HomeMy WebLinkAboutGLACIER VIEW HEIGHTS #4 BLK 2 LT 6ier
View
Heights #4
#050-501-40
Municipality of Anchorage
On -Site Water and Wastewater Program < (907) 343-7904 Page 1 of 4
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number. OSP151128 PID Number: 050 -- ,0 1 - 14c)
Dwelling: ❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑ Upgrade
Name:
Carl & Christine Lundgren
ABSORPTION FIELD
❑Deep Trench FIM Shallow Trench ❑ Bed ❑Mound
Address
22743 Eagle Glacier Loop, Eagle. River...,
El Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
5
0.6 GPD/sF
3.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1.0 Ft.
Gravel depth beneath pipe
2.0 FL
Subdivision Block Lot
Glacier View Heights #4 2 6
Fill added above original grade
2.0 FL
Gravel length
32 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
N/A
Distance between lines
N/A Ft.
SEPARATION DISTANCES
Tol
Septic
Absorptionj
Holding
Lift Station I
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
228.6 Added Ftz
1 added
10+ to exist Ft.
Well
116.4
131.8
I
125.7 1 N/A
100-{-
TANK ❑ Septic ® S.T.E.P. ❑ Holding Other
g E3
Manufacturer
Anchorage Tank
Capacity
12000 Gal,
i
Surface Water
100+
100+100+
I N/A
Material
Number of compartments
Lot Line
65.0
37.7
75+ I N/ANA
Steel
2
Foundation
8.0
30.5
19.8 N/A
LIFT STATION
Manufacturer
Capacity
I
Curtain Drain
i 50+
50+
N/A i N/A
Anchorage Tank/ Orenco
250 Gal.
Remarks Combined total area is 125Qsf.
Pump on level at
43 in.
Pump off level at
40 in.
High water alarm at
5 in.
NZt. 1. ( i ti l I,
Pump make and model
P2005
Electrical Inspections performed by
J ELECTRIC LLC
Installer
PIPE MATERIAL House to tank PVC Tank to
drainfield PVC
Alaska Divers & Underwater Salvage
Drainfield PVC CO/MT V
Inspector Pannone Engineering Services
BENCHMARK (Assumed elevation) 100 ft
Inspection 1�` 9/11 /15 1/25/16
Location and description
2^d
3"' .41h
Bottom of trim at 'A'
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
Q( tkj
Conditional Approval: Date
C0
iteven f$. *99 norae
CE
Lux
Approved'�Utol Date 1,1 q/lg
11 Q1JJC000I I MZPUI t_tl- 1- 14.UUU
WELL (E)
/ r A.�/� \ COLLAPSED 12508 SEPTIC TANK & \
G DECOMMISSIONED PER CODE
x INSTALLED 2000g S.T.E.P. TANK (P)\ \
\ O 6
5BR SEE FIELD CONNECTION DETAIL \
w-HOUSE"w
__._ -__ _ _DRAIN FIELD
(E)
T ADD 5'W x 32LF x 2.0'ED x 3.0'TD
\\ AT\ 4. \ MT1 1 " LATERAL W/ 3/6" HOLES 36" O.C.
WITH MONITOR TUBE AT EACH END "
MH \ \-• �/ 108
e MT TH-PES
104
'� S \
Fp�o TH-1984 - LSEPTIC ARE'k(E)
100
RESERVE DRAIN FIELD (P)
26.25LF x 5'W x 2.0'ED x 3.0'TD - es -
I \ \\ BASED ON CAT III
� 92-
84.
z- -
WELL (E)\
DESIGN PARAMETERS DESIGN PARAMETERS
UPGRADE SEPTIC SYSTEM RESERVE SEPTIC SYSTEM
NO. BEDROOM: 5 (750 gpd) NO. BEDROOM: 5 (750 gpd)
TANK SIZE: 2000g S.T.E.P. 'TANK SIZE: 2000g ADVANTEX TANK
PERC RATE: 16-30 MPI WITH (2EA) AX20 PODS
SOIL RATING -0.6 GPD/SF PERC RATE: 16-30 MPI
AREA RQD: 1250 SF SOIL RATING: 4 GPD/SF
SYS. TYPE: WIDE TRENCH 2.0'ED AREA RQD: 187.5 SF
RF: 0.70 SYS. TYPE: WIDE TRENCH 2.0'ED
MIN LENGTH: 175 LF RF: 0.70
MIN LENGTH: 26.25 LF
USE:
EXISTING 1 43L x 5.0'W x 2.0'ED x 3.5'TD USE:
ADD 32 LFx5'Wx2.0' E.D., 3.0' TD 26.25LF x 5.0'W x 2.0'ED x 3.5'TD
TOTAL AREA: 1250 SF TOTAL AREA: 187.5 SF
0
NOTES:
A
B
FC
17.3
14.10
T1
14.5
23.6
T2
18.3 .
35.0
MH
19.8
37.2
MT1
33.0
55.4
MT2
60.0
73.40
NOTES:
PANNONE ENCS SVC LLC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-821149
*� 49 TMy*�
. .. ... . ....
... .. ....
�� SteveCER8149 no��'
RECORD DRAWING
GLACIER VIEW HEIGHTS #4, BLOCK 2, LOT 6
CARL & CHRISTINE LUNDGREN
22743EAGLE
ARI VERGLACIER
AK 1995770P �,tl>1i�`�/�?0�SS10NP���
PLAN
Date
01/26/16
Scale
1"=50'
P.I.D. NO
-050-501-40
PERMIT NO.
OSP151128
Sheet
2OF5
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS. ASB
2. SCOPE OF WORK: INSTALL NEW 2000g S.T.E.P. TANK AND VERIFY SOIL ABSORPTION SYSTEM. IF SYSTEM IS IN FAILURE
PERFORM TEST HOLE FOR FIELD UPGRADE, IF FIELD IS OPERATING ADEQUATELY ADD FLOW SPLITTER AND ADDITIONAL
ABSORPTION AREA. ASB
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 7.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 7.55 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. ASB
4. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA 1N CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER
(OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE
CONTRACTOR. ASB
LFILTER
BRIC
TOPSOILERF PIPE `t! 3 16" HOLES DRILLED 36" O.C.
AND VEGATATE / /OCK 6" ABOVE PIPE INV
TH-1 •5 b4P0
EL, 104.0
—1.0 OR OL v
0f
N 0.5
x.: -1
GM 50—
.1 1. — .,1 t.
—9.5 94.5 SECTION N �w R.I. wm
DRY 9/18/15 FILTER FABRIC 12
p 1.0" m PERF PIPE 4'd/ x 6" TOPSOIL
z Z 3/16" HOLES DRILLED 36" O.C. t= AND VEGATATE
z
�= ~_ DRAIN ROCK 6" ABOVE PIPE INV g
r 0 0 O
C) 3 SRX 3'7 a"4 EL.t04.0
EL. 100-0 r
a....1 ji <
.101.
2000g S.T.E.P.F
EL.95.4 TANK (P)
ILE
NOTES: �"t ' LLC�"a� Dote
RECORD DRAWING �l �F AC q>� 01/26/16
P.O. BOX 100217 ANCHORAGE, AK 99510 s� !F- Scale
PHONE (907) 272-8218 FAX (907) 272-8211 NTS
49
P.I.D. NO
GLACIER VIEW HEIGHTS #4, BLOCK 2, LOT 6 050-501-40
CARL & CHRISTINE LUNDGREN Sievers R Ponnone PERMIT NO.
CE 8149 05P151128
22743 EAGLE GLACIER LOOP + cs•.
SECTION/PROFILE EAGLE RIVER, AK 99577PROfESS10NP�Sheet
� � • Q'�� 3OF5
SPECIAL PROVISIONS TO SPECIFICATIONS
1 . ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS.
2. SCOPE OF WORK: INSTALL NEW 2000g S.T.E.P. TANK AND VERIFY SOIL ABSORPTION SYSTEM. IF SYSTEM IS IN FAILURE
PERFORM TEST HOLE FOR FIELD UPGRADE, IF FIELD IS OPERATING ADEQUATELY ADD FLOW SPLITTER AND ADDITIONAL
ABSORPTION AREA.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 7.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 7.55 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
-PROJECT AS -CONSTRUCTED THIS -DATA IN -CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER
(OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE
CONTRACTOR.
1" PIPE TO PF
1.5" PIPE FROM LIFT STATION
1.25" PIPE
LEGEND
W WATER LINE/
WELL RADIUS
SS NEW SEPTIC
ABBREVIATIONS
7
TH TEST HOLE
FIELD CONNECTION DETAIL
FC FOUNDATION CLEAN OUT
T# TANK CLEAN OUT NO.
C# CLEAN OUT NO.
M# MONITOR TUBE NO.
R.I. RIGID INSULATION
DCO DOUBLE CLEAN OUT
DV DIVERTER VALVE
FS FLOW SPLITTER
NOTES:
PANNONE ENG SVC, LLC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
-�`� ��
���F A�q�lj
�,`Q-. ' S,�
j C-) y �O
*: * F,
Date
01/26/16
RECORD DRAWING
scale
NTS
GLACIER VIEW HEIGHTS #4, BLOCK 2, LOT 6
_aolOao
CARL & CHRISTINE LUNDGREN
22743 EAGLE GLACIER LOOP
EAGLE RIVER, AK 99577
Steven R. I'annorie /
c . CE 8149
+� sr
ORFSQOA-
.
PERMIT NO.
05P15t 128
DESIGN DETAILS
Sheet
4 OF 5
1
2
3
4
5
6
7
8
9
TH-PES
ORGANICS/
ORGANIC SILTS
LOOSE SILTY
SAND AND
GRAVEL
BOH
DATE PERFORMED:09/11/15
SOILS LOG - PERCOLATION TEST
SLOPE
TH
WAS GROUND WATEF
ENCOUNTERED? N
IF YES, AT WHAT
DEPTH? 0'
DEPTH TO WATER AF
MONITORING? DRY
DATE: 09/18/
READING DATE
CLOCK
TIME
NET TIME
WATER
LEVEL
READING
NET DROP
1 11SEP15
1055
---
4.96
---
2
1105
10 MIN
9.01
4.05 2.46
3
1105
---
4.94
---
4
1115
10 MIN
8.07
3.13 3.19
5
1115
--
4.95
---
6
1125
10 MIN
8.02
3.07 3.25
PEROLATION RATE 3.25 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 2 FT AND 3 FT
COMMENTS: Test hole excavated by SPINELL HOMES. Prec hole was presoaked.
Test run for at least one hour. Last 3 readings reported
PERFORMED BY: Dan Moran. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: PAMONE ENG SVC, LLCq�\alt cite 16
RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211 W.-.4 TH * Scale
+�� NTS
....... ... P.I.D. NO
GLACIER VIEW HEIGHTS #4, BLOCK 2, LOT 6 .... .. / 050-071-17
Steven R. Pannone PERMIT NO.
CARL & CHRISTINE LUNDGREN �,'. CE 8149
Fri/ OSP151097
22743 EAGLE GLACIER LOOP �� ' _
SOILS LOG EAGLE RIVER, AK 99577 �lli��ossl=i�?� Sheet
5e0F 5
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP151128
Tax Code Number: 05050140000
Work Type: Septic Upgrade
Permit Effective Dates: August 25, 2015 to August 24, 2016
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: GLACIER VIEW HEIGHTS #4
Site Legal Address: GLACIER VIEW HEIGHTS #4 BLK 2 LT 6 G:0159
Owner/Address: LUNDGREN CARL E JR &
CHRISTINE M 22743 EAGLE GLACIER LP EAGLE RIVER AK 995770000
Site Mailing Address: 22743 EAGLE GLACIER LOOP, Eagle River
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy
All construction must be in accordance with:
Lot Size in Sq Ft: 43560
Total Bedrooms: 5
N Private Well N Water Storage
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions:
1. The testhole location does not match the location shown on the 1984 soils log. For the
northernmost trench, the Engineer needs to do an additional test hole, minimum 6' deeper than the
proposed field, prior to the construction of the septic field. Construction may proceed at your own
risk before the 7 day water monitoring is complete. Please submit stamped and signed results
with the As -built Inspection Report. If the results require a design change, construction of the
system will stop pending On -Site review and approval.
2. A squirt test is to be done to show adequate distribution between the two sections of the field
prior to backfilling. The test is to be observed by MOA staff.
Received
Issued By:
Qslaais
Date: g Z✓r /5
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division QD Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 050-501-40
SUS "TTA
MAY 15 2015
Gretchen Stupe, -
Property owner(s) Carl & Christine Lundgren - Day phone None Available
Mailing address 22743 Eagle Glacier Loop, Eagle River, AK 99577
Site address 22743 Eagle Glacier Loop
Legal description (Sub'd., Block & Lot) Glacier View Heights #4, Block 2, Lot 6
Legal description (Township, Range & Section)
Lot Size 43,560 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(E all that apply)
Absorption Field �( Initial F-1 Single Family (SF)
(w/wo ADU)
Septic Tank Upgrade ❑x
Duplex (D)
❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings
❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
354 Distance:
Zti
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner. or authorized agent)
Permit/Rush Fees: 02/5
Date of Payment:
Receipt Number:
Permit No. QSYlJ�/�e�g
IP -3.5q 0601,36 7//30/s
Permit App__ :-:L�c,
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No. _
Pannone Engineering Services Lac
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve(d)Daneneak.com
August 14, 2015
Subject: Glacier View Heights #4, Block 2, Lot 6
Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install a septic system to be issued for this property. The
proposed systems will serve an existing five (5) bedroom house. The existing system was designed and
installed for a four (4) bedroom house and will be expanded to accommodate five. The existing field is
currently dry and operating adequately. Currently the lot is developed. This lot is served by a private
well. The surrounding developed lots are served by private wells. There are no wells within 100' of the
proposed septic system.
1. Soils. One test hole was performed in the vicinity of this system by Lee Reed in May of 1984, and
groundwater was monitored for at least seven days. Ground water was observed at a depth of 7.5'
below thesurfacein the test holemonitor tube in May of 1984. Bedrock was not encountered in the
test hole. Based on the results of the percolation tests and overall soils appearance; an application
rate of 0.6 gallons/day/square feet was used for a conventional wastewater system in the area of
these test holes.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage
ditches.
4. Topography: The existing topography slopes from the northeast to the southwest at
approximately 16% in the area of the septic system. There are no steep slopes within 50' of the proposed
drain field. The proposed drain field will maintain 50' separation all steep slopes.
S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification t15at
the review is complete and that there are no further comments is received from MoA On -Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
m
"?o v
\ v W-41- (E) _ • _ A \ A
\ LQ
Zt
+ COLLAPSING 12509 SEPTIC TANK (E)
"WELL (E)
DECOMMISSION PER CODE \
INSTALL 20008 S.T.E.P. TANK (P)
17.6 \ /� SEE FIELD CONNECTION DETAIL
SBR
iy W- HOUSE \ DRAIN FIELD (E)
\ (E). \ ADD 5'W x 32LF x 2.0"ED x 3.0'TD
fy \ 34 j 5.7 1" LATERAL W/ 3/6" HOLES 36" O.C.
WITH MONITOR TUBE AT EACH END
ol
- 4b FR \ \ TH-1984 ! LSEPTIC AREA,(E)
10.0
\ v A 100.0 \ RESERVE DRAIN FIELD (P)
\/2—
\ � � �• 26.25LF x 5'W x 0'ED x 3.0'TD _
BASED ON CAT III
I A �
WELL (E)
NOTES: _���� \\ Date --
CHANGE ORDER Ip�ONgp Oj ONO2E1{7 ENG
ORA�SGEV, CK 99JL0 c�°F... g-d l� 7/28/2015
PHONE (907) 272-8218 FAX (907) 272-8211%g�p —01 Scale
�.... .. .. .. ... I 49
P.I.D. NO
GLACIER VIEW HEIGHTS #4, BLOCK 2, LOT ........... 050-501-40
CARL & CHRISTINE LUNDGREN S'te'ven R.'. on'none' j PERMIT No.
22743 EAGLE GLACIER LOOP ��'Pc E 81 ag, \��/ SOSPI
hee61128
PLAN EAGLE RIVER, AK 99577 1klla, p sheet
\\ "�� 1 OF 2
SPECIAL PROVISIONS TO SPECIFICATIONS
1, ALL CONSTRUCTION SHALL. BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS.
2. SCOPE OF WORK: INSTALL NEW 20009 S.T.E.P. TANK AND VERIFY SOIL ABSORPTION SYSTEM. IF SYSTEM IS IN FAILURE
PERFORM TEST HOLE FOR FIELD UPGRADE, IF FIELD IS OPERATING ADEQUATELY ADD FLOW SPLITTER AND ADDITIONAL
ABSORPTION AREA.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 7.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY .THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 7.55 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
1" PIPE TO PROPOSED LEG OF FIELD 32' LEG (P)
1.5" PIPE FROM LIFT STATION—
II F —
1.25" PIPE TO EXISTING FIELD
I
I I
I I
I I
1 .25 x 4" REDUCER
I
)11
I
EXISTING FIELD L
I
I
FIELD CONNECTION DETAIL
DESIGN PARAMETERS
UPGRADE SEPTIC SYSTEM
NO. BEDROOM:5 (750 gpd)
TANK SIZE: 20008 S.T.E.P.
PERC RATE: 16-30 MPI
SOIL RATING: 0.6 GPD/SF
AREA ROD. 1250 SF
SYS. TYPE: WIDE TRENCH 2.0'ED
RF: 0.70
MIN LENGTH: 175 LF
DESIGN PARAMETERS
RESERVE SEPTIC SYSTEM
NO. BEDROOM: 5 (750 gpd)
TANK SIZE: 20009 ADVANTEX TANK
WITH (2EA) AX20 PODS
PERC RATE: 16-30 MPI
SOIL RATING: 4 GPD/SF
AREA ROD: 187.5 SF
SYS. TYPE: WIDE TRENCH 2.0'ED
RF: 0.70
MIN LENGTH: 26.25 LF
USE:
EXISTING 143LF x 5.0'W x 2.0'ED x 3.5'TD USE:
ADD 32 LFx5'Wx2.0' E.D., 3.0' TO 26.25LF x 5.0'W x 2.0'ED x 3.5'TD
TOTAL AREA: 1250 SF TOTAL AREA: 187.5 SF
NOTES: PANNONE ENG SVC, LLC
CHANGE ORDER P,O, BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
GLACIER VIEW HEIGHTS #4, BLOCK 2, LOT 6
- CARL & CHRISTINE LUNDGREN
22743 EAGLE GLACIER LOOP
DESIGN DETAILS EAGLE RIVER, AN 99577
LEGEND
W WATER -LINE/
WELL RADIUS
— SS — NEW SEPTIC
ABBREVIATIONS
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#.
MONITOR TUBE NO.
R.I.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS -
FLOW SPLITTER
BFG
BELOW FINISH GRADE
OG
ORIGINAL GRADE
FG
FINISH GRADE -
TS&V
TOPSOIL AND VEGETATE
NIC
NOT IN CONTRACT
OF A/ ---I )ll
8/14/2015
Scale
NTS
*: Fi
49 T 6
P.LD. NO
........�
Steven R. Pannone /
050-501-40
IPS CE 8149 ��
PERMIT N0.
OSPI51128
Sheet
(�1'1�F��DIONpV�` ROFESFESS
'
2 OF 2
Glacier View Heights
SRP 150911
NOMINAL PIPE SIZE
(in)
PVC Plastic
(in)
Pipe Length
(ft)
Pipe Length
(miles)
Kinematic viscosity
(ft%)
Smoothness (a)
(in)
Flow in gpm
Volumetric Flow Rate (Q)=
Velocity (v)
Reynolds number (RE)
Ratio (e1D)
f (from Moody diagram)
Headless (4)
Headless (h)
Number of 90 Bends
Long Sweep Elbe Coefficient, K
Bends Headloss (q) -
Bends Headless (YI)
Total Headless (q)
Total Headless (hr)
Check: Hazen Williams
Coefficient, On
Hydraulic Radius
Head Loss (4)
Headless (h)
Total Headless (h)
Total Headless (hf)
Static Suction Head (hR>1
Static Suction Head (t5!s>1
Static Discharge Head (111
Static Discharge Head (11t,$)
Data for Pump
Head Loss calculations
ENTERJDATA'INBLUE' CELLS 01 IN -
gpm
Suction
Discharge
.1.25
50
`' 37 ,
1.24
---0-.013
- -
17
-=U311
-
0.003219E
'ff=
_`-0•= _0 �;� _-
1.66E-05-
1.66E-05
1.66E-05 1.66E-05 -1.66€ 05 - -
0
0
#DIV/Or
gpm
6
89
_55
50
`' 37 ,
(ft3/s)
---0-.013
-0x98
-_=0.123
-=U311
4—"0:082 R4..
(fus)
9.59- :=;='#DIV/0r
-
-#DIV/0!
:;#DIV10Y
#DylOr
(ft)
(psi)
2
=4.90€+03
-::_ #DIV/01
.'#DIV/OL
'-#DIV/01
- #DIY/O{-
--::-0.0:-
-•-0.00000
#DIV/01
`IDIV/OY
#DIVIO17#DIV/Or 71Ctlf .
r #DIV10l =.#DIV/Dr -#DIVIOt- -,12 ._
0.0320
0.0170
.- 0.0170 1
0.0170
1 0.0170 -
(psi)
,.-: 0.1 ::#DIV/OL
#DIV/Or
I --#DIV/O! #DIV10r
(ft)
r 0.2'_
-:e-_#DIV/01
--#DIVIOr
:-#DIVfOt
--#DIV/Or _
(psi)
'•0:1:.-
:'#DIV/OF
<'. 0.1 -
`-.-#D#DIN/0! ----
--#DIV/01 _
=#DIVJOE
-:#ONlOr
(ft)
(psi)
2
2
2
0.6
0.6
0.6 - -
--::-0.0:-
-- #DIVrot _.-
:-#DIV/O! - ,-#DIV/0r-#DIVIOr 7ED- _
'-0.0.
--:#DN/O(- s
r #DIV10l =.#DIV/Dr -#DIVIOt- -,12 ._
(ft) - -0.3 - #DN/0! #D1VI01 r:#DIVIOt -#DIV/Or Dk17. ._.
(psi)-...0.1_-#DIVI01 -- -#D!M-#DIV101 -=#DISI/OL �fQL
(ft) 1 4.0
(psi) -,-.1.7 - -
(psi)
NPSHA
NPSHA
NPSHR
NPSHR
Total Headless
Total Headloss
135
135
135
150 -
(ft)
0.03
-"0.00 =r-
-.::-0.00
(ft)
_: 0.2: -
-- --#DIV/01
-<#DIV/O!
=-#DIV/OL
(psi)
,.-: 0.1 ::#DIV/OL
#DIV/Or
I --#DIV/O! #DIV10r
(ft)
- =-0.2
-=V101.
-
--#DIV/Or _
_ 11DIVI01
(psi)
<'. 0.1 -
`-.-#D#DIN/0! ----
--#DIV/01 _
=#DIVJOE
-:#ONlOr
,#D11- -
(ft) 1 4.0
(psi) -,-.1.7 - -
(psi)
NPSHA
NPSHA
NPSHR
NPSHR
Total Headless
Total Headloss
(ft)
(psi)
(ft)
(psi)
(ft)
(psi)
3.5
---1:5-:-
4.3
-=-4:6.- �'
external piping is copper
Temperature @ 40 F
raze=62.4 Ib/ft'
Volumetric Flow Rate (Q):
Reynolds number (RE):
f:
Headless (h):
Headless, Bends (11):
g=32.2 ft?/s
Q=gpm/6017.48 -
RE=DvN
from Moody diagram
h,=f`UD`V12g
hr -K` 129
Pump Selection for a Pressurized System -Single Family Residence Project
Parameters
Discharge Assembly Size
1.00
inches
Transport Length
25
feel
Transport Pipe Class
40
gpm
Transport Line Size
1.00
inches
Distributing Valve Modd
None
Transport Velocity
Max Elevation Lift
6
feet
Manifold Length
0
feet
Manifold Pipe Class
40
Manifold Pipe Size
1.00
inches
Numberof Laterals per Cel I
1
Lateral Length
32
feet
Lateral Pipe Class
40
Lateral Pipe Size
1.00
inches
Orifice Size
3116
inches
Office Spacing
3
feet
Residual Head
4
feet
Flow Meter
- None
inches
'Add-on' Friction Losses
5
feet
Calculations
Minimum Flow Rate per Office
9.87
gpm _
Numberof Orifices per Zone
11
feet
Total Flow Rate per Zone
9.8
gpm
Numberof Laterals per Zone -
1
feet
Row Differential lst(Last Office 6.3
0.7
Transport Velocity
3.6
fps
Frictional Head Losses
Lossthrough Discharge
3.1
feet
Loss in Transport
1.3
feet
Loss through Valve
0.0
feet
Loss in Manifold
0.0
feet
Loss in Laterals -
0.7
feet
Loss through Flowmeter
0.0
feet
'Addon' Friction Losses
5.0
feet
Pipe Volumes
Vol of Transport Line
1.1
gals
Vol of Manifold
0.0
gals
Vol of Laterals per Zone
1.4
gals
Total Volume
2.6
gals
Minimum Pump Requirements
Design Flow Rate 9.8 gpm
Total Dynamic Head 20.1 feet
M
Ore co Systema°
lwnmowad
f'rgdre l&n rAe
lta./dDee leum�mm'
a
F
Pu
Net Discharge (gpm)
System Curve:
Pump Cum:,—
Pump Optimal Rahge�
Operating -Point
Design Pointo
Pump Selection for a Pressurized System - single Family Residence Project
Parameters
Discharge Assembly Size
1.25
inches
Transport Length
10
feet
Transport Pipe Class
40
feet
Transport Line Size
1.25
inches
Distributing Va the Model
None
feet
Max Elevation Lift
0
feet
Manifold Length
0
feet
Manifold Pipe Class
40
Manifold Pipe Size
1.00
inches
Number of Laterals per Cell
1
Lateral Length
32
feet
Lateral Pipe Class
40
Lateral Pipe Size
1.00
inches
Orifice Size
1/8
inches
Orifice Spacing
2
feet
Residual Head
4
feet
Flow Meter
None
inches
'Add-on' Friction Losses
0
feel
Calculations
Minimum Flow Rate per Onfics 0.39 gpm
Numberof Orifices per Zone 17
Total Flow Rate per Zone 6.6 gpm
Number of Laterals per Zone 1
Flow Differential lsULast Orifice 3.4
TAnsport Velocity 1.4 - fps
Frictional Head Losses
Lossthrough Discharge
0.3
feet
Loss in Transport
0.1
feet
Lossthrough Valve
0.0
feet
Loss in Manifold
0.0
feet
Loss in Laterals
0.3
feet
Lossthrough Rowmeter
0.0
feet
'Add-on'Fdcdon Losses
0.0
feet
Pipe Volumes
Vol of Transport Line
0.8
gals
Vol of Manifold
0.0
gals
Vol of Laterals per Zone
1.4
gals
Total Volume
2.2
gals
Minimum Pump Requirements
Design Flow Rate 6.6 gpm
Total Dynamic Head 4.7 feet.
cis
Oreeeo syat e
Incarrmra
Cbang�gok Wgrbe
World Lb Wmmxxr"
2
12
Pu
Net Discharge {gpm)
System Curve:
Pump Curve:
Pump Optimal Ranger
Operating Point
Design Pointo
/ MUNICIPALITY OF ANCHOHAL~E
DEPARTr IT OF HEALTH & ENVIRONMENTAL PieD' TION
..VIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska ~501 Telephone ~720
' ON~ITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECT'ION REPORT
MAILING ADDRESS
LEGAL DESCRIPTION
~ Liq, capacity in ~llons I Inside length Width Liquid depth
/~ IF HOME.DE:
6OM DISTANCE TO: Well Dwelling PERMIT NO~
-J Z
OZ~ ~
3: -- ~ Manufacturer Material Liquid ~pacity in gallons
Q Well Near~t lot line
~ DISTANCE TO:
~7~ ~ lq/ 37/
.~ ~ ~ No. of lines Length of ea~ line ~ Total length of Jines T~nch ~dth ~ Distance ~t~en lines
~ Top of ti,e to finish ~/~' ' .teria, ~neath the . Total eff~tive absorption area
Length Width ~th PERMIT ~.~
Ty~ of crib Crib diameter ~ib depth Total ~ti~ absorption area
~ Well Building foun~tion N~r~t lot line
DISTANC~
TO:
.~ CI.&~__~ ,~ Depth Driller Di~tan~ to lot '~e PERMI~
Building foundation ~r line ~pfic tank Absorption area(s)
OTHER
~,PE MATERIALS
SOIL TEST RATING
~NSTALLER
~EMARKS
,
72-013 (Rev. 3/781
PERMIT
DEPTH TC PiF~. ~OTTOF (':T.)
GRAVEL DFpTH (FT.)
TOTAL OLPIH (FT.)
GfiAVEL WiNTh (FT.)
GRAVxL LENGTH (FT.)
GRAYEL ~OLUf,'L (CU.VO].)
SOZL RATikG
-'-(1, '~ lZ; 0 *¢,
1,,750.0 ~ !.,259.0 **
=* ~RAVEL LENGTh > 75 F~, RE'~bI~'ES PULTIUL~ PUNS
i C~RTIFY THAI:
" 1, I AM F.a)I!Li'~ ',~fH TPE RZqUiHE~',E~TS FOf~ Ch-Sl~'r S':bE~S Ak) W~LLS .;~S SET
. _. ¢OFTh EY T~.{ -IUS~ICIP?~LI'FY CF NNCHO~&EC (FCA) ,~N) '"H;: ST&X'~ OF ALASKA,
~. I WTM * GUL~T']C
], i NZLL. A~Ht~c TO ALL MCA AND ST~T~ 3F AL~SKq N~.aU~iN'~NT~ FOE
SEkEfiAEE SY~'F=~- CH TH;S CR AhY AOJACF'~T C" ~'~;;A~Y LOT,
4. I bNOEGSIAND .THA1 T'JIS P~RMZT ZS VALi') FC? ~, '~AX~IU''~ OF
~F A LIFT ,; AIiCN .'S I,~,:ST~L.L~'P. IN AN /~:~ COVE'~ .... ~ '
WiLL NO1 BF AFPFOV=D ~[T~ICUT ~?,1 CL';:CT.q~C:~. ZXS-)F-'CTTC','~ ~['~C?~; q~,;b ('¢) THE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
7
8
10
12
15-
~7
~8
SITE PLAN
I+
WAS GROUND WATER S
ENCOUNTERED? 7,(~ ~ L 0
/ P
IF YES, AT WHAT ~ E
/
DEPTH?
/>, :.
Gross Net Depth to Net
Reading Date
Time Time Water Drop
.... l ¢/¢m ~.?~.:..,iiD .
:-.' b',//I 0 ~..,.?--,:?,,. I I
.:~ ~: ~_.: .... ,7o %..:
PERCOLATION RATE I~//,~ (mi
TEST RUN BETWEEN . FT AND ,,,=.--~-,,~-,.-~ FT
72-008 (6~79)
MUNICIPALITY OF ANCHORAG~
Df!PT. OF HE,z',I.1H &
ENVIRON,MEN fAL PRO I EC FION
LOCATION OF WELL
AUG 2 !984.
Ri::C, EIVED
Anoh
i~DISTA"C~
Street Addrese end Area of Well Location
WELL
Material Type
Topsoil
---~rave!, si~$~, soi~--
Gr~vel, si!~, ! wa~er
Gravel, clay silk
Gravel, sand, sil't, water
Section No,
A"O 0,R~CT,O. "RO~ .O^O ,.TERSECT,O.S
Well # 1:
WATER WELL RECORD
STATE Of ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological I~ Geophysical Surveys
OrllHng Permit No,
A.D.L; No.
35 -'-'F,'TO--'
140 148
M=rldlon
~. OWNER or WELL: M~' Ray Pel!etier
shasta .co'ns~ruct ton
Add~e,,: :67 i iQ'ii!;E ;,. ~:1 6t~ i' '. '
~ d'hb:z'age'; Ak. 99504
,,.("""" ,' 4_
?. UB~:~omelfle : El Public 'Aapply [] Indue/fy
[] .,rlw.en [] n.~e*o. []Co~,n,e~[col
[] T.e,w.,, [] O,h.,:
__ Diameter:.
Longlh:
fl, end
Gravel pock
ft.
g. FINISH OF WELL:
Type:
Slot/Mash Size
Sol bolween
Baokfllllng
STATIC WATER LEVEL'~_ 55 fl. 5 ~.0 /
Dote
[] Above or ~ Below land surface
Equipment us.d:
II,PUMPING LEVEL below land surface and YIELD
__ft. after hfs, pumping g.p,m.
ft. after ~hrs. pumping ~l.p.m.
I:).GROUTING Well {3routed: ~ Yes [] No
Material: []Neat Cemenl [] Other:
I~, PUMP= (if available) HP
Length of Drop Pipe ft. capacity
~4'REMARK~Sroduotion of 3 GPM
WATER WELL CONTRACTOR'S CERTIFICATION:
This wall Wal drilled ~nde~"my lurlsdlollon and lhls raper1 I$ Iruo to the besl of my knowledge end belief;
Magnuson':~Drilllng AA 5385
.0. ~ox.v'./UpU~ Eagle River, ~.
Addre~:
1984
POuQ,~ ~ 6-650
ANGIiORAGE, ALA',}KA 99502 0650
(907') 2{;,i-411 I
DEPARTMEN'I'OF HEALTItAND ENVIRONMEN]AL PI~OTECTION
Permit ~: 840371
January 31, 1985
TO: Permit Applicant
SUBJECT: Lot 6 Block 2 Glacier View Heights Subdivision #4
A permit issued by this Department for an individual well
and/or on-site sewer system has expired as of December 31,
1984.
Permits are issued on a calendar year basis by authority
of Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system not
installed by the expiration date.
If you have drilled the well, a well log needs to be sent
to this Department for documentation of the installation
and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, the original as-built inspection report
and the yellow copy must be sent to this office for review
and approval, and for documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Environmental Engineering Program
KEB/ljw
enc: Copy of Permit
SWP/057
1
Municipality of Anchorage
• Development Services Department
Building Safety Division e
On-Sfte Water and 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
FOR A SINGLE FAMILY DWELLING
Parcel I.D. o a -o Y-ei yo HAA #711
(� 2
Expiration Date: ��TZ
1 GENERAL INFORMATION
v fi.Ompferte fega{ description /'���,f� !/.f,,, ,yi.,r9,vzs 10'y JBG,er .4 en
Location (site address ar directions) dig ;ryS oc
Current Property ownelr(s) ,"� ja" E;w re . Day phone '7;t9- 1-%50
Mailing address
Lending agency
Mailing address
ZZ7g3 z azir -c t r"P
Day phone
Real Estate Agent BE" %t"f Day phone 241— 760o
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work.
4. 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 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. p
Name of Firm .froze .hersPhone Fr `�q-6.7
Address io+rsri dir/ .P.e seg r& toi
Engineer's Printed Name ,I' le.is(co
S. DSD SIGNATURE
Approved for
Disapproved.
_ bedrooms.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: t M Original Certificate Date:
(Rev. OV7q
Municipality of Anchorage bF
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program ' " E T ` n
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: z5f_4a,,W.r !/ems //r, �y 744-- 2 Ar 6 Parcel ID: oSB 3'0/ yp
A. WELL DATA
Well type �' &"y.— if A. B, or C provide PWSID # _
Date completed Sxlrolv y, Sanitary seal d9N) �
Total depth _ /�Yy ft. Cased to ✓yy ft.
FROM WELL LOG
Date of test Sz.90 Ary
Static water level S3 ft.
Well production 3 g.p.m.
WATER SAMPLE RESULTS:
Coliform _Qcolonies/100 mi. Nitrate <644 mg./I.
Arsenio 6 mg./I. Date of sample: 104YI y
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
Tank gize 1.?S- gal Number of Compartments 0
Well LogC/N) .A i
Wires properly protected ON) y o:I
Casing height (above ground) 3 Z in.
AT INSPECTION',
LVf .z/ a y
3. I g.p.m.
Other bacteriaO colonies/100m].
Collected by: L.q t4 R- )( ) ad b
Date installed Y/t m. /irV
Cleanouts (P)N) ym,
Foundation cleanout (94 _y&�o Depression over tank (YS? .aD High water alarm (Yt0 ti/,s
Date of pumping 9- /5 - DY Pumper Is
C. ABSORPTION FIELD DATA
Date installed t- as Soil rating (g.p.d./ft2 or ft2/bdrm) ,wiz System type T,e�,e�csr
Length /H3 ft. Width ft. Gravel below pipe .2 ft.
Total depth y ft. Eff. absorption area/yxi ft2 Monitoring tube�Z Depression over field .✓D
Date of adequacy test._dtV?/ei Results Fail) A o For 1o' bedrooms
e'
Fluid depth in absorption field before test /.2 in. Water added rgmogai. New depth/ea in.
Elapsed Time: _e,4;' Final fluid depth /0- in. Absorption rate >_ Gmo g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y4ZPL type) .✓ If yes, give date
Date installed Size in gallons 7 anhole/Access (Y/N)
"Pump on" level at _in. Pump o "
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO
Septic tank/lift station on lot
f too'
Absorption field on lot
4100,
Public sewer main
f Vtr,
Sewer/septic service line
► P-5-
in. High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots -F /do )
On adjacent lots
-r 100'
Public sewer manhole/cleanout +i u o'
Holding tank t toe,
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation /D' Property line to- ' Absorption field c'
Water main +/o' Water service line -c 1 u 0 Surface water t 0 "
Wells on adjacent lots -r., 400'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line /v' Building foundation .?S " Water main +to'
Water Service line Y iDSurface water '► 1400 , Driveway, parking/vehicle storage 3y,
Curtain drain -SSV Wells on adjacent lots re D'
w A -'"a Mn,aw. '
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and
�yr� w_ vD+
review of Municipal records that the above systems are in ss CHRISTOPHER R WOOD
conformance with MOA HAA guidelines in effect on this date. + ��
Engineer's Printed Name e.ary orcz .� ic%w.a ...,P*..��
Date 1(!)
HAA Fee $ nb • oo Waiver Fee $
Date of Payment II Date of Payment
Receipt Number INIC)Z9 -IPt Cllr Receipt Number
(Rev. 12/01)
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTMUTIONSSPECIFICALLYTO SHOW ANYCONFUCTS BETWEEN
EXISTING STRUCTURES AND PUTTED LOT UNES OR EASEMENTSAND IS NOTTO BE USED FOR POSITKININOADDITIONAL
STRUCTURES OR FENCEUNES
EASEMENTS OF RECORD, OTHER THAN THOSE SHOMM ON THE RECORDED PUT, ARE NOT SHOWN HEREON.
NOTE ANY FENCEUNES SHO" ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINE
OR LOCATESTRUCTURES.
ANY PAWINGSHOAN MAY SEAPPRO)UMATE DUETO SNOW CONDITIONS.
ASBUILTSURVEY
SCALE: 1' a 10'
I HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEES INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT B, BLOCK 2, GLACIER VIEW HEIGHTS 140.1
ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT
THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
ENCROACHMENTS E)UST OTHER THAN NOTED.
DATED AT ANCHORAGE, ALASKA THIS iBTH-
DAY OF OCTOBER 1001
HOLT LAID SURVEYING 3381, FB 31 -,, 1472
TEL. 315-9513
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONbLENTAL tLEALTH
DEPAR~IENT OF HF~kLTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1 General Information ~cation Date ,h'~/~ b/?~j
(a) Legal Description (include lot, block, sub~%~i~_., section, township, range)
(b) Applicants Name
Applicants Address
(c) Applicant is (check one) Lending Institution
Buyer ~ ; Other ~--'-. [ (explain);
(d) Lending Institution
Address
.~-o>~ %~, ~ Telej2hone -- Home Business
............ T___ele~p~one
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2..T~y_pe of Residence
Single-Family [~i ~
Number o£ Bedrooms
3. Water Sul0p17
Individual We].~.~'---~ .
Multi-Family
Other (describe)
Note: If community well system, must have written co[~firmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. S e wa~._e __D i_.~p.o s a 1
Note: If community well system, must have written confirmation from the State
Department of Envirorm~ental Conservation attesting to the legality and status..
[Page 1 of 21
5. En__g. ineering Firn Providing Inspections; Tests, File Searchz Data and Infotnnation.
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that ny investigation of this Health Authority ApprovaI'shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedroons 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
systen is in compliance with all Municipal and State codes, ordinances, and regula~
tions in effect on the date of this inspection.
blame of Firm
Date
(ENGINEER SEAL)
Approved for bedrooms
Approved "." Di sappr oved Cond i t ~ onal
6. DHEP A~roval I..--' .
"-~, By .'. " ' '
CAUTION
THE MUNICIPALITY OF ANCIIORAGE DEPARTMENT OF HEALTH AND EiWIRONMENTAL PROTECTIO~I
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TIlE REPRESE,hU.~
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIO~kL ENGINEER R~,GIS~ERED
IN T~IE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR IJ~NDING INSTITUTIONS IN ORDER TO SATISFY CLR1A.[N FEDEILAJ., AND STATE REOUIRE-
MENTSo EMPLOYEES OF DHEP t30 NOT CONDUCT INSPECT. IO?~5 OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. TIlE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIOMS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP $EzkL)
RR4/ej/D1.8
[Page 2 of 2]
7-'1 9-8z~
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Legal Description:
1984
Well Classification
Well Log Present (Y/N)
Total Depth / L/~-
Cased to
Static Water Level
Casing Height Abov~ Ground ~l /
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot_.
If A, C,
/~/~/ Depth of Grouting
Pump. Set At /
Sanitary Seal on Casing (Y~__~_~_
Depression A~ound Wellhead (Y/N) ~.~
; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot. /o~ '~ ; On Adjoining Lots
To Nearest Public Sews. r Line /~/~x¢~ To Nearest Public Sewer
Cleanout/Manhole /L/~ To Nearest Sewer Service Line on LOt
Water Sample Collected By /~'~ ; Date
Water Sample Test P~sults ~'~-~
Cor~rents --~ ~3 ~-~/~r ..
SEPTIC/HOLDING TANK DATA
Date Installed ~/l ~/~ ~ Size / ~
Standpipes (Y/N) y Air-tight Caps (Y/N)
Depression over Tank .(Y/N) /L7 Date Last Pumped ~/~
Pumping/Maintenano~ Contract on File (Y/N) ~,. ; for ....
Holding Tank High-Water Alarm (Y/N) ./'~ Temporary Holding Tank Permit (Y/N)
Separation Distances f~cm Septic/Holding Tank:
To Water-Supply Well ?~z~ '~ To Building Foundation
To Property Line /~ f- To Disposal Field_
To Water Main/Service Line ~ 7L
Course
No. of C~%~artmmnts 22_
Foundation Cleanout (Y/NJ
To Stream, Pond, lake, o~ Major D~ainage
[Page 1 of 2] 2-15-84
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ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption A~ea
Depression over Field (Y/N) .%//
Date .of Last Ac~quacy Test
Type of System Design
Length of Field -~ /L/~ /
/
Depth of Field ~/5-
Gravel Bed Thickness ~ ~,
~ Standpipes P~esent (Y/N)
Results of Last Adequacy Test /~/e~ ~_~,~ 2k~. (~
Separation Distance from Absorption Field:
To Water-Supply Well /~ M To P~operty Line /~ p
To Building Foundation ~ ~, 3- / To Existing or Abandoned System an
Lot /b/~- ; On Adjoining Lots ~ :~
To Water Main/Service Line .~ '~ To'Cutbank(if present) /~w~
To St~eam/Pond/Lake/or Majo~ D~ainage Course /~_
To D~iveway, Parking A~ea, or Vehicle Storage A~ea ./~ ~-
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Con~ents
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Meets MOA
** Check Permitted Bedroom Rating Against HAA ~quest
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect
on the date of this inspection.
~;~, 4 9 ~I~G.~N~ERS
KB1/d5/s ... 4~ .~. ~.~. ~'-"
,,-~; No. 2 2 ~ 5-/.
~t ~'. JUNE 25,