— of ca�yene.a"
114.3'
236'
132'
—
100.3'
90
12 ga. steel
2
wed
>100'
>100'
—
LIFT STATION
suteoewry
>100'
La Line
89,
32'88'
—
100 Da,
Anchorage Tank & Welding
'PNIVW M.ar
Punp dr MNI.t HNn wMe!r/mr
FaM.Dan
10.5'
135'
27.1'
—
32 „
zz ., I.
Cuba Dm — — — — V OSI -20 MOA
Remarks
Old tank was abandoned in place, per MOA code. BENCH MARK
r ao-
Old 1983 bed was abandoned in place. *East trench Garage Slab
installed 8128106 had only 40% effective absorption 98.17 Ft
area due to poor soil quality. Only 1 ft effective depth
Engineer's Stamp
considered on west trench, due to change in soil strata.
Changed design to AdvanTexAX-20. Tank is standard 12 ga. 1500 gal STEP.
Inspections performed by:
Cindy W. Ellis, P.E. Dates: 1r 823106
2nd =4106
Development Services Department Approval
Conditional Approval by: Date:
Reviewed and Approved by: Date: 07
ew Iwo!
49LH
11dY W. Ellis
CE. tos77
12/20/2006 10:43 3491934 WATKINS ENGR PAGE 01
Watkins En %neer%n In 907-349.1851 F.O. Box 110443
9 g, 907-349-1934 fax Anchorage. AK 99511-0443
Email: cwelfiisMod.net
Fax
a:
oe Goodall 1 MOA Onsite
ram:
�Iroy^ Ellis, P.E.
ax:
49 7847
ages:
LJtticWing cover
hone:
3-7908
2006
Another design change for
Contour Acres Bk 1 Lot
C:
As per our phone conversation today, we are changing the design of the septic
system for the subject property to be an AdvanTex AX 20 with a 1500 gallon steel
tank.
We have installed 2-50 It log trenches with 1.5 It effective depth and 2.5 ft maximum
depth near best hole #2. When we dug the last of the 3 trenches, we could not find
suitable soils. We then dug outside the 30 It radius of best hole #2, looking for
suitable soils, with the Mention of digging another test hole. We were unable to find
suitable soils. Therefore, we will Install an AdvanTex advanced wastewater
treatment system. The 2 trenches that we have already installed will provide more
than adequate absorption area. The 1993 trench will be retained for future use. The
proposed 15 It extension will not be required to provide sufficient absorption area for
4 bedrooms, considering the increased application rate far the AdvanTex
I appreciate your prompt consideration of this design change. This letter will serve to
document our phone conversation and the verbal approval.
Please call me If you have any questions or concerns.
Thank you,
Cindy Ellis
12/20/2006 10:43 3491934 WATKINS ENGR PAGE 02
1993 trench WELL 100'
to be retained I
for future use.
Lateral pipe to
be leveled.
OM /
\ + ASPHALT DRNEWAY \ o
P N
C All
$ Existing 1250 gal
a \ steel septic tanko
(1983)tobe DESIGN DETAILS
\ �Ct abandoned in plod 5.0 g.6GPD
0 /
CO Requires
ShallowTrench chh
Proposed AdvanTex AX -20 with 1.5 It effective
1500 gal steel tank RF = 0.78
and pump vault. Requires 19 It length
,gyp Max 2.5 ft deep
TH1oQ D� O TH4
io � rI
15 S
g I
m O TH3 I
1
2 trenches installed 11x28/06
50 ft long, 1.5 ft effective \
0 max depth 2.5 ft. /
(Approximate locations)
TH2 East trench: Soil quality only /
° 40% effective. Actual
absorption area ■ 128 f12. \�
West trench: Sal quality good.
Absorption area = 32o U. DESIGN CHANGE
ProLine
Contour Acres Bik 1 Lot 4
Proposed AdvanTex Septic System
James R & Beth A Byshelm Watkins Engineering, Inc.
Parcel ID 017-451-05 9'
Q
Permit Na SW060235 : ' 491r
Y.
Cindy W. Ellis, RE P.O. Box 110443 `,� wmnue
August 29, 2006 Anchorage, Alaska 99511-04430
Sple 1 Inch - 40 ft Phone: (907) 349-1851, Fax: (907) 349-1934e�o........ `°••
,(� J 44.5' to Property line
I F
o WELL I
CD
o I
E �pJ ASPHALT DR VEWAY
W'
CO2
MT5
b
ST1 Advan Tex AX-20 with o
1 MH T2 1500 gal 12 ga. steel tank o ,
Pump Vault Z
Based upon a survey U
by Shane Holt, LS-6914 ,
September 20, 2006
(2) 5-wide trenches
50 ft long. 1.5 ft
effective.
T T3
TH
T2 T4
AS-BUILT
D = Property Comer
S 89°59'00"E
Contour Acres Blk 1 Lot 4 0 00000O
Record Drawingof Septic Upgrade QE.A
p pg Watkins En ineerin , Inc. o cq o
James R.& Beth A Bysheim g g
ParcellD:017-451-05 �" 49 L">�o
Permit No: SW060235'1�/Jr '
A...... cnio. w eu ...... .
Cindy W. Ellis, P.E. P.O. Box 110443 C( - 10577 .00�
September 25, 2006 Anchorage, Alaska 99511-0443 �Oo.,; .......•••.',��
Scale 1 Inch - 40 ft Phone: (907) 349-1851, Fax: (907) 349-1934 °4D000�o"�
A
B
C
D
FCO
—
8.5
8.9
_
ST1
—
12.7
25.5
_
ST2
—
18.9
33.5
—
MH
—
20.4
35.2
—
PV
—
26.8
42.3
—
001
28.3
41.2
—
_
CO2
43.2
80.7
—
—
MT1
—
137.2
—
111.0
MT2
_
182.4
—
62.2
MT3
—
136.4
—
123.4
MT4
_
181.2
—
74.7
MTS
35.3
72.9
—
—
TH
—
161.9
—
87.9
FINAL GRADE=
STI 98.51
97.00
M77
ADVANTEX
92.40 JAX-20 POD
1500 GALLON
91.78 12 GA. STEEL TANK
N.T.S.
Final Grade = 98.59
HOLE
FILTER FABRIC + INSULATION
Bottom of" —,
" `
ench= 94.78 Sewer Rock
Bottom of ' West Trench
MT1=94.78
Note: Test Hole Relative Depth: 82.23
Water @ 90.73
Bottom of
Trench = 95.71
Bottom of
MT3 = 95.71 -,-
AS -BUILT
Final Grade = 99.97
FILTER FABRIC + INSULATION
Sewer Rock
East Trench
Note: Test Hole Relative Depth: 83.21
Water @ 91.71
Contour Acres Bik 1 Lot 4
Septic Upgrade Record Drawing
Parcel ID: 017-051-05
Permit No. SW060235
Cindy W. Ellis, P.E.
October 9, 2006
Scale: N.T.S.
95.19
PUMP
VAULT 1.25" HDPE
Can change to
1993 trench
in Pump Vault
of Pipe = 96.38 NOTE
Original Grade
9716- 97.23
Bottom of
MT2 = 94.78
Invert of Pipe = 96.28
of Pioe = 97.36
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Phone: (907) 349-1851, Fax (907) 349-1934
Original Grade =
98.16 -98.21
Bottom of
MT4 = 95.71
SEPTIC SECTION
N.T.S.
EDS ELECTRIC INC 907 272 4590 08/30/06 11801mm P. 001
Y
From +10078308507 Tue Aug 20 05:54:43 2006 Page 1 of 1
INSPECTION REPORT
MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION
4700 SOUTH BRAGAW
INSPECTION INFORMATION &HELP: 343-7962
INSPECTION: VOICE 343-0300 INSPECTION. FAX (907)249-7777 w .muni.orglBSDAnspecilons.c'm
NAME: EdsElect PERMIT#: 06-7414
COMPANY: INSPECT DATE: 6129/2006 AM
PHONE #: 272-4591 PHONE#: PHONE #:
ADDRESS: 5301 COUNTRY CLUB LN
LOT BLOCK 1 SUBDIVISION: CONTOUR ACRE'S GRID*: SW2837
COMMENTS or DIRECTIONS
Septic Lift / call to meet
TYPE OF INSPECTION: Olner Electrical
COMMENTS: (FOR INSPECTOR USE ONLY)
PRINTED NAME DATE:,'
EASEMENT
------------------------
Omu
� /nTul Foo
- FVIovAUT
PR
ABAPLT ORNEYMY
OF.Ak"NN
3 49
...............................
0 SHANE A. HOLT °
•' LS -6914
��e!d, ..... '•'A9'YOG
THE IIIFDRMATION HERECN ffi fOR THE URE Of LENdNO SMRTRITIDNR BPEOFKALIY TO SHCAV ANY COIFUCTB BETWEEN
EAIRTNO STRUCTURE$ AND RUTTED LOT LNES OR EASEMENTS AND M HOT TO BE USED FOR POSITIONNO ADDRKINAL
STRUCTURESORFENCEUNES.
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PUT, ARE NOT SHOWN HEREM
NOTE :A "Y ELNESBW MARELOCATEDAPPROKSMTELYA AREM TOBEUREOTODETER PROPERTYLNES
OR LOCATE STRUCTURES.
ANY PAYNO NDWII WY BE ARPROKSMTE DDE TO B COHORHONB.
1-'I+R1#
I HEREBY CERTIFY THAT I IWVE PERFORMED A
MORTGAGEES INSPECTION OF THE FOLLOVANG
DESCRIBED PROPERTY.
LOT 4. BLOCK 1. CONTOUR ACRES SUB.
ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
ENCROACHMENTS EAIST OTHER THAN NOTED.
DATED AT ANCHORAGE. ALASKA THIS —2fITH_
DAY OF SEPTEMBER 2_.
HOLT LAN008
D SURVEYING 10025. FB 121-60.12582
TEL 9454517
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
AND TAMES + QtiH VSHEIM
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
,Tdayof Atl GusT of200(,byandbetween TAMES + BETH 6MEINI
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as A dyar1Tex AX -a0 located
at -5-301 iounlr� C Lar "vie Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
includes the installation or removal of any parts, components or pieces
not included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC') 15.65.
B. Certificate of On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
(1 q s)
These approvals certify that the systems are adequate for the homes that
they support and meet the codes that were in place at the time of system
construction.
C. Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
D. Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included in
the original design which would allow the AWWTS to continue to
perform as designed.
E. Permit (Construction) An On -Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AWWTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On -Site Wastewater System Construction Permit and
all relevant provisions of AMC 15.65
3. Fee. Owner shall pay to Municipality an annual fee of Z e rO
($Oj-.00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AWWTS.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On -Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or additions to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWWTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is: Q h rl U Q
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
(3ofs)
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AWWTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AWWTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Owner: J Ct wie S 4 -
Anchorage:
Anchorage: Purchasing Officer
SAe'm
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OWNER: /1
By: U -
Date: R /a 9 l0 (o
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
MUNICIPALITN':
By:
Title:
Date:
) ss.
The foregoing instrument was acknowledged before me this day of
20 ,, by 10i Ahit the oof
rj30c oh behalf of the Municipality of Anchorage.
N T Y FOR L SI
My of mion ssion a Aires: rt
Notary Public
PAUL JACOB HURLEY
State of Alaska
My Commwsion E*m Aw.16. 2W
Municipality of Anchorage
Development Services Department
• i+ Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.8850
www.muni.orgfonsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Watkins Engineeft
Legal description: Contour Acres. Block 1 Lot 4
The attached paperwork has been reviewed and Is being returned for the following reasons:
❑ Original signature or stamp missing on
❑ Calculation error in design. _
❑ Additional soils information needed. _
❑ Water monitoring results Inadequate.
❑ Discrepancy in information submitted.
❑ Topographic information missing or inadequate.
❑ Additional adequacy test information needed.
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well tog required. _ f �39
Omission in narrative. The ins2letion report is missing the number o
❑ Insufficient fill over tank or field.
® Other. 1. An effective depth
14- '15 #VWLC
Name of reviewer: Deb Woekerfuss
S` -t-
Date: 12/27/06
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK z
Absefp4icn,4rea,: W.ret : RF --0.8'7; 5x50' 250; 26v/g7= 2g7 -k y
Ecm.t : 4090 cP z8�- I15:41 Told = 402 -Al-
t
60,
MUNICIPALITY OFANCHORAGE
Development Services Department
On -Site Water 6 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Permit Number: SW060235
Legal Description: CONTOUR ACRES BLK 1 LT 4
Design Engineer: 0844 WATKINS ENGINEERING
Owner Name: JAMES & BETH BYSHEIM
Owner Address: 5301 COUNTRY CLUB LANE
ANCHORAGE. AK 99516-3013
This permit is for the construction of:
❑✓ Disposal Field ❑Q Septic Tank
Upgrade
Date Issued: Jul 31, 2006
Expiration Date: Jul 31, 2007
Parcel ID: 017-451-05
Site Address: 005301 COUNTRY CLUB LN
Lot Size: 91200 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be In accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Date: 3
Issued By: (J(/ Date: 7 r 7y
Municipality of Anchorage
• Development Services Department
_Building Safety Division
On-Sfte Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsfte
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-451-05
Property owner(s) James & Beth Bysheim Day phone
Mailing address 5301 Country Club Lane, Anchorage Zip Code 99516
Site address same Zip Code
Legal description (Sub'd., Block & Lot) Contour Acres Blk 1 Lot 4
Legal description (Township, Range & Section)
Lot Size 91.200 Sq. Ft.
THIS APPLICATION IS FOR (® all that apply):
Absorption Field
0
Septic Tank
0
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
U
Number of Bedrooms
THIS APPLICATION IS AN:
Initial
❑
Upgrade
0
Renewal
❑
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.
1vw�, n�_
(Signature of property ownetdor authorized agent)
Date of Payment:
Receipt Number. 83:we Receipt Number.
(Rev. 17105)
Watkins Engineering, Inc.
P.0 Box 110443, Anchorage, AK 99511
(907)349-1851 cwellis@gci.net
July 25, 2006
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
RE: Contour Acres Blk 1 Lot 4
Proposed Septic System Upgrade
To Whom It May Concern:
Attached please find the application and supporting documentation to upgrade the
septic system for the referenced house, upgrading from 3 bedrooms to 4 bedrooms.
There are currently two drainfields serving the property: a bed installed in 1983 and a
trench installed in 1993. It is proposed to retain the trench and abandon the bed. The
trench was designed for 3 bedrooms, so an additional section of trench is proposed to
upgrade it to 4 bedrooms.
The trench addition is based upon a test hole dug and evaluated by Tobben Spurkland,
P.E., on July 27, 1993. A copy of the soil log is attached. The trench addition will be
based upon the original design criteria. The absorption area of the existing trench is
600 ft', and the soil rating was 0.8 gpd/ft' . Four bedrooms will require 750 ft', so an
additional 150 ft' is proposed by adding 15 ft of length with 5 ft effective depth. The 4"
distribution pipe will be at the same elevation as that in the original trench.
The proposed new drainfield is based upon Test Hole #2 dug on June 30, 2006. The
hole was dug to 15.0 ft with no water encountered. After a 7 day monitoring period, no
water was detected. The proposed drainfield will be installed in a silty sand layer
between 2 ft and 8 ft. Two percolation tests were performed at depths of 3.5 to 4 and
7.5 to 8. The upper interval had a percolation rate of 7.5 minutes per inch, and the
lower was 40 minutes per inch. An average application rate of 0.62 gpd/ft' is used in
the design. Other test holes were excavated and had poor soil quality. The soil logs for
TH#1 and TH#2 are attached. Test holes #3 and #4 were visually inspected and not
fully evaluated.
Sewer Upgrade Permit Application for Contour Acres Blk 1 Lot 4
Watkins Engineering, Inc.; July 25,2006; page 2
Proposed Soil Absorption System:
4 Bedrooms x 150 GPD/BR =
600 GPD
System Type:
Deep trench
Application rate:
0.62 gpd/ ft'
600 GPD / 0.62 gpd1W =
968 ftrequired
Maximum Depth:
9 ft
Effective Depth:
6.0 ft
Proposed Length:
2 x 50 ft
Absorption Area:
1200 ff
There are no surface waters or private wells within 100 ft of the proposed septic system.
There are no slope concerns.
I am not aware of any adverse effect that this upgrade would have on any adjacent
properties' water and wastewater treatment needs.
Thank you for consideration of this permit application. If you have any questions or
need further information, please call me at 349-1851.
Yours truly,
4,de W ��
Cindy Ellis, P.E.
President
Contour Acres
Contour Acres
t
Contour Acres
Block 1 Lot 5
Block I
Lot 3 /
I
Block 2 Lot I
/
t
II
\
I Approximate kxation
/
of well
t
IWELL
t
� �
t
WELL
ISII�s
• WELLI I
t
Contour Acres
Contour Acres\
/
t
Block 2 Lot 2 ,
Block I Lot 6
Tit
by T
/
'Existing
m
Seplic 1110.1.
/
/
\
system pp'e-
t�
'J /
°
J
I�
\
nI
/
nu
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o I
t
Ej
'WELL
n13
O
I WELL I
n12
Proposed Septic
System
s
Contour Acres
t
Block 2 Lot 3
Contour Acres
Block 2 Lot 4
t
/
\
100' well red/
Contour Acres Bik1 Lot 4
Site Plan for Septic Upgrade
James R & Beth A Bysheim
Parcel ID: 017-451-05
Cindy W. Ellis, P.E.
July 20, 2006
Scale 1 Inch -100ft
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Phone: (907) 349-1851, Fax: (907) 349-1934
�Qq OF q...10
a�' 4.. rH� .•;y„
GU........
CIN W. ELLIS
10577
0�
a,
.•.
10' UTILITY EASEMENT _
nGerrrnl nr-TA11 e `
Need additional 1 1
150 sq. ft
Deep Trench WELL 100' _ I
5.0 ft effective
15 long
Maxx 10.0 ft deep
Contour Acres Blk 1 Lot 4
Proposed Septic System Upgrade
James R & Beth A Byshelm
Parcel ID: 017-451-05
Cindy W. Ellis, P.E.
July 20, 2006
Scale 1 Inch — 40 ft
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Phone: (907) 349-1851, Fax: (907) 349-1934
OF At -N
E.......�....... qs poo
491HSv„
CIN
-1os77 5n ' �•�
,.'o
/
1993 trel1ch
to be retaliiinnl
ON
pSCJASPHALT DRIVEWAY
for futurettrr��e.
C Lateral to
�o
C pipe
_, be leveled.
y.?AQP
/
rX
Existing 1250 gal
2MT
steel septic tank
Tobbe
COL Sobbe n o (1983) to be
F �� abandoned in places
DESIGN DETAILS
TM,1993
C
i
4 BR, 600 GPD
PfOposed 15'x5
AVG 0.62 gpolft2
eff�L trench, adde . CO
Requires 968 ft2
Lateral at sameDeep
elevation.
gal
Trench
6.0 ft effective
STEP , w1
STEP tank,
2@50 ft long
outlet &check valve.
ve.
Max 9.0 ft deep
d0•
O TH4
6
Q
°y
O TH3
Q
000
Q
1
N zO (b
,�• y
Test Hole #2
Proposed 2 trenches: 6t30t2DD6
Proposed
Trenches
50' long, 6' effective,
/Max depth 9. Organics
ML
0.5
l
Fabric. lnsulatro�
1.25 PVC w1V.25'
t.s
2.o
1.25• Pvc
holes, 18' OC. SM
wro.zs
Was
MT ��_
0 TH2
MT
s.o
6.0 ft
savver
\
MT �I
e.s
8.0
M
ML
12.2
yG��
BOH
's.oG�O� OyG�
No Water �O
Contour Acres Blk 1 Lot 4
Proposed Septic System Upgrade
James R & Beth A Byshelm
Parcel ID: 017-451-05
Cindy W. Ellis, P.E.
July 20, 2006
Scale 1 Inch — 40 ft
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Phone: (907) 349-1851, Fax: (907) 349-1934
OF At -N
E.......�....... qs poo
491HSv„
CIN
-1os77 5n ' �•�
,.'o
Performed For.
Municipality of Anchorage
Development Services Department
Building Safety Division
a1
On -Site Water and Wastewater Program
4700 South Bragaw St
P.O. Box 1966W Anchorage, AK 99519.6650
www ci enchoraae.ek.us
(907) 343.7904
Soils Log - Percolation Test
James & Beth Bysheim Date Performed: June 30, 2UW—
Legal Description: Contour Acres Blk 1 Lot 4 Township, Range, Section:"- --
TN?
Depth
(Feet) or9ania5
1 rML 0Coarct
/.5
snA p Pgza
14-
Reading
Date
Gross Time
WAS GROUND WATER
9-
Net Drop
1
ENCOUNTERED? NO
3:25/3:55
MLa
6"-1.75"
4.25"
1f)_
6/30106
3:58/4:28
IF VES, AT WHAT DEPTH? — 0
6"-2.0"
4.0"
3
Depth to Water After
11-
30min
6"-2.0"
Monhodng? Dry E
12-
Date: 7-7-06
14-
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
1
6/30106
3:25/3:55
30min
6"-1.75"
4.25"
2
6/30106
3:58/4:28
30min
6"-2.0"
4.0"
3
6/30/06
4:2914:59
30min
6"-2.0"
4.0"
PERCOLATION RATE 7.5 PERO HOLE DL4METER
TEST RUN BETWEEN 3.5 FT AND 4.0 FT
COMMENTS 4 hr presoak prior to test.
PERFORMED BY: Rocky Trainor / Cindy W. Ellis 1 6a oa4; CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDE INES IN EFFECT ON THIS DATE. DATE: 7-215-06'
Municipality of Anchorage
Development Services Department
Budding Safety Division
a1
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 9951g-6650
www.cl.anchoraae ak.us
(907)343.7904
Solis Log - Percolation Test
Performed For. James & Beth Bysheim Date Performed: June 30, 2006
Legal Description: Contour Acres Blk 1 Lot 4 Township, Range, Section:
Depth
01
an res
45
t.5 Ped Lo4rn
4-15m
r4re-
10-I try L
11-
15 X5.0
16- SDN
17-
18 -
WAS GROUND WATER
ENCOUNTERED? No
S
IF YES, AT WHAT DEPTH? — L
Depth to Water After O
Monitoring? Dry e
Date: 7-7-06
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
1
6/30/06
3:26-3:56
30min
6"-5.25"
0.75"
2
6130/06
3:57-4:27
30min
6"-5.25"
0.75"
3
6/30/06
4:28-4:58
30min
6"-5.25"
0.75"
PERCOLATION RATE 40 (eenLt"Awn) PERC HOLE DIAMETER
TEST RUN BETWEEN 7.5 FT AND8.0 Fr
COMMENTS 4 hr presoak prior to test.
PERFORMED BY: Rocky Trainor / Cindy W. Bills I Vi"X IV GGCc- CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDE ES IN EFFECT ON THIS DATE. DATE: 12J'b�O
Municipality of Anchorage
Development Services Department
Building Safety Division
�r On-site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www el anchoreae ek.us
(907) 3437904
Soils Log - Percolation Test
Performed For. James & Beth Bysheim Date Performed: June 30, 2006
Legal Description: Contour Acres Blk 1 Lot 4 Township, Range, Section: ^u ^
Depth
(Feet) D rga„ i cs
9to
M L to""
4- bond4ax
5- MDISf•
6- 5rou foe"
7- of 5a"
s- rW+ Con'finuDU5
16-
17.0
WAS GROUND WATER NO
ENCOUNTERED?
IF YES, AT NMAT DEPTH?
Depth to Water After
Moottodng4 Dry
Date: 77/06
Reading
Date
Gross Time
Net Time
Depth to WaterHNODmop1
6/30/O6
3:24
30min
6"
2
6/30/06
3:54
30min
6"
3
6/30/O6
4:24
30min
6^4
6130/06
4:54
30min
6^
PERCOLATION RATE >120 (e+ ) PERO HOLE DIAMETER 6 -
TEST RUN BETWEEN 5.5 Fir AND6.0 Fr
COMMENTS 4 hr presoak prior to test. Did not take water.
PERFORMED BY: fiOCky Trainor/ Cindy W. EIIIS ( 4%7lt`y N/ MG, CERTIFY THATTHIS ST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: , 25 O &
I --
Municipality of Anchorage Page I of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
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: PID Number: D 17 —0S
Name`
Wastewater System: ❑ New (Upgrade
Address:
ABSORPTION FIELD
Phone:
No. of Bedrooms:
{Deep Trench ElShallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating: p
Total Depth from original grade:
• G GPD/Sq. Ft.
to
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
B w V
Ft.
=3 Ft.
Township: Range:
1 I
Section:
7
Fill added above original grade:
Gravel length:
O
MN 3 VX/
X
Ft.
k Ft.
WELL: ❑ New ❑ Upgrade
Gravel d&W:AA
Number of lines:
Distance between lines:
�^
ems+ Ft.
Ft.
Classification'(Private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe material:
Ft.
Ft.
010 So. I.
r_ ts it 6
Driller:
Date Drilled:
Static Water Level:
Installer:
Date i1 [led:
Ft.
��
YGL
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
❑ Septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
Well135
t
Material:
Number of Compartments:
Surface
LIFT STATION
Water
r4o tt Q,
Lot
Size in gallons:
Manufacturer:
Line
15
1
Foundation
"Pump on" level at:
"Pump off' level at:
High water alarm at:
Curtain
Pump Make & Model
Electrical Inspections performed by:
I
Drain
No 1144L L
Remarks:
BENCH MARK
Location and Description:
Assumed Elevation: dLp
iso
-ENGINEER'S.SEAL
f�
S
Inspections performed by: I ' Dates: 1st
2nd_ `14i1q.3
Department of Heal and Human Services approval
Reviewed and approved by: Date: d" 7--�_'
72-013 (1/91) MOA 26
I I
----I------ ---------------- ---�
-A ------------------ --
�tiF
I cr FFcl I
+'• Well GAS
..
4 . . ♦ • . ,
♦ t ♦ ♦ ♦ ♦ ♦ i
+t♦ ♦ ♦ ♦ t r ♦ t ♦ + + • + • • • r
♦ ♦ ♦ ♦ f ♦ + f + ♦ + + ♦ �1+i ♦ ♦ ♦ ♦ ♦ ♦ i
+ f ♦ ♦ ♦ 4 ♦ + ♦ + f + ♦ ! r ♦ ♦ ♦ . ♦ t i • f a • •.
+ ♦ ♦ r ♦ ♦*..+.+++.+ +
♦ • ♦ ♦ f + ♦ +++++++++
♦ •i ♦f ri + ♦ ♦ ♦ r + f • ♦ ♦ t • •♦ r r. +♦ •♦ ♦ }
+ r + ♦ ♦ a r ♦ ♦ r + + + r ♦ + ♦ + ♦ ♦ ♦ + + r a
♦ + • . ♦ ♦ ♦ ♦ ♦ + • ♦ ♦ f + + . + a .14
+'+++♦++'++
I o I
EXIST, 1250 GAL TANK i
i I
i I
1 ll
I � �
l
l
25 0 25 50 75 / 100 125 150
I /
SCALE,'! "' - 0 FT,
TOBBEN SPURKLAND P.E. LOT 4 BLOCK 1 CONTOUR ACRES SEPTIC SYSTEM AS BUILT
203 W 15TH. AVENUE DATE, SEPT. 29, 1993
ANCH, AK. 99501 SEC 27, T12N R3W
ANC AK, ,L .XTSEPH CALBARER4 5301 COUNTRY CLUB LANE SHEETi 2/3 GRID, 2837
Mira F1' 140
5 Feet of Sep tic
UNDER PIPE
60 wool
Monitor Clean Out
Clean Out
Standard Trench.
60' LONG TOTAL
ank 10' DEEP
5' OF SEWER ROCK
4' mm, Co ver
81,5
rBM, .-
BOTTOM OF SIDING 100,OOFT
TQBBEN SPURKLAND RE, LOT 4 BLOCK 1 CONTOUR ACRES S,WPMCSSSSESMABEBMT
203 W15TH, AVENUE JOSEPH CALDARERA DATE, OCT, 4, 1993
ANCH^,AK. - 99501 5301 COUNTRY CLUB LANE SHEET, 313 GRID, 2837
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE n ULDI
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502 X1-11 X13
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930311 DATE ISSUED: 8/20/93
DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. EXPIRATION DATE: 8/20/94
OWNER NAME:CALDARERA JOSEPH H &
OWNER ADDRESS:5301 COUNTRY CLUB LN
ANCHORAGE, AK 99516
PARCEL ID:01745105
LEGAL DESCRIPTION: CONTOUR ACRES BLK 1 LT 4
LOT SIZE: 91200 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
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 343-4329 OR 343-4681 AFTER BUSINESS 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 PR
RECEIVED B
ISSUED BY:
DATE: _:%'
J /13
DATE: 413
-F _ E31=�U f -C 1< L i=% IN -1 I> 1=- - E
203 W 15th. Avenue, Suite 206
ANCHORAGE, ALASKA 99501
(907) 279-3916
SEPTIC SYSTEM DESIGN
LOT 4. BECICK i CONTDLJR ChCRES
JOSEPH CALDARERA
No Ground Water or Impervious Layer to 16 ft.
Use Standard Trench
Soil mating. From test 7/27193
10 min/in = .€3 gal/min
Required Area per Bedroom:
150/.8 = 187.5 sq.ft..
Testhole Total Depth 16
Less 6 feet 10
Less 5 feet Cover 5
ROCS Depth
Number of Bedrooms 3
Length of Trench 187.5 x 3 1 10 = 56.215
SYSTEM CON I GURAT I ON
i
STANDARD TRENCH
�� � d.� r `e ► - ' TOTAL LENGTH �OF T .
gjrt I TOTAL WIDTH 2---€ T.
i i�y > TOTAL DEPTH 10 FT.
r a'
,? ROCK DEPTH 5 FT.
COVER 5 FT_
! EXISTING SEPTIC TANK
CHECK INTEGRITY
ABANDON EXISTING SYSTEM
REPAIR STANDPIPES
INSTALL DIVERTER VALVE
'The installation of this septic system will not prevent wells
from be installed on the adjacent lots.
'There are no developed or natural surface / sub surface drainage
courses on this or the adjacent lots.
The proposed septic system will not change the general slope of
the area. Ponding and/or concentration of surface runoff will not
result from this installation.
�, r•.:;� �::; tt:.:i. � :: .:, y <s � -. e:;r i n .t.i c � �::>'.r, r.;(r �
4
HUFFMAN ROAD ��►�`o�@e�i
a.
9& •,
— I� a�`niosy�
O C -j ae'
I 6o
t� I
O I ®3 wa•s ea aLa oalo•e+•
�/y Yr s !Oi iJ C'1 Ji" ur'::iG
��%\C'`.'ao., cae^^e �•`, war
Lar 3 `I I car 1
I I
� I I
LOT 5 Q
I J
j
50 0 50 100 150 200 250 30) I V
SCAL E. 1' = 100 7 T,
j
—
-------A— — — — — — — —— —
--------0�--——--——— — — — - -I
0
O
i
LOT 6
Well I I
I
J
I
R
W.
PI I I
LOT 2
a
o R
a 0 --_
LOT 4 / (�
TRY CL UB L ANE IV
LOT 3
4 \
2
I UBBLN SFUKKLANU F.E. LOT 4 BLOCK 1 CONTOUR ACRES SEPTIC SYSTEM DESIGN
203 W 15TH. AVENUE
ANCH, AK, 99501 SEC 27, T12N R3W DATE AUG 12, 1993
e0n7% 0'7o_.3a14 JOSEPH CALBAR£RR 5301 COUNTRY CLUB LANE SHEET, 113 GRID- 2837
cc
��FCl
es,tnote
I
'------ - - - - -- - - --
— — — — — — — — — — — — — - -
I
•;••- Wel( GAS
a
r + ♦•
♦ r ♦+a r ! e
a ♦ ♦ r ! r
i + a ♦+a ♦ + + + ♦ ♦++
+ i ♦ ♦ a a
•♦aa t a f ♦ ! a♦ ♦h r
++aa ♦aa♦♦ i + 1a++ ♦• i ♦ + + a♦♦ i
♦ ♦ ♦ ♦ i ♦ + ♦ a r ♦ + a ♦♦♦ ♦ • ♦ a
♦ ♦ ♦♦ a ♦ a ♦ ♦ a ♦ a}♦♦
t ♦ f a+F♦+ h+♦ fafa aa++l+r+f ♦+♦+f♦f !♦4♦+ ! + f t+! + +
♦ f ♦ f ♦ ! 4 t h f ♦ a ! h f + f ♦ ! ♦ ♦ t ♦ ♦ + + ♦ + ♦ ♦ a
a + i ♦ a ♦ ♦ a ♦ • • a ♦ ♦ • a• a + ♦ ♦ ♦ ••+
++ f a a t•♦♦ ♦ e f t t
+ a♦♦ i! a f a • a s♦♦♦♦♦+f+ f
rf♦ t a + i ♦ ♦
♦+♦ ++♦ a r+
♦ • a ♦ a t
+ a t
f ♦ +r
I
I
EXIST, 1250 GAL TANK
o EXIST, BED
PREPESED TRENCH N
O '
yrd
114i1
L'
3i � � ✓ / /
25 0 25 50 75 i 100 125 150 /
SCAL E, 1 " - 0 FT,
TOBBEN SPURKLAND P•E. LOT 4 BLOCK 1 CONTOUR ACRES SEPTIC SYSTEM DESIGN
203 W 15TH, AVENUE DATE. AUG. 12 1993
ANCH, AK. 99501 SEC 27, T12N R3W
_ f„1 JOSEPH CALDARERA, 5301 COUNTRY CLUB LANE SHEET 1/3 GRIDi 2837
— 60
Monitor
Clean Out
Standard Trench,,
60' LONG TOTAL
10' DEEP
5' OF SEWER ROCK
4' min. Co ver
Clean Bu
DIVER TER VAL VE
1250 gal Septic tank
r EXIS TING
Mlro FI 140
5 Fee t o F Sep tic
UNDER PIPE
TO EXIS T BED
1e,)U VAL 3tt'111-: 114NK
INSTALL CLEAN OUTS AS REQUIRED
IIUBEEN SF'UKKLANU F.E. LOT 4 BLOCK 1 CONTOUR ACRES SEPTIC SYSTEM DESIGN
203 W15TH, AVENUE JOSEPH CALDARERA DATE- AUG, 12, 1993
ANC1-1 -A K,^99501 5301 COUNTRY CLUB LANE SHEET- 3/3 GRID- 2837
(Elf t EEW&S&AI�)' 9
° v , r
r ` eon iR �
4 4
rk1
e Municipality of AnchorageTO
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650�y.`
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: cbe ,212-CY" DATE PERFORMED:
'LEGAL DESCRIPTION: L-0 Township, Range, Section:
SLOPE SITE PLAN
C0" A e�
1 \ C✓i � i��/ �o ave... N
2
Net
Time
ENCOUNTERED?
,�L7
• -� >A 911-4.6
S
4-
L
IF YES, AT WHAT
5
DEPTH?
P
6
Depth to Water fter
Monitoring? �' '" -7�
Date: 7
8
..
9
�.
10
• ��
11
'•
0
12
i
w
13-
314
1,9,0
I 10
14-
t0
b1-0
15
15-
16
y
40
7'/
3*/
%A0I
17-
18
19
20
COMMENTS
WAS GROUND WATER
Net
Time
ENCOUNTERED?
,�L7
• -� >A 911-4.6
S
L
IF YES, AT WHAT
O
DEPTH?
P
E
Depth to Water fter
Monitoring? �' '" -7�
Date: 7
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
• -� >A 911-4.6
Prc..
��;0�
e-�
..
y
O
15.0 r1
0
1.10
w
tO
1,9,0
I 10
t0
b1-0
6
40
7'/
3*/
PERCOLATION RATE 10 (minutes/inch)RC HOLE DIAMETER
��ff /
TEST RUN BETWEEN 7 FT AND / 2—f -T
PERFORMED BY: Q r Jc- CERTIFY THAT T S TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
72-013 (Rev. 3/78)
CS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL" PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street_- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPI?§AL SYSTEM AND/OR WELL INSPECTION
REPORT
NAME
PHONE
®1TE-W
L
5j(0';>_0Q
E:1 UPGRADE
MAILING ADDRESS
` 5-:5722--B
LEGAL DESCRIPTION
L o i `i �t_pCI i t.1 Tr
S
LOCATION
NO. OF BEDR OMS i
DISTANCE TO:
Well
Absorption area
Dwelling
PERMIT NO. 30 Z
V
t 0
aZ
Manufacturer
G ZF_E.c2
Material
sT>cE�
No. of compartments
W 9
Liq. capacity in gall ns
a2SO ,
IF HOMEMADE:
Inside length
Width
Liquid depth
C Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
Jaz
2 Z �
Manufacturer
Material
Liquid capacity in gallons
j
DISTANCE TO:
Well ,
ot7
Foundations
Nearest lot line �t
PERMIT NO Q,,ZQ
W
C7
J LL
No. of lines
Length of each line
Total lengt of lines
Trench width
'
Distance between lines
?
60
'L X it as
q..5
Q
Q
i Top of tile to finish grade
Material belheath tile
�
Total effective abs ption are
Q
inches
(
Length
Width
Depth
PERMIT NO.
W
C7
aF
Type of crib
Crib diameter
Crib depth
Total effective absorption area
Wa
LU
Well
Building foundation
Nearest lot line
DISTANCE TO:
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
3:
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
1
PIPE MATERIALS
>, r
Cpisc- IVb(51f+P-0,,rs
T,�e
SOIL TEST RATING
3-5 fl
/�
O
INSTALLER
� E12 2 i
REMARKS
QS
2 '
APPROVED DATE LEGAL
t,, . 2 - Q L 1-/
a 4Co N-r
72-013 (Rev. 3/78)
CS
Date Drilleds 5-29-84
Static Water Level 208 feet
Draw Down N/A feet
Type Material Drilleds
0 feet to 40 Sanc'y clay w/roc.ks
40 feet to 52 Sand
52 feet to 55 Sandv clay
55 feet to 60 Snml wlr/ ,navel
.?ve Calderera
Lot 4 Rl.k 1.
Contour Acres Subd
Gallons Per Minute 1.3.5
Total Feet of G"asing '32
60 f. e e t
to
1.00
Silty clay
1„614II . ripen iTv QF ANCHORAGN
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
100 feet
to
1.1.5
Sand
115 feet
120 feet
to
to
120
135
`'pndv clay w/Travel.._._..
Sand
JAN
,_..
" �D
135 feet to 180 Sand w/�ravel.
Hefty Drilling
180 feet to 220 May wlf/ ravel
S.R.A. Box 1553 H
Anchorage,Alaska
9950?
1
9200 L
220 feet to 232 Gravel w/wa.ter
--
'
�11 r-4 I CZ: I ' K_ I _r�e Cl F= F� N���0��0��
DEPHRTMEN. . [ HEALTH AND ENVIRONMENT' ' TTECTION
.--
825 'LSTREET, ANCHORAGE. -HK. 99-11
/-' 264_47220 6�
WEEL-L- F:4ND -FE-= ' ������� �F=Fe_M I�
`ePERMITNO. �
��5� '
-'& HNN W%NDF CIRCLE 99�0 562-0942
' HPPLICHNT JOSEPH S. ��'f�*��� ����-� �vw�n |
LOCHTIONLOT 4 BLOCK 1' CONTOUR ACRES 5/D. I' ^
LEGAL T14N RaW SFC 26 LOT 5IZE -�58050 SQUARE FEET �
____
`
TYPE OF SOILABSORPTION SYSTEM
MAXIMUM NUMBER OF BEDROOMS = 3.
IS:, TRENCH
SOIL RATING
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
�� ��
����H = �� ������= ��� ����a � �����= '
`
.HE LENGTH DIl"IENSION IS THE LENGTH (IN BET) OF THE TRENCH OR DRAINFIEUl
'
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE.SURFACE OF THE
GROUND AND THE BOTTOM.OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THEMINIm«M DEPTH OF GRAVEL BETWEEN THE OUTFHLL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
�F:�r-4K JLC -71C -31D ������"-=
/ `
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
< 2' ":F. F=FE C _r I ID F� Fe E: FR a Q U I F -C FE C'
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN WELL HND 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 HND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
� OF THE WELL COMPLETION.
i'OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
�F;;?- M I -T �X F� I F= -H. F= M E --r- FE��
`
I- CERTIFY THAT
i: I HM FAMILIAR WITH THE REQUIREMENTS FOR um -SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2' I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. '
2' I UNDERSTAND THAT THE ON-5ITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS.
ROOM5 ` . .
'--- ��
y / | .0
�SIGNED: & ANNIE CHLDT PH S. _H_R_E_R_H
5
o
,
ISSUED -BY - ^� _~_DHTEu/�_(a _______ \d�� � --V4.0
~����
, � -~
����'�� �� ` ��~ �..~
� y� w~ v�°��
xSOI LS LOG
MUNICIPALITY OF ANCHORAGE
EPT. OF HEALTH A MUNICIPALITY OF ANCHORAGE
ENTAL PROTEGT66ARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
•
TEST
G 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
RECEIVE. _ -71 /03PERFORMED FOR: d R��� DATE PERFORMED: s2S
LEGAL DESCRIPTION: Loa 4 B V, I CON 1 0O R. ANLR E..S S F—: C_ .2(..7lyM, lea W
-ro I' L
SLOPE SITE PLAN
P sa
l„aavh
1 n
2
3� 11111 G1L<T H L
4
5
6
7
8
9
-10
11
12
13
14
15
or- F} C)1-1 -
16
,�
O �t
a�qit
s
Net
Time
:4
,...
0-,�00
71L
M
'Wafter
•7 /2
19
'
�Q
2225-S :�
�'i
/2-0
s'a'•
U E 25, 19A :
20
�
�y;•
�t
••���id
�•E���
NAL ?
NAL
3o#-ei;q�
%
~�
COMMENTS
WAS GROUND WATERS
ENCOUNTERED? b L
O V
P
E
IF YES, AT WHAT
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Net
Drop
0-,�00
71L
'Wafter
•7 /2
a; v -n
/20
/2-0
Z
'a.o
30
16 0
3o#-ei;q�
%
0.5
3; rro
f i o
-bo
% �l Z
>-
PERCOLATION RATE i6 0 (minutes/inch)
TEST RUN BETWEEN /20 FT AND 1-�; FT
PERFORMED BY: � CERTIFIED BY: / • s DATE: t-3
72-008 (6/79)
�t, �. ��4:._,
�� ,� 4
Ii/
/' S' � ..
� �
.t � �.�
_y
i
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� 1
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Municipality of Anchorage e°
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650 /
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. n 1 -7 - 4.49' I- b b COSA# O G 0 0 5 7
1. GENERAL INFORMATION Expiration Date: _r3,- -.P- 7 - O w
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
CONTOUR ACRES SUBDIVISION; LOT 4. BLOCK 1.
5301 COUNTRY CLUB LANE • ANCHORAGE. AK 99516
NICK TRAWINSKI
Day'phone 348-6094
5301 COUNTRY CLUB LANE * ANCHORAGE. AK 99516
DEBBIE CLOUTIER w/ REMAX
Day phone
Dayphone 242-9131
110 WEST 38TH AVENUE * ANCHORAGE, AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
N
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
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 On -Site Systems
Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional 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 Certificate of On -Site Systems 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 riles and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
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, GEG, Lt D. attempted to provide a thorough,
conscientious engineering analysis of the system to accordance with ADEC and MOA
DSD Guidelines 8 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 readilyldentifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
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 :3 bedrooms.
Disapproved.
Conditional approval for
Phone 337-6179
Date 7�Li/C6
bedrooms, with the Mowing stipulations:
................
ey Garness:
CE -795)
2, ;1WO cgPQv
proressi0��oo
Septic System Advisory Maintenance Agreements
Well Flow Advisory
Nitrate Advisory
Supplemental Engineer's Reort
Other
By: Original Certificate Date: 2— 27-06
IF. IIASI
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragsw Street
P.O. Box 196650
Anchorage, AK 995198650
www.muni.orglonsits
(907)343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: CONTOUR ACRES SUBDIVISION: LOT 4. BLOCK 1, Parcel ID: 0 /7- 45-1-.OS-
A.
s1-O.-
A. WELL DATA
Wen type PMVAIE If A, B, or C provide PWSID# N/A
Date completed 5/29/1984 Sanitary seal (Y/N) YES
Total depth 232 ft, Cased to 232 ft.
FROM WELL LOG
Date of test 5/29/1984
Static water level 208 ft.
Well production 13.5 g.p.m.
Well Log (YM) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
1/31/2006
212 ft.
3.4 g.p.m.
Coliform 0 colonies/100 ml. Nitrate O.603 mg./L. Other bacteria _ 0 colonies/100 ml.
Arsenic: cs.o ug./L. Date of sample: 1/31/2006 Cone«ed by; GEG. Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL Data installed 11/2/1983
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A
Date of pumping 2/9/2006 Pumper MCDONALDS PUMPING
C. ABSORPTION FIELD DATA TESTED OLD BED
Date Installed 11/2/1983 Soil rating (g.p.d./ t'orl�d 330 System type BED
Length 65 ft. Width 23 ft. Gravel below pipe 0.5 ft.
Total depth 04•e -e• 1 ft. Eff. absorption area7 495 ft' Monitoring tube YES Depression over field NO
Date of adequacy test '2/10/2006 Results (Pass/Fan) PASS For 3 bedrooms
Fluid depth in absorption field before test 2_5 in. Water added 1002 gal. New depth 6 in.
Elapsed Time: 205 min. Final fluid depth • 5.5 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date -
•PRESOAKEO WITH 1003 GALLONS ON 2/9/2005.
••0.5" BELOW INVERT OF DISTRIBUTION LINE.
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at _in.
E. SEPARATION DISTANCES
High water alarm level at
Cycles tested Meets alarm & circuit requirements?,
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAifi station on lot 100'+
Absorption field on lot 100'+
Public sewer main
100'+
On adjacent lots 100'+
On adjacent lots
Public sewer manhole/cleanout
100'+
100'+
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 50+ 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 10'+ Water main N/A
Water service line t0!+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 25'+ Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field insperdfons and e!
review of Municipal records that the above systems are In
conformance with MOA COSA guideAnes in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date 21zZ/04
COSA Fee S Y 47 4�
Date of Payment
Receipt Number t7 2
(P V.Ivo5)
Waiver Fee $
Date of Payment
Receipt Number
.... ./....
........:**,
am ess:
CE -7 3
X171 W, c�
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
February 13, 2006
Municipality of Anchorage
Department of Development Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Subject: IiAA for Private Well & Septic System. Lot 4, Block 1, Contour Acres Subdivision.
To whom it may concern:
The subject lot has a 3 bedroom house on it which is served by a private well and septic system.
A site visit was made to the property on 1/31/2006 to test the well and septic system. At this time
it was noted that the drainfield that was installed 9/17/1993 was surcharged and was not testable.
On 2/6/2006 the bed that was installed on 11/2/1983 was connected to the septic tank. The bed is
23 feet wide, 65 feet long, and has an effective depth of 0.5 feet. The bed was presoaked with
1003 gallons of water on 2/9/2006. Prior to starting the adequacy test the drainfield had 2.5
inches of liquid in the monitoring tube. A total of 1002 gallons of water was added to the
drainfield which caused the liquid level to rise 3.5 inches to 6 inches (liquid at invert). The
drainfield was then checked 205 minutes later and found the liquid level to have dropped 0.5
inches. Based upon this data, it was determined that the absorption rate of the bed exceeds 450
gallons per day, as required for a 3 bedroom house.
If you have any questions, please contact us at 337-6179.
P.E., M.S.
3701 E. Tudor Road, Suite 101 * Anchorage, Alaska 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com
N
1Or UTI$lW CAS C M C NT
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r....:............................D AS -BUILT SU Y
44 SCALE : 1• 40•
A a SHANE A. HOLT: QQ
oo•A Y
Q' L6:6914 If , MORTGAGEE'S
INS INSPECTION
HAVE PERFORMED
440''••••• d MOCRIBED RINSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
OgY0w4 uOw,L ✓oo LGN, BLOCK 1, CONTOUR ACRES SUB.
S Ei9 5900E 120.00
ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT
THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
THE INFORMATXNN HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIRCALLY TO SNOW ANY CONFLICTS BETWEEN WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
EXISTING STRMMRES ANO PUTTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL ENCROACHMENTS EXIST OTHER THAN NOTED.
STRUCTURES OR FENCEUNES.
DATED AT ANCHORAGE, ALASKA THIS _ITT"_
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PUT, ARE NOT SHOWN HEREON. DAY OF _FEBRUARY 2008
NOTE'. ANY FENCEIINES SHOWN ME LOCATED APPROXIMATELY AND ME NOT TO BE USED TO DETERMINE PROPERTY LINES HOLT LAND SURVEYING W025. FB121E
OR LOCATE STRUCTURES TEL 945-0515
ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS.
Location (site address or directions) 30! CQ0N7A%Y GLaB L&NI-
Property owner CfAL bA fzg ►2 A<.T s i� p 1-I Day phone
Mailing address
Lending agency
Day phone
Mailing address
Agent kle400 P vG:5:�U �.-aLA UlIL44e- Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. ' NUMBER OF BEDROOMS: — ?
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA k21
5. 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 of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. l further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in complianipe with all Municipal and State codes,
ordinances, and regulations in'effect on the'date of this inspection.
Name of Firm urV la k.al P = Phone A79 - B'l �6
Address :W is,
Engineer's signature Date 3�g19?
AW
74 /.rypyP�y, w•� tl � �i..•.'rA etfYt�•� t
r ©tl eUJJ32il' fi59 tlf' ` Ar 2
otl�tltl •tlse ea uca oo
6. DHHS SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional' Comments _
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA 021
D. LIFT STATION,/
Date installed Size in gallons
Manhole/Access (Y/N) "Pump on level at* "Pump off' level at*
High water alarm level at* *Datum
Cycles tested
E. SEPARATIONDISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/lig tank on lot IQ ; On adjacent lots !fes
Absorption field on lot /-35+ Ft ; On adjacent lots Si / 6ae7
Public sewer -main NIA- Public sewer manhole/cleanout M/At
Sewer /septic service line 7 i Da G,!~ Lift station ov,e-
SEPARATION DISTANCES FROM -SEPTICS TANK ON LOT TO:
Building foundation 17 P Property line 5 /'0 P Absorption field /D P/ --
Water main/service line —Surface water/drainage Nl o Wells on adjacent lots 7� /yo P&
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO;
Building foundation l e2 r—& Water main/service line '> 50 lC t
Surface water %D Driveway, parking/vehicle storage area 7.? -r FLS
Curtain drain N/ D Wells on adjacent lots Property line /5 IC76
F. ENGINEER'S CERTIFICATION
1 certify that I have determined thru field inspections and review of Municipal records r c terh�
in conformance with MOA HAA guidelines in effect on this date.°4:
Signature OPN
:_^+
Engineer's Name be� 5��raae `Q�.•�G•j �.� e•!e
er
bfcr S rkkm
d
��sA CE -1 144 • `R° s
.�
_ Erni J_ Fjlw
HAA Fee , $ lt1J . fj Waiver Fee $
Date of Payment G / Date of Payment
Receipt NumberReceipt Number
Rev, 8/95 OSS- haa.wk.doc
MUNICIPALITY OF ANCHORAGE
• '� DEPARTMENT OF HEALTH & HUMAN SERVICES��
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.# 01% qJ I-D_�;
HAA #1�`i?)UQlro
1. GENERAL INFORMATION
Complete legal description Lo Y 3 K C-0 u, o�.�-�c' �c�-•�
Location (site address or directions) 5 3D 1 C" La. 6
1)._3(
Property owner ti i' _ !�' Day phone
Mailing address 5
Lending agency AIA4L, US A D401- X94-+ V-4nour54Day phone 79-6 -21`lo L(
Mailing address
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 �(
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA N21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
invnntin_n+in of +hio Wnol+_k ALi+hnri+v AnnrnwoI onnlirnotinn chninec th2t_tha nn_cito uio+or ci i-n-nI
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I furtherverify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm o e- t4 _1� P u La�vL9 -I > Lz Phone 2-7q-&91.6
Address
Engineer's signature
I/,/ Ls— l- I--( 2a 3
6. DHHS SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for
Date 1" I l a3
l
".)
bedrooms, with the following stipulations:
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L4 B k 4 covto,, r lures Parcel I.D. 017 " L461 - 0-5
A. Well Data
Well type If A, B, or C, attach ADEC letter. ADEC water system number N,,///A
Log present (Y/N) �� Date completed 5129' 1,6 y �l�t Driller *
Total depth c 3Z Cased to 3Z Casing height
Sanitary seal (Y/N) Wires properly protected (Y/N)
FROM WELL LOG
Date of test ,1�i 9 / S- y
Static water level 20 g
Well flow 13.s- 9 -p -m
Pump levell Go
SEPARATION DISTANCES FROM WELL TO:
AT INSPECTION
71;L7 /f s MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
7
5�
9-p.mOCT 0 5 1993
RECEIVED
Septic/holding tank on lot
1 DSD +
; On adjacent lots i� 1 C?'tD
�I,� .
Absorption field on lot
4, 1°t q 3
On adjacent lots > / S o
Public sewer main
Public sewer manhole/cleanout N/A
til 1 O
Sewer service line
>
Petroleum tank
WATER SAMPLE RESULTS:
Coliform 6J Nitrate O / 1 Other bacteria 4�
Date of sam le: 8 A g 3 Collected by: - g
B. SEPTIC/HOLDING TANK DATA
Date installed 1 1 • Z. -e95 Tank size Compartments o2-
Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (Y/N)
N1
High water alarm (Y/N)
NSA
Alarm tested (Y/N)
�I,� .
Date of pumping ("� !4
4, 1°t q 3
Pumper z to
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 16.0 t- On adjacent lots >� t at--> Foundation
161
l Ofl fi —Absorption t
To property line ption field � o �' Water main/service line > X O
Surface water/drainage
X10
72-026 (3/93)' Front LJ"Ov, "CSX pa A
CONTINUED ON BACK PAGE
C. LIFT STATIONfit%
Date installed ,,
Size in gallons
Vent (Y/N)
High water alarm level _
"Pump on" level at
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
D. ABSORPTION FIELD DATA
On adjacent lots
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
Cycles tested
Surface water
Date installed 17 q 3 Soil rating (GPD/Ft2) e 0 SystemtYP e
Length 10.0 Width 2- Gravel thickness Total depth
Total absorption area to &-C�l Cleanout present (Y/N) ` Depression over field (Y/N)
Date of adequacy test tq1/, Results (pass/fail) for 3 Bedrooms
Water level in absorption field before test N /,4, After test
Peroxide treatment (past 12 months) (Y/N) N If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot 1 3 -15 On adjacent lots > /3-0 Property line
To building foundation A iv To existing or abandoned system on lot d 0 :
On adjacent lots > 30 Cutbank N o vt C Water main/service line
Surface water N0 ,n -e—Driveway, parking/vehicle storage area b O +
Curtain drain 'l`4 o 0 e -
E. ENGINEER'S CERTIFICATION
1 certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
HAA Fee $ J66, a O
Date of Payment
Receipt Number's J 1
72-026 (3/93)" Back
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
(a) Legal,pescription,(include lot, block,
Location (address or directions)
�v c_%U J /
(b) Applicants Name _ A 0 V1
Applicants AddressS7-3(;"160(-104'y
Application Date �Z(lq �g-N
.vision, section, township, range)
A
Telephone - Home .s4�73 Business '55"
1,
(c) Applicant is (check one) Lending Institution Ra ; Owner/builder = ;
Buyer ; Other E'�:l (explain); -h
(d) Lending Institution SA J ptt4;, Telephone
AdbssC-
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. ape of Residence
Single -Family 5Q Multi -Family
Number of Bedrooms 3
3. Water Supply
Individual Well M Community =
Other (describe)
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 �z 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]
S. Engineering Firm Providing Inspections, Tests, File Search, Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein, I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm
Telephone 979 -34 �,
Address 3 1,r/ ! "f
Date /��1�- �'�% = 4�.. G�..�'.�` tA�4
4 l'
i
(ENGINEER SEAL) r Oro�`: 1H
got
6. DEEP Approval
Approved for 3 bedrooms
Approved Disapproved
Terms of Conditional Approval
r.. ••.........-...... -!
.a o. 2225-E "r
Pr '1 .• JUNE 25. 1971
a • •P, �x
By
Conditional
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2] 7-19-84
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 390 Type of System Design as c)
Date Installed 1111-183 Length of Field a 3 x6
Width of Field ----� Depth of Field y 5
- Gravel Bed Thickness
Square Feet of Absorption Area Q�� Standpipes Present (YM) 'T1X/y
Depression over Field (YIN) N Date of Last Adequacy Test
Results of Last Adequacy lost _N/A
Separation Distance from Absorption Field:
To Water -Supply Well 175 r.•+' To Property Line 30
To Building Foundation 55 To Existing or Abandoned System cn
Lot N 014 E On Adjoining Lots N Q lei
To Water Main/Service Line 10 '�' To Cutbank(if present) N ON e
To Stream/Pond/Lake/or Major Drainage Course N Q N ;
To Driveway, Parking Area, cr Vehicle Storage Area O 'i
Comments
D. LIFT STATION N o N C
Date Installed Dimensions
Size in, Gallons Manhole/Access (YM)
"pump On" Level at "Pump Off" Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes(YM)
Congnents
** Check Permitted Bedroom Ranting Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect
on the date of this inspection.
Signed Date /2.-/94
7
Company H p MOA No 907-011
KB1/d5/s
(Page 2 of 21
�• ♦•• • SZ'LAL......
�. • • i • •.. . • • • 7 • • •• .
2225-E.
NE 25, 1971 ..ti
2-15-84
ALA$KA LoInOMMAL COnTROL �Cr��� C�, Inc.
engineerinq & 6nuironmental Studies
/')
January 25, 1984 f
Cory Willis
Department of Health and
Environmental Protection
825 L Street
Anchorage, Alaska
Dear Mr. Willis:
With reference to the inspection conducted by AECS for Lot 4, Block 1
of Contour Subdivision, I attempted to contact Mr. Joe Caldra to
confirm that his home was indeed a three bedroom. I was unable to
reach him but his realtor, Mr. Alan Loveland, had a floor plan of the
hoarse, and verbally verified that it was indeed a three bedroom hone.
The number of bedrooms noted in the inspection report is in error.
However, the as -built for the system is correct and appropriately
sized for a three bedroom hone. In addition, I noted the legal
description in the approved space at the bottom of the form is
incorrect, and should read "Lot 4, Block 1", as in the upper section
of the report.
Thank you for calling this matter to our attention, and I hope that
we may minimize such errors in the future. Should you require any
additional clarification, please feel free to contact me.
HRE/cad
Harald R. Ehlers
Environmental Engineer
1200 West 33rd Auenue, Suite B • Anchorap, Alaska 99503 • (907) 276-1361