HomeMy WebLinkAboutGREENLAND BLK 7 LT 5171
Municipality of Anchorage .;,,~:
Development Services Department .-,~:~
Building Safety Division
On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: .~'cc/ O30 I I I PID Number: 0 t~- -15-/ -
Name. Do ~o O"A? Z. . C~ ,~o,,n Wastewater System: [] New [] Upgrade,
¥(?_o _~ //'7_ w, ,4-,..-~n~:/ /~,,.4 ~-q~-;~" ABSORPTION FIELD
Phone Number of Bedrooms:
G Y ~ --,.~,~'~ ~ -~' [~[OeepTrench ri ShallowTrenc~ ri Bed ['1 Mound ri Other.
LEGAL DESCRIPTION SoiiRa,~: ~o"= Total Oepth from original grad,.
~.~' 9.
Block: Lot: Subdivision; Depth to pipe boltom Irom original grade: Gravel depth beneath pipe:
-7 ~- ~-me e~ t~ :~. 5' ,,. o". ~ pt.
Township: Range: Section: Fiji added above original grade: Gravel Length:
O. 5- ,,. 6' .7 ~,.
Well: ,~'~,/£7" [] New [] Upgrade Gra,,~dm: ~' ~ ~1. Numheroflinae:l I Distance beh~een line,:__ FL
Class,ficabon (Private. A. B, C): Total Depm: Cased to: Tolal absorption a~ea: Pipe Material:
~,. F,. 7,5'04. n' 0-.30 3
Driller: Date Drilled; Static Water Level; L'tstallec ! Date Installed:
p, cz~. N 5'IZ~ Io..~
Yield:GPMI Pump $~t at: FI, Casing Heighl Above Ground:FL TANK
!
SEPARATION DISTANCES [] septic I-I Holding [] S.T.E.P. [] Other:
Manufacturer. Capamty:
Septic Absorption Lift Holding Public/Privat~
Tank Field Station Tank Sewer Une ,'~ ~-/~or~ ~ o/~ lO 04:2 Gal.
Material:k/ Number of Compartments:
~ -- in. in. in.
Pum,o Make & Model Electrical Inspections performed by*
Cu~mn Dra~n ~ -- ~
Roma~, BENCH MARK
I ! Assumecl Eleveuon:
fi`o,..
~.0~ J-,O~' /~ u.,'cetc,,~r- ~.r.~e..~c~ ,5--/I /0_~ Engineer'sStamp
Inspections performed by: /~'t'~-,4::,,,,~ V"e-e.~, ,~'c,,c. Dates: 1st ,ff'/C~"~'O 3 ~' vt · -~' o' ;--;-;
t ~'{~ a · · · · e ~-~e~r~ e e e e e e e e_~ e-~
Development Services Depart Approval ~: · - ·
~, ~· THcODORE F MOORE
Reviewed and approved by: (?~~,//~. ~=~Date: 7- ~'- z'~-O~ ':-'~'~' ".
PERMIT NO: SW030111
PID NO: 015-171-08
SWING TIES
FROM: COR."A" COR."B"
TO:
S.T.C.O. "C" 36.5' 54.5'
S.T.C.O. "D" 42' 57.5'
DBL. C.O. "E" 44' 59'
TR. C.O. "F" 33' 71.5'
TR. M.T. "G" 54' 76.5'
TR. C.O. "H" 97' 104.5'
PAGE 2 OF 2
"C" NEW 1000-GAL
SEPTIC TANK
63-FOOT LONG
SOIL ABS. TRENCH
w. 6.0" EFF. GRAVEL
LOT 5
BLOCK 7
PLAN VIEW
SCALE: 1" = 30'
li~ ' ::::::::::::::::::::::~:~::::::::::::::::::: ::,-,
· 4 '::: ..... :::::::::::::~; .............. ~47 ......
I:~::......"i~[~i9 .7 ............. ::::::::.~:: :: ............ · ....
~ BOTTOM OF TRENCH ELEV. 88.7'----.~
BOTTOM T.H. #1
ELEV. 80.0'
M.T. DRY 4118/03
PROFILE VIEW
NOT TO SCALE
2' SOIL COVER
(-2" INSULATION-
1000-GALLON ~t~ J
SEPTIC TANK II~ ~ ~,
LOT 5, BLOCK 7, GREENLAND SID
SEPTIC SYSTEM UPGRADE
AS-BUILT INSPECTION REPORT
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
SCALE: AS NOTED
DRAWN BY TFM
MAY, 2003 ,
* MUNICIPALITY OFANCHORAGE
Development Services Department
On-Site Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: May 01, 2003
Expiration Date: Apr 30, 2004
Permit Number: SW030111
Legal D es c rip tio n .r~(~'E-E~N--I.~N D 'B LK ~.7~1.;T~-5
Design Engineer: 0019 Flattop Technical Services
Owner Name: Dorothy L. Odom
Owner Address: 4620 E 112TH AVE
ANCHORAGE, AK 99516-1610
Parcel ID: 015-171-08
Site Address: 004620 112TH AVE E
Lot Size: 18880 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [~ Septic Tank
[] 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: ..5-"! 4~'"'-,/' ~T).~
Issued By:
Date:~
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Permit Number.SW O,~D/! /
Property owner(s)
Mailing address (1)
Mailing address (2)
Legal description (Lot, Block & Sub'd.) Lo~
Legal description (Section, Township & Range)
Lot Size 1~8~
Day phone "~ ¢~'-
Acre~.
Zip Code
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Number of Bedrooms
[-'] Well Only r-]
[-'1 Water Storage []
F-'I Jacuzzi []
[--I Water' Softening Unit []
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.
(Signature of property owner or authorized agent)
Permit Fees: ~
Date of Payment:
Receipt Number:
Waiver Fees:
Receipt Number:
THEODORE F. MOORE, P.E.
PH: (907) 345-1355
M.O.A. DSD
P.O. Box 19-6650
Anchorage, AK 99519
April 24, 2003
14530 EcHo ST.
ANCHORAGE, ALASKA 99516
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for
a permit ,[o upgrade the wastewater disposal facilities on Lot 5, Block 7, Greenland S/D, located at 4620
East 112"' Avenue. We are also requesting a lot-line waiver allowing the proposed trench to be
constructed within 2 feet of the lot line. The existing wastewater disposal system is operating in a
surcharged condition. Soils logs, perc test results, a site plan, design drawings and specifications are
enclosed for your review.
The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil
log, the native material below 1 foot is a silty gravelly sand with a measured pert rate of 2 minutes per
inch. Despite the relatively fast measured percolation rate, this design is based on a more conservative
0.6 gpd/sq, ft. Therefore, this 3-bedroom residence requires a total absorption area of (3 x 150)/0.6 = 750
square feet. The proposed 63-foot long trench design with an effective gravel depth of 6 feet has a total
absorption area of 756 square feet.
The topography of the lot in the area of proposed construction is generally level. The purpose of the
requested waiver is to allow construction ora maximum length single trench and to locate it to one side
of the only available area on the lot. This should allow room for a parallel replacement trench to be
constructed to the east of the proposed trench in the future after the soil in the vicinity of the existing
seepage pit has had a chance to rejuvenate. The two foot separation would be from the south lot line
which fronts a 20-foot alley, so there would be no adverse impact. The trench would also be about 5
feet from the west lot line abutting Lot 6. I recently did the engineering work to upgrade the system on
Lot 6 and there is ample room for further upgrades without adverse impact from the requested lot-line
waiver.
The proposed project will have no significant impact on present or future water supply and
wastewater disposal systems serving adjacent properties,' nor will it have any significant impact on
reserved space-surface and subsurface, or on drainage.
Please give me a call at 345-1355 if you have any questions on this submittal.
Sincerely,
Ted Moore, P.E.
I · .' S 112 LOT 21, SEC. 22
, T12N, R3W, S.M,
I ! ; EAST 112th AVENUE \ \
' R 100' WELL~o (~--- WELL '
I ~-~ , R 100' i
' ' ' '
I
i i ~ ~ SEPTIC
J ', ', LOT6 J :'::; ?; ~'; { ! ! ii : LOT $ _>'" ,' ,' A
i ' ',
i ' i BLOCK 7 ,
I '
27'
I T.H. .... -~
I .... -'--" --='-'-'--- ~ / 1000GAL. SEPTICTANK
...cz ...... ~ ~ '~ /
I - .... [--' :, ,.,
SEPTIC
- -~'~ ~.-~ ; SEPTIC TANK
I
I ~ WE
i'"
· I- ~ L_~ -r u ~_ABANDON EXISTING
o
I ~ ~ \CONSTRUCT NEW63-FOOT EONS
' n 20' ALLEY ~----SOIL ABSORPTION TRENCH WITH
J ~ 6.0 FEET GVL. BELOW DIST. PIPE
I SEPTIC AREA SEPTIC AREA '-.
I '- LOT 9
J LOT 7 LOT 8 ' ' ' - - -. _
I r aod
I ...... -!- - _. ,,~..?~ ?'~ ~ ra ~.s SEPTIC AREA
go?.?o,.?,?.~,,,~,,'~, ,,,, j~' ',¢ LOT 5, BLOCK 7, GREENLAND ElD
~ ~/"~' .... ;" ~",- ""~ WELL AND SEPTIC SYSTEM
i ~.~,o~o,,ooo? ~ SITE PLAN
~;~';~..'°.. . o.,' ~..~. 3, FLA'I-rOP TECHNICAL SERVICES I lNCH=40FEET
:~!!~ous~ '~",~ ...... .'.,; ~¢;~. 14530 ECHO STREET DRAWN BY TFU
i ~;' : ;: ~:' ~'~'~':~1':'~:~ ~ ~. ' ..... .,.,,C~ ANCHORAGE, ALASKA 99516 APRIL 2003
~ ~" ~! ~'":;::~': NOTE: THIS IS NOT A SURVEYED PLAT.
J ALL LOCATIONS SHOWN ARE APPROXIMATE.
========================================================================= c.o.
/' o.o. I LL'
"A" ~ ~ 1000-GALLON
· 4,, DIA. ASTM C.3034~/~ ~ SEPTICTANK
PLAN VIEW EXISTING WASTE LINE
SCALE: 1" = 10'
MONITOR TUBE
/ / CLEANOUT ,,
/~ MOUND BACKFILL 6
IIIII I ~ F,~T~F^~,C
/ ii ' ' I~ 4 DIA. F-810 PERF. DIST. PIPE
6.5 6i II. 1/2" - 2 1/2" SEWER GRAVEL
:',
CROSS-SECTION "A - A"
SCALE: i" = 5'
LOT 5, BLOCK 7, GREENLAND S/D
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATI'OP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, AK, 99516
SCALE: AS SHOWN
DRAWN BY: TFM
APRIL, 2003
TEST HOLE
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH
(~e0
9
10
11
12
13
FLATTOP TECHNICAL sERVICES
14530 ECHo ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 5, Block 7, Greenland S/D
Apdl 10, 2003
Domthy_Qdom
Pt and loam
SM/GM Silty gravelly sand
Less gravel below 7'
SLOPE
O~
:
· -~"', ,* ... -._'
<.?.- ', CE-3589 .' ,J'.,
SITE P~N
PERC
TEST
Depth to Groundwater Date
No_ groundwater 4/10/03
M.T. d[y 4/18703
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
_4L1D 12"Presoak 27_1/2
1~)" resoak ?7_3/4
Add_water_&_start 11:3_5:40 23_3/_8
#1 11:_45;_40 10 16_718 6112
Add_water 11:46_L15 73.3/8
#2 11:56:_15 10 16_3/_4 6_518
Add_water 11:56:50 23_3/8
#3 12.'06:50 10 16 7/8 61/2
14
15
16
PERCOLATION RATE 2 (minutes/inch) PERC HOLE DIAMETER 6"
TEST RUN BETVVEEN 6~Q__ FT AND 6.5__ FT
couuENTS:__Despite_rapid.measumd_pem_mte._recommend_desig n_be_based_on_0.6_gpd/~q J"t
PERFORMED BY FLATTOP TECHNICAL SERVICES. I.~"~ ~
ACCORDANCE WlTH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE: ,/8/7) ~'~ J ~ ~ '~'~'~::~ 3'
P&ttOp Technical$~
14550 ~_.c~o Street, Ancl~roOe, AK 99516
· (9o7) 34s4 ss
Lot 5, Block 7, Greenland S/D
4620 East 112th Avenue
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project consists of abandoning an existing septic tank and log crib seepage pit
and installing a new 1000-gallon septic tank that discharges effluent into a new 63-foot long soil
absorption trench containing a total of 6.5 feet of sewer gravel.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform to MUnicipal and State
requirements. All separation distances Shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around
any buffed utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components to ensure that proper drainage is achieved after settlement and that there are no residual
depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading
after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the
construction.
2.0 Septic Tank:
2.1 The existing septic tank and log crib seepage pit must be properly abandoned by thoroughly
pumping, removing the tops and backfilling with soil.
2.2 The new 1000-gallon, 2 compartment septic tank shall be Municipally approved and shall be set
level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a
4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial
type, rigid insulation.
2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the
waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot.
A cleanout shall be installed 1 - 4 feet from the building foundation, and a double cleanout shall be
installed within 5 feet downstream of the septic tank.
3.0 Soil absorption system:
3.1 The soil absorption system shall be constructed by excavating a 63-foot long trench to a depth of
10 feet below ground level. The long axis of the excavation shall parallel an existing contour
3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked
to allow proper infiltration.
3.3 A total of 6.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with
the perforated distribution pipes laid level such that the pipe inverts are no less than 6.0 feet above the
bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing
the #200 sieve.
3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on
the design drawings. The portion of the monitor tube extending through the sewer gravel shall be
perforated.
3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A
minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less
than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the
gravel, in addition to the filter fabric.
3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper than 3:1.
3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have
the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and
seed to promote rapid revegetation of all areas disturbed by the construction.
4.0 Inspections:
4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface to ensure that it is level and at the right elevation, and conforms with the 'soil test
information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected
up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and
grading is complete. The septic tank requires one inspection after it is set level and the piping
connected, but prior to backfill. This inspection may be incorporated with any of the above inspections.
4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastcwatcr Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci.anchorage.ak.us
(907) 343-7904
Waiver Review Worksheet
WR#: WR030031
PID#: 015-171-08
HA#:
Permit:
Date Received: 4125103
Legal Description: Greenland Block 7 Lot 5
Engineer: Theodore F. Moore, PE
Flattop Technical Services
Applicant: Dorothy L. Odom
Waiver Requested: 2 feet from proposed trench to lot line
Criteria: Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Points:
Waiver is Granted: '~ Waiver is not Granted:
List Conditions or Reasons for above: :~' ~A/~,I~VE'E'/,~ "~' ~'77'~ ~/-/~"~
Date: ~ ~ .~ By: /"~/~/{/
Name of Reviewer
m m m mm mm mm mm m m m m mmmm m mmmmmmmm m m m m m m mmm mmm mmmmm m mm mm m mmm mm m mmmmm mm mm mmm mm mmm m m m m m mmmmmmm m mm mm m mi
Rec#: 34416 Amount: $150.00 Date Paid: 4125103
Municipality of Anchorage
George P. Wuerch, Mayor
P.O. Box 196650 · 4700 S: Bragaw Strcct
Anchorage, Alaslm 99519-6650 · (907) 343-8301
http://xxxx'w.ci.anchorag¢.ak.us
5/1/2003
I
Department of
Public Works
Theodore F. Moore, PE
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Subject:
Waiver Request for Grdenland Subdivision Block 7 Lot 5
Waiver Request #WR030031
Parcel ID #015-171-08
Construction Permit Number SW030111
Dear Mr. Moore:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
2.0 feet.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water & Wastewater Program
GREF' .R , NCHORAGE AREA BOR JGH
Department of Environmenta~ Ouality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MAILING ADDRESS ~'20 J/~/. ~'0
LEGAL DESCRIPTION
PHONE
M AN U FACT U R E R t..~[.~
NUMBER OF
MATERIAL ~,'~J"-'~ /~/~ COMPARTMENTS.
INSIDE WIDTH
LIQUID DEPTH __
.LIQUID CAPACITY /O~ (~ GALLONS.
SEEPAGE PIT:
/
NUMBER OF PITS / DIAMETER ~ OR WIDTH~Z~/',/ LENGTH o.~, DEPTH
LINING MATERIAL d~--II~ CRIB SIZE: DIAMETER~/~' DEPTH 7 DISTANCE FROM: WELL /2~J:9/2 /~Z~;/.
BUILDING FOUNDATION,~.5 NEAREST LOT LINE~)1 ' TOTAL EFFECTIVE
, ABSORPTION AREA (WALL AREA) 6 SQ. FT.
ADDITIONAL ABSORPTION
WELL: r)t~o ~e~
TYPE II~bll)/h~rtb CONSTRUCTION
BUILDING NEAREST
FOUNDATION , LOT LINE
CESSPOOL , OTHER SOURCE5
APPROVED DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
, SEWER LINE , TANK __ , SYSTEM
REMARKS
DISTANCES:
INSTALLED BY: "~O[L"//¥ '~i<g'
PIPE MATERIAL: ~lt 0AE"
LOT SLOPE:
REMARKS: ~,I~L]
Form No. EQ-031
DIAGRAM OF SYSTEM
DATE ~ ¢'~, /~)7...,'.'~ APPROVED '~,~¢L/./~,~' L/)- ~J~/I~Z4~
G.A.A.8.
GrEaTEr ANChOraGe ArEa BOrOUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456 !
SEWAGE DISPOSAL SYSTEM - , APPLICATION AND PERMIT
PERMIT NO.
INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT ~
· DRAIN FIELD
FINANCED THROUGH TO BE INSTALLED BY
so,L TEST RESULTS. ~//~../~/~'~, ,
COMPLET,ON DATE ANT,C,PATED-- /~ ~ ~
OTHER
NOTE~ THIS PERMIT IS NOT VALID WITHOUT SOIL 'r~sT
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE /~'~
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK ~
FOUNDATION TO SEEPAGE PIT ~ O
SEPTIC TANK TO SEEPAGE PiT WALL /--~'
SEPTIC TANK ,~' ~ . SEEPAGE PIT ,;~
TO NEAREST LOT LINE.
WATER .~. TO SEPTIC T~NK /0
DR'Al N FIELD /0
DRAIN FIELD
SEPTIC TANK. 50 ' . SEEPAGE PiT /'~:)0 DRAIN FIELD ~("0
TO RIVER. LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
Flared WITH AIRTIGHT REMOVABLE CAPS.
· DRAIN FIELD ,/~"~
· ', SEEPAGE.PIT ' ?00 )
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G .A .A. B. ~
DIAGRAM OF SYSTEM
I
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DATE q--.2 /2-- 7~7 APPL,CA.T'S S,GNAT..~')-- - '~'-';--'-~ ---,~,'--.---~ .
FORM NO. EQ'OI 6
-~]':' ,- ~l'~ 'lEl' ~2,~-~AIXOEPAREMENT OF ENVIRONMENTAL QUALITY CASE
, . ANCtiORAGE, ALASKA 99502
Per~ormed For~~_~_Bj~m~n~' - Date Performed ~/~4/?.~
'Legal Description: LO t__5__B 1 DC ~_S ubd i v i ~ ~ o '
This.Form RePOrts Soils Log ' n~est
Depth
Feet
Was Ground
If Yes, At
Soil Characteristics
Brown Silt (ML)
Brown Gravelly Silt (ML)
Gray Sandy Gravel
Gray Silty Sand w/Gravel Seams
'and .Pockets (SM)'
Water'E~countereU? No
What DePth?
Reading ·Date
Gross
Time
'
.Net Time Depth .to H20
Ne t
Drop
I
~e'rcol'"a'ti on' R'~te M'inute
Proposed Installation: Seepage Pit XX Drain Field
Depth Of Inle.t · Depth To Bottom Of Pit br Trer, ci~ ,
COMMENTS i 211 sq. ft o~ clra~nage area ~s required per bedroom. ' ' '
Yes:" P6rformeo' .By. R .~.. O.,~r]is~e ~ ojta
· Alaska ·Mineral & Materials Lab, Inc~
C e r t i f'i e c[~ y: ~~:~q~'~a . .
Date: ~/2~/?$ '-'
.~GREATER ANCHORAGE AREA BOROUGH ~-~/~__-xt~ ~.¢-
Department of Environmental Quality /~,c
3330 "C" Street, Anchorage, Alaska 99503 :i274-4561
'Date Received
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Time of Inspection
Date of Inspection
Address:
Approval requested by: i.. ~
Mailing Address: -]~ ~',E'O 'rd '" ~..~" ~"
Property Owner: ~.,~j,, ,~. J.~--,~ ...... '"
/ ~
3. Legal Description:
5. Type of facility to be inspected
Phone:
Phone:
e
e
No, of bedrooms
Wel 1 · Data~~;;]~.. ;, ,.
A. Type~ ~... B. Depth
C. Construction ~;.~...~ _. .... _~ 'D; B'acte'~ial "Analysis
Sewage Di sposa 1 Sxstem,~~~~-~---~-/-'
C. Septic Tank: 1. Size /~/7~ 2. Manufacturer
, Absorption area
, Other contamination
~,~i , Absorption area
E. Disposal Field: Total length of lines
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septiciitank
C. Absorption area to n6arest lot line
EQ-034 (1/74) '~
, Sewer Lines
:1
Page 1 of two pages~
'GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
· l. Type of. Inspection: .CMRO VA ~ FHA'
2..ProPelrty Owner:
Mailing Addressl:
Name of Buyer:
'Mailing Address:
Name of Lending Institution:
Day Phone
Mailing Address: Phone
Name of Realtor or Agent: /:(~o~r~.~.~/~_~
Mailing Address. .~Yfff~ ~
Legal Description:'
Locati on:
Type'of Facility to be inspected:
water Supply
Type Of Supply: Public Uti.lity
No. Bdrms. ~.~
individual '.~/
If Indivi.dual, number of dwellings.presently .served · .
I.f Individual, depth of well.,//~?~ Im
Sewage Disposal. System
Type,of S~stem: Public.UtilityI
If'Individual
IndividUal (on-site)
date of i·nstal 1 ati'on ,_~:~~,i/_~/ '~'~
Page 2 of two pages - R est for Approval of Individual ,wer & Water Facilities
Legal Description
Comments
Approved
~ pproval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in 'this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site 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. 0 r ¢' - /'~! - ~,~ ~
1. GENERAL INFORMATION
Complete legal description Lo/'
Location (site address or directions)
Current Property owner(s) /~o'-~'
Expiration Date:
. Mailing address /1/d'?--O ~'
Lending agency {x/~.lt c Fa,"~c/
Mailing address
Real Estate Agent ~" · .,-',. *,.'
Mailing Address
Day phone '~'
A-,~c6..,"'
Day phone
Day phone
Unless otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY: '
Individual Well []
Individual Water Storage []
Community Class Well []
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
[]
[]
[]
[]
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HA,&) 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 sewed 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 pdvate or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a pedod 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(ara) 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.
NameofFirm F'/c~/-,.~p 7-~c6~q,;¢~/ ..C~,','-~¢~_/
Address I¥~'D ~
Engineer's Printed Name
Phone ~' y_c'- 13' ~,~-
Date '~--cdv ~_Z. ,?-CO}
DSD SIGNATURE ~~ ~ ;,,,,,,~
]/ Approved for ~ ~drooms. ~ ~,' ' · ~
Disapproved. . ~, ~, "' ..... . (~
Conditional approval for bedrooms, with the following stip~]atiohs~,~='~'
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory ..
Well Flow Advisory
(Rev. 01/02)
Maintenance Agreemen. ts
Supplemental Engineer's Report
Other
Original Cedificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK g9519-6050
www.cLanchorage.ak, us
(907) 343-79O4
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type ?~'/'
Date completad ~
Total depth .'~ I~ f.
IfA, B, otC provide PWSID #
Sanitary seal (Y/N)
Cased to ~ 18~ lt.
FROM WELL LOG
Parcel ID: C:s ! .S~- / 5-/-~,,~'~
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform O colonies/100 mi.
Arsenic: '-' mg./l.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ~?/'~ r~
Weld Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground) I ~. in.
AT INSPECTION
g.p.m. ~.Jf g.p.m.
Nitrate ~,O, I mg./I. Other bacteria ~. colonies/100 mi.
Date of sample: 7/P'1/o...~ Collected by: ~(~/-~ 7'e~ K'~¢
Tank size IO~,~ gal. Number of Compamnsnts
Foundation cleanout (Y/N) Y' Depression over tank (Y/N)
Date of pumping ~..,~ (_ M.~ cu~ Pumper H'
ABSORPTION FIELD DATA
Date installed 5'/~/c~ Soil rating (g.p.d./lt~ or ~/bdrm)
Length ~',~ lt. V~dth '~ .~ ft.
Total depth ~. ~ It, Eft. absorptJon ama '75~',~ Monitoring tube Y'
Date of adequacy test A/./5. (M~e,~,) Results (Pass/Fail)
Fluid depth in absorption field before test ~ in. Water added ~ gal.
Elapsed Time: 0 min. Final fluid depth _~_ in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
Date installed 5'1 ~ /
Cleanouts (Y/N)
High water alarm (Y/N) A/. ,~.
System type "7-fe~
Gravel below pipe ~'. C~ ft.
Depression over field ~L~
For ~ bedrooms
New depth O in.
~.5'~, g.p.d.
If yes, give date
D. LIFT STATION /~. ,~.
Date installed
'Pump on" level at in.
Datum
E. SEPARATION DISTANCES
Size in gallons
'Pump off" level et in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot I C) 3 '
Absorption field on lot I ~' ~
Public sewer main lc/. A
Sewer/septic service line
Manhole/Access (Y/N) ...
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots ';> ! 4~'
On adjacent lots. ",>
Public sewer manhole/cleanout
Holding tank ,k/./~..
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Property line ~c)' Absorption field
Water service line ';> cc,' Surface water
Building foundation
Water main /~.
Wells on adjacent lots
Building foundation ~r ?.. ' Water main N'. ,4.
Surface water ~ ~ oo ' Driveway, parking/vehicle storage. ~ .,,'>'~ '
Wells on adjacent lots ~ ,' ~'~"
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 3 '
Water Service line "~
Curtain drain k,/~,~,
COMMENTS
in.
HAA Fee $ ~'-"-*~
Date of Payment 7/ .3
Receipt Number "~q
(Rev. 12J01)
Waiver Fee $
Date of Payment.
Receipt Number
ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name
Date ,~",.< Iv 'ZZ. ?_oo
GREENLAND' SUBDIVISION
LOT 5, BLOCK 7
18,080 S.F. (REC)
EAST 1 12TH AVE.
~00.~9'
s 89'55'30"E IO0.O0'(REC)
EXISTING EIUILDfN{3
19.0'
1"=20'
· <,.
SEPTIC
22.7'
S 89°55'20"E IO0.O0'(REC) N
:z
GREENLAND 'SUBDIVISION
LOT 5, BLOCK 7
~8.oso s.r. (REC)
EAST 112TH AVE.
loo.19'(v~s)
s 69.55'3o-£ loo.oo'(E[c)
X 4,I,
19.0'
1 "=20'
22.7'
