HomeMy WebLinkAboutALPINE TERRACE BLK 1 LT 8
Name
MUNICIPALITY OF ANCHORAGE -
DEl TMENT OF HEALTH AND HUMAN SER¥ S
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
No. of Bedrooms
Address
CIO /Zoo
~ Permit No
Phone(s)
LEGAL DESCRIPTION
J I Subdivision
Lot ~ B~ock t A/?,"~
Township, Range, Section
TANKS
WELL
LOT LANE
FOUNDATION
DISTANCES
WELL
SEPTIC
TANK
5-¢
ABSORPTION
FIELD
AS-BUILT DIAGRAM (Show location ol well. septic system, property lines, Ioundatlon.
dnveway, water bcd*es, etc.)
SEPTIC [] HOLDING
Manulacturer Capacity in gallons
Materlai No o Com~.~ments
TYPE OF SYSTEM
[] TRENCH '~ BED ~] W. DRAIN [] OTHER
Depth to p~pe bottom horn Total depth from original grade
or~g,nai grade/~,}oe ,5 ~',J, ovE ~'~- FT / - ~ FT
Fill added above original grade Gravel depth beneath p~pe
Grave~ ~ength Gravel w~dth
~ ¢ Ff / ~ FT
TOtAl absorphon area Distance between hnes
Number o~ i,nes
Pipe
material
installer Date Installed
WELLS
PRIVATE
Classdlcat~on (A,B,Ci
REMARKS:
[] OTHER {Identify}
q'otal Depth
FT1 Cased to
I
Date nstaled:
FT
Scale: /~ .5-;~ r~ tV
Inspecbons Peflorrned by:
Date
~unicipalandStategld~flinesinellectonthisdale~) ~_.~ 27-~-/ /~Sff.
HealthDepa.mentApprova,' ~' '~~ '~'~' Date
72-013 (3/85)
ENGINEER'S SEAL
2.10
// /
~'~)Ei'i:::'~.:iJ::;:TMENT [}.. K-~E~i~-'-'~t..'TH AND EN',,~ ]: I::;;(i]N[.~E~.iNTAL i ..)TE(Z;'T';r. ON
825 [.. '.:.!ii:TF;:EET'~ ANE;HORAGE, AK 9950 !
,:..:. ,:=,.L~ ...... ]. ,. ~:.
08 /:'20 /E! 6
MIKEL,..I ....MURPHY
L']/fl I;2.0() B) 33RD ~.-.¢vE.
ANCHORAGE, Al< 99503
561 .-.-504.0
LOT: 8 BLOCK.:: 1
am fam~.iiaP with the r'ec.!Lti!-emer"~'t.s fop on-site se~'~E.:,rs and wells as set
f'c)pth~ by the i"tu.r~icipa].i'Ly of Ar~cl-'~cCr'age (MOA;.' and the State of Alaska,
w:i.].l ir"~sta;L1 the system in accor'dance wit. h all MOA codes and regulat:i.c.',r"~s,
~,~ ir"~ cc) mpliance with the design c.:r'iter'ia c,f t. hi~ per'mit.,,
will adhere 'Lc, a!]. ?'IE)A and State c,f Alaska requirements fop the set [::,ack
d:ist.;[~nc,,.:.:.,s fporn ,'.:-',.r"~y e.:.:::i, st..:Lr~g we].l, wast. ewateP disposal system or' pLtDIic::
s(-;¢(.~er'a(:'_.t(-.'.? '.--:.~ystEcm (::;r'~ t. hiE.~ (::~r' any ~CJj~..':'tCE.~ri'~. C:~P neaPby lot.,
I:I:::' .... A t IFT "'T"""]'Ot',I,:_,, ~* ~ .... , ]'"'.0 tNSTAL. L..ED IN AN ARI:<A r":OVE:'FRED ....... BY MOA BUIL. DING CODES
I'F-E?N (I) AN EI_...IECTRICAI .... PERMIT AI',ID INSF'E;CTtON MUST BE C)BTA!NED; (2) AS-.BU]:LTS
MII....L NCiT BE AF:'PROVED Wt'THOUT AI',I ELEC"f'I.q'.ICAt .... INSF'ECTION RfEPORT'~ AND (3) -r'HE
E;I...iEE; 'f'R I CAI .... WOF,'K MUEFf' BE. DONE BY A L.. I CIE!',ISED EL._E:.C T'R I (31AI'..I ,,
t :S'.i.9 t. t E.(} h: ¥
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: ~1~/~
DATE PERFORMED:
"~~ Township, Range, Section:
( EN Gl I~,~E R'"~,.S EAL)
1
2
3
4
5
6
7
8
9
10
11
12
13
SLOPE
WAS GROUND WATER ,/~.~.
ENCOUNTERED?
S
IF YES. AT WHAT ,~y/ OL
DEPTH? p
E
Depth to Water After~
MonilorinD? /'? Dale:
SITE PLAN
2'~o
14
15
16
17
18
19
2O
Reading
Depth to
Water
.
Date
Gross
Time
Net
Drop
Net
Time
/o
/o
/e
/o
/o
PERCOLATION RATE ~' t (minutes/inch) PERC HOLE DIAMETER
COMMENTS ~'~/~' ~
~/.. ~_.,4-~-~
PERFORMED BY: ,~
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
',
CERTIFY THAT THIS TEST WAS PERFORMED IN
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
/~/~' ~..~Township, Range, Section:
(ENGINEE~.S SEAL)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
DEPTH
(FEET)
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
S
t L
IF YES, AT WHAT
~'., . O
DEPTH?
P
E
Oepth to Water Alter.~,, ~/
Monitorino? 'Date:
Gross Net Depth to Net
R ~,,~'-'~"" Date Time Time Water Drop
PERCOLATION RATE __
(minutes/inch) PERG HOLE DIAMETER
TEST RUN BETWEEN __ FT AND __ FT
PERFORMED BY: ~ ~' ~/~ I ~,~ ~~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORMED:
(ENGINEER'~r~)
LEGAL DESCRIPTION ~-~'~' ~'/
,,~Z./~,4/~"'~ownship, Range, Section: "~.~ ~,~'~,J
SLOPE
SITE PLAN k~,
N
·
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
(.
WAS GROUND WATER
ENCOUNTERED?
S
/ L
IF YES, AT WHAT .~r. O
DEPTH? '~' p
E
Deplh to Water After
Moniloring? Dale:
Gross Net Depth to Net
R~ Date Time Time Water
Drop
PERCOLATION RATE __
(minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN __
FT AND __ FT
PERFORMED BY: ~'~' ~'~ '~/~"~(~ ' ERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:~
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DATE PERFORMED:
Township, Range, Section:
( EN G 1%'~....AL)
SLOPE
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Depth to Waler After
Monitoring? Date:
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
__ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN
COMMENTS
__ FT AND FT
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION:~-~"'~"' ~'~/ ~-~4~' "~~ Township, Range, Section:
(EN G I,~EAL)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Depth lo Water Alter
Monitoring? Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
-- (m~nutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN
COMMENTS
__ FT AND __ FT
PERFORMED BY: /~:~ ~P~' ~llJ/~//~ I IFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7-/~'''~
72-008 (Rev. 4/85)
ALASKA I I uIROFIITII FITAL COI1TROL $1 F uiCl $, IFIC.
~nqJn¢¢rJnq Fa ~nuironmentol Studies
SPECIFICATIONS FOR BED WASTEWATER TREATMENT SYSTEM - LOT 8, BLOCK 1,
ALPINE TERRACE SUBDIVISION
1.0 GENERAL
1.1 THE DRAWINGS, SHEETS 1 THRU 3, SHALL BE PART OF THIS
SPECIFICATION.
1.2
ALL MATERIALS AND WORKMANSHIP SHALL MEET THE
REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE,
DEPARTMENT OF HEALTH & HUMAN SERVICES (DHHS), THE
CONDITIONS OF THE PERMIT, AND ALL APPLICABLE
RULES AND REGULATIONS CURRENTLY IN EFFECT.
1.3
ALL EXCAVATIONS AND DEPTHS ARE ADVISORY, AND ARE TO BE
VERIFIED OR MODIFIED IN THE FIELD BY A DHHS APPROVED
INSPECTOR.
1.4
IT IS THE RESPONSIBILITY OF THE INSTALLER TO ADHERE
TO APPROVED DESIGNS FOR INSTALLATION, TO MAINTAIN THE
SPECIFIED SEPARATION DISTANCES, AND TO HAVE THE
APPROPRIATE INSPECTIONS.
1.5
IF THE INSTALLATION IS NOT INSPECTED BY AN AECS
ENGINEER, AECS WILL NOT BE RESPONSIBLE FOR THE
SYSTEM. AN ENGINEER AT AECS SHOULD BE CONSULTED
PRIOR TO CONSTRUCTION, TO DETERMINE THE NUMBER OF
INSPECTIONS THAT WILL BE REQUIRED AND TO EXPLAIN
WHAT THESE INSPECTIONS WILL INVOLVE.
2.0 SEPTIC SYSTEM (NOT USED)
3.0 SEEPAGE BED
3.1
THE GRAVEL FOR THE BED SHALL BE 0.5 TO 2.5 INCH,
SCREENED ROCK WITH LESS THAN 3~ PASSING #200 SIEVE
RESIDUAL. ALL SUBSTITUTES MUST HAVE PRIOR DHEP
APPROVAL.
3.2 THE BOTTOM OF THE EXCAVATION SHALL BE LEVEL AND RAKED
WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT
BEEN COMPACTED DURING EXCAVATION.
3.3 THE DISTRIBUTION PIPE SHALL BE 4-INCH RIGID PVC WITH
A MINIMUM CRUSH STRENGTH OF 1500 LBS. ALL PIPES SHALL
BE LAID LEVEL, AND SPACED ACCORDING TO THE DRAWINGS.
3.4 MONITOR STANDPIPES SHALL BE PLACED AS SHOWN IN THE
DRAWINGS. THEY SHALL BE RIGID PVC ASTM D-3034, OR
OR 4 INCH DIAMETER CAST IRON. THE SECTION SHOWN WITH
HOLES MAY BE EITHER DRILLED 0.5 INCH HOLES ON THE 6 INCH
1200 UJcst 33rd Aucnu¢, Suite B, Anch0ro§e, Alaska 99503 0(907) 561-50z10
CENTERS ON OPPOSITE SIDES OF THE PIPE, OR A SECTION OF
REGULAR PERFORATED SEWER PIPE MAY BE CLAMPED TO THE
SOLID SECTION WITH A NO-HUB COUPLING OR SOLVENT JOINT.
A RUBBER RAINCAP (JIM CAP OR EQUIVALENT) SHALL BE PLACED
OVER THE TOP OF THE PIPE.
3.5
IF THE FINAL GRADE OVER THE BED IS LESS THAN 4 FEET
ABOVE THE GRAVEL, INSULATION IS REQUIRED, USING DOW
EXTRUDED BLUE STYROFOAM BOARD. THERE SHALL BE 1 INCH OF
THE
INSULATION FOR EVERY FOOT OF SOIL LESS THAN
OF
4 FEET OF COVER, BUT THERE MUST BE AT LEAST,~8'INCHES
SOIL EVEN THOUGH INSULATION IS USED. THE SOLID PIPE
EXTENDING FROM THE SEPTIC TANK TO THE DRAINFIELD SHALL
ALSO HAVE 4 FEET OF COVER OR AN EQUIVALENT LAYER OF
INSULATION COMBINED WITH SOIL TO PREVENT FREEZING OF
THE LINE.
3.6 IF INSULATION IS NOT NECESSARY, THEN THE GRAVEL MUST BE
COVERED WITH A LAYER OF A NONWOVEN FABRIC (SUCH AS
MIRAFAI, FIBRETEX 200 GRADE, POLY-FILTER X, OR
EQUIVALENT). ~- ~,~l~-- ~-~ ~~,/ ~,.~l'Y'Y¥
3.? THE TOP AND SIDES OF THE BED SHALL BB PLANTED WITH A
WHITE CLOVER AND RED FESCUE MIX OR BLUE GRASS.
3.8 FILTER SAND SHALL MEET THE REQUIREMENTS OF AG 86-21,
15.06.077 A, 3.
4.0 INSPECTIONS
4.1
THIS BED WILL REQUIRE TWO INSPECTIONS. THE FIRST
INSPECTION WILL BE OF THE OPEN EXCAVATION, TO ASSURE
THAT THE SYSTEM IS INSTALLED IN PROPER STRATA AND
DEPTH.
4.2 THE SECOND INSPECTION WILL BE AFTER PLACEMENT OF THE
GRAVEL, MONITOR STANDPIPE(S) AND DISTRIBUTION PIPE TO
VERIFY PROPER INSTALLATION AND MATERIALS PRIOR TO
BACKFILL.
5.0 THE LIFT STATION
5.1 REFER TO THE ATTACHED ANCHORAGE TANK 500 GALLON LIFT
STATION SPECIFICATION.
5.2 PROVIDE A CALDER COUPLING AT THE CONNECTION OF THE 4"
SOLID PVC INFLUENT PIPE AND 4" STEEL NIPPLE.
5.3
MOA BUILDING CODES: WHEN LIFT STATIONS ARE INSTALLED
WITHIN THE MUNICIPALITY, AN ELECTRICAL PERMIT AND
INSPECTION ARE REQUIRED. IN AREAS NOT COVERED BY MOA
BUILDING CODES, THE SYSTEM SHALL BE INSPECTED BY A
LICENSED ELECTRICIAN TO INSURE THAT THE ELECTRICAL
INSTALLATION IS IN ACCORDANCE WITH APPLICABLE CODES
AND RE6ULATIONS.
5.4 THE PRESSURE SEWER BETWEEN THE LIFT STATION AND THE BED
SHALL BE INSULATED WITH 2 INCHES OF DIRECT BURIAL
INSULATION AND BURIED NOT LESS THAN 4 FEET DEEP.
Anchorage Tank & Welding, In~.
2700 Porcupine Dr.
Anchorage, Alaska 99501
(9o7) 272-3543
'¥'ANK FOR LIFT SYSTEMS
SEPII[.: TANK SHALL BE"' A MODIFIED A~"-~C~'!ORAGE TANK
Slti:.EC TANK, THE DESIGN OR ANAI..,YSiS SHALL BE IN
ACCORDANCF WITH ACCEt:'iED ENGINEERING PRACTICE
AND LOCAL REGU!,.ATORY AGENCIES,
I'HE TANKS SHALL BE [EolGNED FOR LOADING
CO~.!DIT[ONS AS RI-ZQUIRED BY' MUNICIPAL AND STATE
REGULATIONS,
ALI, WEDDING SHALL BE IN ACCORDAix!CE WITH
APPLICABLE CODES AND STANDARDS,
COATING SHALL BE TNEME:": t~6.--1~65 HI-BUILD
TANK COATING AND APPLIED AS
SURFACE PREiPARATIO~',' - ALL SURFACES MUST BE
DRY, CLEAN, ANi) REASONABLY FREE OF RUST AND
MILL SCALF EXCESS RUST, MILL SCALE AND
WELDING SLAG SHALL BE RFiMOVED BY WIRE BRUSH
OR OTHER MEANS AS NECESSARY,
APPI.,ICATION SHALL BE AIRLESS SPRAY TOUCH UP
WITH BRUSH OR ROLL. ER,
THiilNNING SHALL BE ACCOMPLISHED WITH
APPROVElq MATEF'IAL, ANI) WILL NOT EXCEED 5%,
SURFACE TEMPERATL.;I~E SHALL NOT BE BELOW ~OF
OR 5 BELOW DEW POINT WHICH EVER IS LOWER,
IN]ERI IR SHALL BE COATED TWO TIMES Ah~D SHALL
BE A MINIMUM OF 20 T~RY MILLS EXTERIOR SHALL
BE COATED ONE TIME ANB SHALL BE A MINIMUM
0~:' 10 I)RY MIL. L,S.
j
RISER
Anchorage Tank & Welding, Inc.
2700 Porcupine Dr.
Anchorage, Alaska 99501
(007} 272-3543
OUTLET RISERS; SHALL BE GALVANIZEB STEEL CLIL.VERT,
AND SHALL BE 5~+ INCHES (MIN]i~',UM), HIGH, SHALL
HAVE A MINIMUM NOMIHAL D]A~!ETER OF 2q- INCHES,
ANB SHALL BE C.P.~PABLE OF BEING EQUIPPED WITH
FOLLOWINi:'
A. A JUNCTION (NEMA bX) BOX OR EQUA!.., BONDED
OR ATTACHED TO THE RISER,
B. UL LISTED ELECTRICAL CORi~ GRIPS, INSTALLED
IN THE J-BOX,
A L, IB - SHALL BE FURNISHED WITH 'I'HE RISER, IT
SHALL BE CEINSTRUCTED OF FIBERGLASS OR EQUIVALENT
AGGREGATE FINiIioH,
RISER INSTALLATIOi".! - EACH RISER SHALL BE SEALED
OR WELDED TO THE TOP OF THE TANK IN SUCH A MANNER
AS TO PREVENT INFILTRATION OF GROUND WATER
WHIilRE PRESENT,
D. INSULATION" 2" RIGID EXTRUDEI) POLYSTYREN[
SHALL BE PLACED IN THE RISER ])IRECTLY BELOW THE
LI D.
L
E. INSULATION - 2" SPRAYED URETHANE ON
CIRCUMFERENCE OF RISER.
Anchorage Tank & Welding, Inc.
2700 Porcupine Dr.
Anchorage, Alaska 90501
(9O7) 272-3543
EFFLUE:NT PUI,'i liNG ASSEMBLY
A, EFFLUENT PU~.ii"ING ASSEMBLY SHALL BE ORENCO
SYSI'EMS (TM) MODEL OSI WE 100O SERIES CONSISTING
OF FOLLOWING:
1/3 H,P, MYERS SSM25 115 VOLT OR EQUAL.,
SCREENElrm PUMP VAUbT (U,S, PATENT #L~q39523)
59" DEEP, 3/16" THICK H]GH-i)EiNSITY PVC
C¥'CLINDER HOUSES THE PUMP, LEVEL., COi,~Ft'~OL, S
AND SCREEN ANl"~ SEF:¥':'ZS AS A BAFFLE TO PREVENT
THE SCREEN FROM CLOGGING,
THE FIFILI![N 1-1/2" DIA, HOLES ARE DRIL, t.,ED IN
THE VAULT AT A LEVEL THAI PLACES THEM AT
ABOUT THE MIDWAY POINT IN THi~ DEPTH OF THE
~i;EPTIC,
FLAP CHECK: ALLOWS THE' VAULT TO DRAIN WHEN
REMOVIN(; FROM TANK,
SCREEN: 15" DIA, CYLINDER OF HIGH-DENSITY
POLYETHYLENE 1/8" HESH CAST INTO FIBERGLASS
BOTTOM,
3, A~..!.., PLUMBING SHALL BE PVC OR [)]'I.i!ZR NON--.
CORRODING MATERIAL,
PUMP CONTROLS AND ALARH SYSTEM -
CONTROL SHALl., ~E ORENCO SYSTEMS (TM) ML,--3F
CONSISTING OF:
1, AUDIBLE ALARM PANEL MOUNT WIlTH A MINIMUM Of
80 DB SI')UNI'~ PRESSURE AT 2fi-INCHES, OP,ZRATING
TEMPERATURE -~OA[ TO &~AC, CONTINOLIS SOUND,
Anchorage Tank & Welding, Inc.
~chor~e, Alaska 99501
(907) 272-3543
OIL-TIGHT VISUAL AL, ARM WITH PUSH-TO-SILENCE
F'tLiATURE, AUTOMATIC AUDIO-AL. ARH RESET,
15 AMP MOTOR RATED TOGObE SW)TCI--I, SINGLE
POLE, DOUBCE-THR(i~-.I WITH THREE POSITIONS;
MANUAL (MAN), AUI-OMATIC (AUTO>, AND CENTE~R
(OFF') (I--I.O.A.).
NEMA LI.X-R(.:,I'i!~D, FIBERGLASS, OR EQUAl.,
ENCL.,O'.i::L~RE WITH HINGED COVER,
LEVEL, CONTROL FLOATS SHALl.., BE ORENCO SYSTEMS (TM)
MF2 CONSIE;tlNG OF 2 MERCURY FLOATS ON A!).~!JSTABL~E
PVC STEM WHICH ATTACHES TO VAUI..,'f, ONE FLOAT
SIGNALS ALARM; THE OTHJ!iiI~ SWITCHES PUMP ON-OFF,
INSTALLATION, AI.,L PUMPING SYSTEMS SHALL BE
INSTALLED IN ACCORDANCE WITH THE MANUFACTURER'S
RECOMMENDATIONS AND STANDARDS,
ALASKA ENVIRONI~-.NTAL
CONTROL SERVICL INC.
1200 West 33rd Avenue, 'Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
JOB
SHEET NO
CALCULATED BY
CHECKED BY
SCALE /"~ s~
DATE
DATE
/
/
ALASKA ENVIRONI~Z~NTAL
CONTROL SERVIC, , INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
JoB /°4 ~r ~/.~c> / ,,~/~,,,~¢
SHEET NO. ~ OF
CALCULATED BY 1. ~E.~ DATE
CHECKED BY DATE
r
ALASKA ENVIROI .... ENTAL
CONTROL SERVICES, INC.
12oo West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(gO7) ~1-5040
cO
SHEET ~0
CALCULATED 8Y
CHECKED BY
DATE
DATE
L>£ 7,~/Z. 5'
If ~r~
.~-- 7'e ¢ 3'"'
HI:IL;'
~nd r~Ing r~cho~ls~
NEN'~ ~.X Juncl;Ion box
24' %~ x 4' 6'Cutver~c Ma~nhote
~lexflote hose
;~' sprayed t~e~;h~ne Fc~n
! 1/4' PVC pipe Typ
1 I/4' PVC check v~tve
AdJus"tc~bl.e F'Loci'f, Swrt;ch Assenbty
Secit wl'l;h RAH-NEK or Equc~t
rubber' gromne'l; or welded
s'teet ! t/4' prpe
1/4' cil~l dr-o, ln bo, ok hole
1 3/8' bore.; 6' DC
1/8' ~esh potye'thyiene screen
/5' dl~ x 39' hlgh
Retcuntng cmgtes
~/3 hp eFFtuen'l; pump, vm,-Ious m=nuFc~e
ALASKA eiidlBOFIITI F/TAL COF/TROL SE [ ulC $,
August 13, :[986
Department of Health
and Human Services
825 L Street
Anchorage, Alaska 99501
Attention: Steve Morris
Re:
Lot 8, Block 1, Alpine &~l's Subdivision
Dear Steve,
Attached are the amended drawings for the bed for the subject lot. This
is the only location on which to place an on-site system.
The purpose of this drain is to keep the water level at the present
condition so that there will be no encroachment on the 2.2 feet of dry
soil. It would be very difficult to place the curtain drain on the lot
line as there are buried utilities in this area. The proposed drain
would be 10 feet from the drain and would dump into a rock fill near the
exsisting crib system.
Since the drain water would run into a rock fill, there would be no
danger of it creating a health hazard if there were any leakage from the
bed to the curtain drain.
If you have any questions, please let me know.
Sincerely,
PhD. , P.E.
1200 UJest 33rd Auenue, Suite [~ · ~nchoracl¢, /~leske 99503-(907) 561-5040
ALASKA ENVIRONMENTAL
CONTROL SERVIC INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
~os ,Lo-t- '~ ~glo¢/~ /; ,4/?,,,~e ~*~c~,
SHEET NO / OF ~ '
CALCULATED BY ~' ~ ~'~ DATE ~ /~ ~
CHECKED BY DATE
SCALE ~ ~'~
/
ALASKA ENVIRONMENTAL
CONTROL SERVIC ~ INC.
12OO West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEET NO, Z OF '~
CHECKED BY
sc^LE ./'% /~*'
DATE
'1
~r2~
ALASKA ENVIRONMF,.NTAL
CONTROL SERVIC' INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
JOB
,Re '/ ~ / /
!
,2
-z�
MUNICIPAL17Y OF AtACHORAGe
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION:
'APR i 81986
MORRISON 4Vff--,I-DRILLING Cu. RECEIVED
DRILLING LOG. FOR. -2-5-64.
.e.
VORMT' ,._ ALPINE SUHvD�IV, .- �j L� � a
KIND OF MATERIAL L, -,W to/ S� nu1 n� S J
FORMATIONS. 7- / ANj P,30) S m
FROM ---o FT. TO 5 FT. FI LLG. GRAVEL
N3a --Q6065.�•3-
FROl'Vl- Tu 9 FT. OVER BURDEN,
PROM ---9 FT. TO 20 FT, GRAY CLAY
FROM 20 FT. TO 22 FT 311,T SAND.
FROM _ 22 FT. TO 27 FT, B.RO'f1N SILTY C.
FROM 27 FT._ TO 34 FT, GRAVEL& CLAY.
FROM 34 FT, TO 443* FT. CYT, GRAVEL
STATIC LEVEL OF NATER-35.FEET
E
DRAW DOWN 25 FEET.
GALLONS PER HOUR EIGHTEEN HUNDRED,
KIND uF CASING 6" BLACK
�L`'L..-�,: � `�' J� L�,^!w!.'',�l/ ���/-'t.^ n�L,�i� LGGLJ�•%•{L"
Parcel I.D. #
. ' MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES.
Division of Environmental Services
On-Site Services Section
P.O. Box196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Lot 8; Block I; Alpine T~rrace Subdivision
Location (site address or directions) 11701 H,,3t.Z~ide Drive
Anchora~e~ AK
Property owner Vicky Ch0 Day phone
Mailing address 11601 Hillside Drive Anchorage, AK 99516
545-1285
Lending agency
Mailing address
Day phone
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE. OF WATER SUPPLY:
NOTE:
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Individual well Y, XX
Community well
Public water
If community well system, provide written confirmation from State'ADEc attest-
ing to the legality and status of system.
,:, '
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-~.5(Rev. 1/91) Front MOA#21
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. 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~regulations in effect on the dat~n. , .....
'Name of Firm 5&5 .............. ~ / Phone
Address 17034 Eagle River Loo No.
Engineer's signature Eagle Ri~er, A~
D~S SIGNATURE
Approved for "~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the folloWing stipulations:
,By:
Additional Comments ..~~-~
Date
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. .
72.4~(Rev. 1/~l) Back MOA#21
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L~7- ~) /~_~ [
A. Well Data
· ~/./°//,JE 7-~ Parcel I.D.
~/~
Well type ~::Zl
Log present
If A, B, or C, attach ADEC letter. ADEC water system number /4J//JJ
Date completed ~'/..~/~ 4-- Driller
Cased to ~zJ-'/ Casing height
Wires properly protected(~l)
Total depth ~-~-'
Sanitary seal ~N) ~'~.~
FROM WELL LOG
Date of test
Static water level ~ /
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Septic/hc,~d~;'G tank on lot
Absorption field on lot
Public sewer main
AT INSPECTION
/0o r-k-
Sewer service line
Z~U (_ L / /,,J G Co.
; On adjacent lots
; On adjacent lots /O o '~-
Public sewer manhole/cleanout /Oo/~---
Petroleum tank
WATER SAMPLE RESULTS:
co,,o .
Date of sample: 8//?/
Nitrate
Z, ~ ~'~'/-~- Other bacteria
Oollected by:
B. SEPTIC~I~ll~T~TANK DATA
Date installed ~/7_.. '~ /
Cleanouts~N)
High water alarm (Y~
Date of pumping ~ /
Foundation cleanout~l)
Tank size ,//OOLT..P ~,~/~F_.Z.oi,~J' Compartments
'7'~r-_~ Depression (Y~.)~
Alarm tested (Y/N) ,,~///~
Pumper /~-/- /~0~'
SEPARATION DISTANCES FROM SEPTIC/i,I~E, iJIN~TANK TO:
Well(s) on lot /(...)C3 (7"- On adjacent lots /OO/-/~
To property line / 0 r./.._ Absorption field --~/-/-
Sudace water/drainage /'00 ~'/''
Foundation
Water main/service line
72-026 (3/93? F~ont CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Manufacturer ~
Manhole/A~~~''~
"Pump on" level at ~ "Pump off" Level at
~ycles tested
SEPARA~ FROM LIFT STATION TO:
Well. prr~t On adjacent lots
D. ABSORPTION FIELD DATA
Soil rating (GPD/FF) /-~'0
/ ~' Gravel thickness (_.3, .,~-' '
Cleanout present(~N)
Date installed ~' / Z ~ / ~'
Lengt, h ~,~ r 2 Width
Total absorption are~. ~ ~
Sudace water
System type
Total depth / -
Depression over field ('~
for ~-/..//~-~7 ~_~) Bedrooms
Dateof adequacy test ~)/Z.T/'~/-~ Results(~Jfail) P/'t$S
Water level in abSOrption field before test O After test
Peroxide treatment (past 12 months) (Y/N) /LJd~/.~E' /C/.Jo(.j/.J If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /C)O
To building foundation
On adjacent lots ~.c_.~
Surface water
Curtain drain /t.,r,~
On adjacent lots /~/-/'~ Property line
To existing or abandoned system on lot
Cutbank /~o,~d- ~/~"Water main/service line
Driveway, perking/vehicle storage area /~ r7'-
E. ENGINEER'S CERTIFICATION
ed to all MOA and HAA guidelines in effect o~h~:~'~- ~is inspecEon.
I
cer~'~y
that
I
have
che
Engineer's Name Eagle~i~er' A/'SlCa 9Y5i~')~/~//z'~/Date ' ' ','/'/' ~~i.'~I~ '~ ;~ ': · ..... ~ ....... ,~ .,:~'.~ ~' ', -'
o
HM Fee $
Date of Payment
Receipt Number
~)~ ~ Waiver Fee $
~ - ~.~-- ~Lr~" Date of Payment
O~~ (~Z_('.,,,"~ ,~ Receipt Number
72-o26 (w93)- Back
zTL
CT&E Ref.#
Client Sample ID
Matrix
ClientName
Ordered By
Project Name
Project#
PWSID
Commercial Testing & Engineering Co.
Environmental Laboratory Services ~~~l~'~~J~'J~'fJJ~JJJJJJ~JJJ~'J~'
LABORATORY ANALYSIS REPORT
94.4228-3
LOT8 BLK1 ALPINE TERRACE S/D
WATER
S & S ENGINEERING WORK Order 81456
Printed Date 08/19/94 ~ 14:41 hrs.
RAY CollectedDate 08/17/94 ~ 16:35 hrs.
Received Date 08/17/94 ~ 17:00 hrs.
UA Technical Director STEPHEN C. EDE
Sample Remarks:
Parameter
Nitrate-N
ROUTINE SAMPLE COLLECTED BY: SS.
QC Allowable Ext. Anal
Results Qual Units Method Limits Date Date
2.9 mg/L EPA 353.2/300.0 10 08/19/94
Init
DJS
* See Special Instructions Above '
** See Sample Remarks Above
U = Undetected, Reported value is the practical quantification limit.
D = Secondary dilution.
UA = Unavailable
NA = Not Analyzed
LT = Less Than
GT = Greater Than
5633 B Street, Anchorage, AK 99518-1600 -- Tel: (907) 562-2343 Fax: (907) 561-5301
ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA
Drinking Water Analysis Report for Total Coliform Bacteria
RE. AD INSTRUCTIONS ON REVER~E SliDE BEFORE COLLECTING SAMPLE
Commercial Testing & Engineering Co.
Environmental Laboratory Services
5633 t3 Street
Anchorage, AK 99518-1600
Tel: (907) 562-2343
Fax: (907) 561-5301
MUST BE COMPLETED BY WATER SUPPLIER
El ~UBLIC WATER SYSTEM I.D. # [" I
q~RIVATE WATER SYSTEM
D S~dRe. zut~ ~ Fl .SendInvoice
%'at~q'~em Na.matC. omgaay .Nme
Phone ~umber
1' ax :Number
(~ry $~at, 7,p Code
1'3 Send Resutts Fl Send lnvoice
Company Name
Month Day
SAlvfPLE TYPE:
Routine [] Treated Water
[] 'Repeat Sample (for routine sample [3 Untreated Water
with lab ref. n6. )
[] Special Purpose
Time Collected
S.~'LE LO CATION Collected By
TO BE cOMPLETED BY LABORATORY
Anal~sis shows this Water SAMPLE to be:
~Satisfactory
[] Unsatisfactory
[] Sample over 30 hours old, results may
be unreliable
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received ¢--/7-- Cd
Time Received [7;t~
Analysis Began ~ ~' t q
Analytical Method: ~" Mtmbrane Filter
[] MM0-MUG
* Number of colonies/100 rnl.
Lab Ref. No. Result* Analyst
Sent to A.D.E.C. Anch Fb'ks Jun
Comments:
Date: Time:
Client notified of unsatisfactoo' results:
Phoned Spoke with
Date: Time:
BACTERIOLOGICAL WATER ANALYSIS RECORD
MMO-MUG Result: Total Colifom ~ E Coll
Membrane Filter: Direct Count ~ Colonies/100 mi
Verification: LTB BGB COLIFIRM -
Coliforfft/lO0 mi
/ oo
Fecal Coliform Confirmation
Final Membrane Filter ResUlts
Reported ByT~fY'I ~e
TP,~C - Too Numerous To Count
OB - Other Ba~ria
Fa×ed
Faxed
91 / ~'/~ ,(~// Time
Member of the SGS Group (Soci~t~ G~n~rale de Su~edlance)
ENVIRONMENTAL FACILITIES IN A~S~, COLORADO. FLORIDA. ILLINOIS, MARY~ND, NEW jERSEy. OHIO, UTAH. WEST VIRGINIA
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4'744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
{
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
t oI
Day phone
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: -~ "~
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.
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 #21
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. 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 regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
DHHS SIGNATURE
~ Approved for
bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
Date 8- 2 7- 72
· 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 engineeCs work.
72-025 (Rev. 1/91) Back MOA I¢21
( Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: / ~'~fe I ~v'f'~; ~_ Parcel I.D. 01~"- ,,~q~,
A. WELL DATA
Well type ~'
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter.
Date completed
Cased to ~ Casing height
Wires properly protected (Y/N)
FROM WELL LOG
Date of test
Static water level
Well flow '~ 0
Pump level
ADEC water system number
~ _,.~_~ t~ Driller ~'~, · ~-; ~-v~
g.p.m.
AT INSPECTION
I II
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot I C~
Absorption field on lot
Public sewer main
Sewer service line ~' ~-, ..~
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
rrt
~>
~ co 212
WATER SAMPLE RESULTS:
Coliform ~/q l
Date of sample: R ~
Nitrate
Other bacteria {~
Collected by: ~ ~'z~_.-~-- ~-
B. SEPTIC/HOLDING TANK DATA
Date installed ~/~zy/~ Tank size ,//.,,'-~ O Compartments ~-
Cleanouts (Y/N) Y Foundation cleanout (Y/N) 7 Depression (Y/N)
High water alarm (Y/N) . ~//~' Alarm tested (Y/N) ~/~
Date of pumping 7//4 q/'/Z- Pumper /.,~-.C'-~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot I O ~
To property line ~-O
Surface water/drainage
On adjacent lots ~' 1/~:~ Foundation .-~ ~
Absorption field I ~:, Water main/service line ,.~ ~:~ O
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
,/,-~
Date installed
Manufacturer
Size in gallons
Manhole/Access (Y/N)
Vent (Y/N)
"Pump on" level at
"Pump off" level at
High water alarm level
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed ~a'a'f/~
Length ~ ~ Width
Total absorption area
Depression over field (Y/N)
Results (pass/fail)
Soil rating ~ ~ O System type
Gravel thickness * --~ Total depth
Cleanouts present (Y/N) /
Date of adequacy test ~c///~ ~
,or
Peroxide treatment (past 12 months) (Y/N)
If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
To building foundation
On adjacent lots
Surface water
Curtain drain
On adjacentlots 0/~ Propertyline
To existing or abandoned system on lot
Cutbank I~ o~ ~__ Water main/service line
E. ENGINEER'S CERTIFICATION
Driveway, parking/vehicle storage area
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Engineer's Name
Date ~-~
HAAFee$ /~7 (~ O_.~
Waiver Fee: $
Date of Payment ~3"-" / ~ '".~-"N ~ ~ Date of Payment
Receipt Number __,~ ,~ ,C/, ~/ ,~ .~'~O ) Receipt Number
72-026 (Rev. 3/91) Back MOA 21
CHEMICAL & GEOLOGICAl
A DIVISION OF COMMERCIAL TESTING
LABORATORY
ENGINEERING CO.
TELEPHONE (907) 562-2343 ~ 5633 B Street
~nchorage, Alaska 99518
Drinking Water Analysis Report for Total Colifor~ Bacteria
TO BE COMPLETED BY WATER SUPPLIER
I-'1 PUBMC WATER SYSTEM I.D. #
[] PRIVATE WATER SYSTEM
Name ~/ Phone No.
Mailing Address
CRy State 7Jp Code
Mo. Day Year
SAMPLE TYPE:
~J~-Routine
[] Check Sample (for routine sample
with lab ref. no. ) [] Treated Water
[] Special Purpose [] Untreated Water
SAMPLE Time Collected
No. LOCATION Collected
31 I
nl I
51 I
TO BE COMPLETED BY LABORATORY
AnalySis shows this Water SAMPLE to be:
.~ S~tisfactory
[] Unsatisfactory
1-1 S~mple too long in transit; sample should
not be over 30 hours old at examination
toJindicate reliable results. Please send
n6w sample via special delivery mail.
Analytical Method: Membrane Filter
* No. of colon!es/100 mi.
Lab Ref. No.__ Result* A~
208115 ~ r---~
I I~-~
I I~
I I~
A .D.E.C. _ .
READ INSTRUCTIONS Membrane Filter: Direct Count (~ Coliform/100 mi
BEFORE
COLLECTING SAMPLE
TNTC
Verification: LSB BGB
Fecal Coliform Confirmation
Final Membrane Filter Result$~ ~
,..o..,,, ....
= TOO Numerous To Count Time:
Coliform/lO0 mi
a.m.
p.m.
OB = Other Bacteria
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
ANALYSIS 5ESULTS fo: INVOIC5 $ 56669
Shemlab 5ef.~, 92,~95@ Sample $
?WSID
Collected
8/] ALPINE TERRACE Client Name :TOhBEN SPLFRKLAND.
UA Client Acct :TOBBENS
AUG 4 92 @ 15=0£ hzs. BPO~ : Peg :NONE REC£!VE~
AUG 4 92 @ 15:40 hrs.
AS REQUIRED Qrd~ed By :TOSBEN SPL~LAND,
Analysis Comptetad : AUG 5 92
Labo~:atery Supe~¥xsol :_.j~TEPHEN C. EDE
Send Reports to:
i)TCBBEN SPURKLAND, P.E,
Paramet~[ Results Units Method Allowable
[~z~r.~,E-N ~.9 ~/1 EPA 353 2
~emazk~'
i ~e~t~ ?e~fo~mec ' :i~e~ Special instructions Abc, w U~-l]n.~vaziabl~
hD- Non~ ~etected '* 3ee Zample Rent,ks Above
NA- Not Analyzed Ll-=ess Than GT-Gr~,:ez Than
Member of the SGS Group (Soci~t(~ G~n~rale de Surveillance)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
,x)/p,';~ '/'"'e.-,-~_ ~-~ /-~ 'f ~ £/o~i< I
(b)
(c)
Location (add~ess or directions)
AppliCant Na~ne ./tf ,;.,?( /.~,~,~.~, Telephone: Home
Applica~t~Ad~l~.~ss ,.¢'~/'r ' /~c,'¢~' Z 3 ~ ~' /'Jr
Business
Applicant is (Cl~eCk oae): Lending i~stitution [] ' Owner/builder~J~L; Buyer I-I · Other [] (explain);
(d)
Lending Institution Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~ Multi-Family []
Number of Bedrooms ,~
Other
WATER SUPPLY
Individual Well~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite [~ Public D Community [] Holding Tank r"l.
f
Note: If dommunity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page I of 2 72-025 (11/84)
ENGINEERING FIRM PROVIDIN.. INSPECTIONS, TESTS, FILE SEARCH, D~.,. A AND INFORMATION
As certified by my seal affixed hereto amd 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 regulations in effect on
the date of this inspection.
Name of Firm /~ £ r_ ~' Telephone
Address /2.00 c,,J ~ ~"~ ~,x~'L~ /J ~
DHEP APPROVj~. ~ {~ ) .~/..../.~..~Z~j? Z~ .Da,e
Approved for /~JA.'~.~_. bedrooms by
Approved ~ Disapproved Conditional d
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations 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 requirements. 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.
Page 2 of 2
72-025 (11/84)
Well Classification /o,,-; v ,-,. ¢-e
Well Log Present~N)
Total Depth /-"/ ~ Cased to
Static Water Level 3 ~-
Casing Height Above Ground ¢;g ~
Electrical Wiring in Conduit ~//,~1)
Separation Distances from Well:
To Septic/Holding Tank on Lot /(~ ~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line /v /~
Cleanout/Manhole /v 4
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Water Sample Collected by
Legal Description:
~',~ z ~'
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~' - ,5-- ~' ~ Yield
/~o d; ~ PH
Depth of Grouting ~
Pump Set At --"-
Sanitary Seal on Casing ~,/IN)
Depression Around Wellh.ead (y/~./7
· On Adjoining Lots ~7"
/ O/'-/ ' On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
~,~=,y (//e-cs ") ·Date,,1 ~.~?/- .~ /~'~;~
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed 2~' ,'~'~/~ ¢~'
Caps ~4~)
Standpipes ~,~) Air-tight
Depression over Tank (Y/~
Pumping/Maintenance Contract on File (Y/N) '~'/~
Holding Tank High-Water Alarm (Y/N) "~
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
. Course '~'/-' /O
Size /~)oO No. of Compartments
Foundation Cleanout
Date Last Pumped
; for /"'/~ '
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Co m ments ~.
'h p~tge 1:of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ,~'~,7 2 ~._
Width of Field
Square Feet of Absorption Area /
Depression over Field (Y/~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well -/~ ~'-
To Building Foundation ,~-
Lot ~' T' ,.~ ~
To Water Main/Service Line G
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
~/'~/ Type of System Design ,~'~---
Length of Field
Depth of Field
Gravel Bed Thickness '/Z ~,~
Standpipes Present~)
Date of Last Adequacy Test ' ~ '~
To Property Line /
To Existing or Abandoned System on
· On Adjoining Lots ~' 7'
To Cutbank (if present)
Comments
LIFT STATIO I~,~,,~
Date Installed~ ~ Dimensions /
Size in Gallons _ Manhole/IY/N) _
"Pump On" Level at ~~...~ 0.ff" Level at --
High Water Alarm Level at J ~,~/N) __
Tested for J Pumpm~ing Adequacy Test. Meets MOA
Electrical Codes (Y/N) J "~._
Comments ~~
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
t.,ompany MOA No. ~: -:
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343
5633 B Street
Anchorage, Alaska 99518
[] PUBLIC WATER SYSTEM I.D.#
~ PRIVATE WATER SYSTEM.
Name
Mailing Address
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
~-61 J-OVO
,,~¢ $- /,
/£oo r..: 'Z
Phone No.
City State
Mo. Day Year
Zip Code
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreated Water
TO BE COMPLETED BY LABORATORY
Date Received
Time Received
Analytical Method:
Analysis shows this Water SAMPLE to be:
~ Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Membrane Filter
* No, of colonies/100 mi.
SAMPLE
NO. LOCATION
4 I
I
Time Collected Lab Ref. No. Analyst
Collected By
I
Result*
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane Filter:. Direct Count
Verification: LTB
Final Membrane Filt,~Se~_..Its /?
TNTC = Too Numberous To Count
BGB
Date ....
Time:
Coilformll00ml
Coilformll00ml
, :-. x ( a.m.
p.m.
~',,, ~5 "~, ~ -I~'
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APPLIC ...... NT FILLS OUT UPPER HAt- ONLY
Phone
I~rop,~ty C~wner Mikell L. Murphy
Mailing Address SRA 2396; Anchorage zip Code 99507 ~ 345--0442
Buyer Not Determined
Address Zip Code
Lending Institution ~k)t Determined Phone
Address Zip Code
Realty Co. & Agent Associated Brokers, Inc. Louis D. Campbell Phone
Address 640 W, 36th Ave., Suite ~1; Anchoraqe, Zip Code 99503 563--3333
Legal Description 1.4)t 8, Block 1, Alpine Terrace
Street Location Corner of Hillside Dr. & Nebesna Dr.
Type of Residence
Single Family
Multiple Family No. of Bedrooms 3
[] Other
Water Supply
~:~ Individual ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
~] Community For wells drilled prior to that date, give well depth (attach Icg if available).
[] Public Utility Drilled 1964 depth 50 ft.no lo(~ avail.
Sewer Disposal 19~4
Individual dT~C~ ~-~% ~F--[-~r c_~ ~'~ Year Individual Installed:
[~[] Public Utility~l i(_~.L5 ~-, iL_~C]~/ When Connected to Public Utility: N/;IN
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector In specto, k.
Field Notes: MUNICIPALITY 01=
_ DEPT. 0~= HEALTH
~ EINVIRONM~NTAL pp. OT ECTIOI~
APR 1
RF. CEIVED
(~"~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CON DITION/~,..APPROVAL*
DATE ~ ~'
BY: I~C'
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
Well to Tank Septic Tank Size
72-023 (3182)
>;ikell L. },~urphy
S}~% 239,6
Anchorage, Ak 99507
Subject: Lot 8, }~lock i, Alpine Terrace
Approval for the individual sewer and ~.;at~r f~cllities canno~
be granted until the following items have been compieteu:
o Exposed electricai wires to the well head are in violation
of the Municipality of Anchorage codes and n]ust De encased
in conduit.
"~'bx% The %;ater analysis report neeGs to be submitte¢~ to this
office frol~ the Chem Lab, 5633 ~ Street, for our review.
Please notify this Department for a reinspection ~hcn the
noted discrepancies have been corrected, iY there are any
£urther questions, please call this office at 264-4720.
Sincerely,
RP21/ej/E1
Robert C. Pratt
Associate Environmental Specialist
April 5, 1983
ALASI A CONSULTANTS, INC.
Engineers Surveyors Planners
5313 Arctic Blvd,, Suite 201 P.O. Box 4-3187
Anchorage Ak. 99502 Anchorage, Ak. 99509
office: (907) 561-1044 ADC NO. 830?-6
Ms. Michael Murphy
C/O Associated Brokers, Inc.
640 W. 36th Avenue
Anchorage, Alaska 99503
Re:
Adequacy Test for Existing Septic System on
Lot B, Block 1, Alpine Terrace Subdivision
Dear Ms. Murphy:
At your request our office conducted a percolation adequacy test
on your existing septic system at the above-referenced location
during the period March 31 through April 2, 1983. You reported
that your septic system consists of a 1250-gallon septic tank, a
seepage pit and 2 seepage trenches which were installed in 1964.
Attached is an unstamped drawing furnished by you which shows the
location of the septic system on your property and with respect
to your house.
The septic tank had not been pumped prior to the percolation
test. Since the 3-bedroom house had been occupied up to the time
of the test, a normal degree of saturation within the leach field
is assumed.
In accordance with the Anchorage Municipal Code, Chapter 15.65,
Waste Water Disposal Regulations, any on-site sewage disposal
system "shall have adequate capacity to properly dispose of the
maximum daily sewage flow." The maximum daily flow is computed
at 75 gallons per capita-day (gcpd). Since "the population of
dwellings shall be estimated at two persons per sleeping room,"
the maximum daily sewage flow for your 3-bedroom house is 450
gallons per day (gpd).
To test the soil absorption capacity as well as the surge
capability of your system, 110 percent of the maximum daily flow
or 500 gallons of clear water was added in 50-gallon increments
to the septic tank. The water was obtained from your on-site
private well at its maximum sustained rate of 3.5 to 4.2 gallons
per minute (gpm). The liquid levels were monitored closely to
detect any backup in the septic system.
The attached Table of Test Data represents the depths of liquid
in the septic tank and seepage pit, and the quantities of water
added. The septic tank was determined to be 7.1 feet deep
(bottom of tank to ground surface) with an initial liquid depth
of 4.5 feet in the tank. The seepage pit was measured to be 7.6
feet deep with an initial liquid depth of 6.4 feet. Ground
elevation at the septic tank standpipe is approximately 5.1 feet
higher than the seepage pit standpipe. The relative depth of the
seepage trenches was not determined.
Ms. Michael Murphy
April 5, 1983
Page-2-
The attached Summary of Test Results indicates that the liquid
level in the seepage pit at the beginning of testing on Day 2
fell to 0.05 feet below its initial static level on Day 1, during
a recovery period of 21 hours. On Day 3, the level had fallen to
its static level on Day 2, during a recovery period of 24 hours.
The level in the seepage pit at its highest level during the test
(8.0 feet) was aproximately 3.5 feet below the liquid level in
the septic tank.
Based on two days of testing, an average percolation rate for
your existing septic system of approximately 500 gpd is
indicated. Since an on-site sewage disposal system for a 3-
bedroom dwelling must be capable of disposing of 450 gallons of
sewage per day, the soil absorption capability of your septic
system appears to be satisfactory at this time.
The surge capacity of a septic system is normally considered to
be adquate when 80 percent of the total daily load can be added
in a 2-hour period without backing up in the septic tank. For
your 3-bedroom residence, this would be 360 gallons. Since the
liquid levels in both the spetic tank and seepage pit showed a
rise after the first 50-gallon increment was added, there appears
to be little or no surge capacity within the context of the
above-stated criteria.
It is noted, however, that 110 percent of the total daily load
was added to the septic system in a 2- to 2 1/2-hour period for
two consecutive days. This factor, coupled with the above-noted
soil absorption capabililty, indicates that the system is
operating in at least a marginal condition at this time.
Many factors affect the operation of a soil absorption type of
sewage disposal system. Soil type, groundwater depth, age and
history of maintenance of the system, and types of waste are a
few. This test has been performed in an attempt to determine
actual soil absorption capabilities of your septic system under
normal useage by considering the degree of saturation of the
leach field and surge loads that might be imposed on the system.
This test can only evaluate apparent performance at a given point
in time, and cannot determine either the condition of the leach
field, seepage pit or other components of the septic system, or
the depth of the water table.
Ms. Michael Murphy
April 5, 1983
Page -3-
We appreciate the opportunity given to perform this adequacy
test. If you have any questions regarding this test, please
contact this office.
Very truly yours,
ALASKA DEVELOPMENT CONSULTANTS,
Stephen D. Shrader, P.E.
Project Manager
SDS:mf
Ms. Michael Murphy
April 5, 1983
Page 4
SUMMARY OF TEST RESULTS
Day 1 Day 2
Wtr Added, Septic Tank
Rise in Seepage Pit
Rise in Septic Tank
500 500
1.5' 1.65'
1.45' 1.60'
Recovery Time between
Test (Hours)
Drop in Pit during
Recovery
Average Absorption Rate
(gal/day)
21 hrs
1.55'
500 gpd
No. 83026
Day 3
--0--
24 hrs
1.65'
500 gpd
C~ner:
Adequacy Test for ~isting Septic System
Michael Nurphy
Address: c/o Associated Broker, Inc., 630 W. 36th Avenue
Project No.83026
Legal Description: Lot 8 Block I Alpine Terrace Subdivision
Components of Septic System:
Number of Bedrooms: 3
Now long vacant: N/A ·
Test performed by: Troy Cere~ A.D.C.
Initial Static Levels: Septic Tank 7.1'
1250-qal septic tank; seepaqe pit; seepage ~renches
Occupied prior to test: Yes X No
Last pumped: Fall 198~
. Water meter/S.N.22812186
,; Seepage Pit 7.6' ·
T~ST DATA
Liquid Depth~ ft* ' Water Meter
Time Septic Tank Seeoage Pit ~dded, gal Reading,.gal Remarks
3/31/83 Start Test
12:06 3.20 2.20 0 39025 Day 1
12:18 2.95 2.10 50 39075
12:32 2.00 1.00 100 39125
12:45 1.55 0.90 150 39175
12:58 1.80 0.55 200 39225
Decreased Flow
1:10 1.75 0.90 250 39?75 Rate After 2501
1:27 1.80 0.75 300 39325
1:42 1.60 0.90 350 39375
2:00 1.80 0.70 400 39425
2:16 1.55 0.75 450 39475
2:31 1.75 0.70 500 39525 End Day 1
(1.45' rise) (1.5' rise)
L1
Continued from March 31, 1983
O~ner:Michael Murphy
Project No.83026
Legal Description:Lot 8 Block I Alpine Terrace Subdivision
Beginning Static Levels
Septic Seepage
TEST DATA (Cant'd)
3.35 2.25 April 1, 1983
Liquid Depth,'ft Water Meter
Time Septic Tank Seepage Pit A~ded, gal Reading, gal Remarks
4/1/83 Day 2
9:10 3.35 2.25 0 39545 Start Test
9:20 2.90 2.05 50 39595
9:32 2.90 2.05 100 39645'
&ir Bubblin~
9:44 2.20 1.30 150 39695 up from septic
3gbbliqg
9:57 1.80 0.70 200 39745 s~oppea
10:09 1.~0 0.80 250 39795
10:21 1.70 0.65 300 39845
10:34 1.50 0.75 350 39895
10:46 1.65 0.60 400 39945
10:58 1.45 0.65 450 39995
End Day 2
~11,ln 1.75 0.6fl 5tiff 40na~
(1.60' rise) (1.65' rise)
~/2/83 Day 3 Cheek
~:34 3.20 2.25 0 0 Levels
'CHEMICAL & GE., ~OGICAL LABORATORIES t... ALASKA, INC~
TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER
/~~ 274-3364 5633B Street
~ Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
Water System Name
Mailing Address
I.D. NO.
Phone No.
City
Mo. Day Year
State
Zip Code
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
) [] Treated Water
[] Untreated Water
SAMPLE
NO.
I
LOCATION
,,,J
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[~] Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
[] 'Membrane Filter
Lab Ref. No. Result* Analyst
I r-I-I
i r-T-I
*No. of colonies/100 mi or No of Positive portions
READ INSTRUCTIONS
BEFORE
CO LLECTI N G SAM PLE
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collect~l. Source
Date R~:elved Time ReCeiveD -- p.m. ~-.u. ~.u.
Presumptive 1Omi ZOml ZOml ZOml ZOml Z.Oml O.Zml
24 Hours
48 Hours
ConflrrnetorY
24 Hours
48 Hour~
EMB Broth 24 hours: Broth 48 hours:
Multiple Tube Rel3ort:
Membrane Filter: Direct Count
verification: LTB
Final Membrane Filter Results
Reported BY
.1Omi Tubes Po~tlw/'rotal 1Omi Pm'tlona
Collform/lOOml
BGB
Date
Collform/lOOml
Time-