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HomeMy WebLinkAboutALPINE WOODS BLK 2 LT 14i7&A-� (Kev U5/U2/16) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Pale ; =Qf ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211279 PID Number: 015-234-22 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name JULIE &MICHAEL LINA ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 11831 MOOSE ROAD, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil RatingTotal depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot ALPINE WOODS 2 14 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area 2 Number of trenches Dist. between trenches From Tank Field Tank Line Ft Ft. well zoo'+- -- 15`+ TANK ® Septic ® S.T.E.P. ❑ Holding ❑ Other --- Manufacturer GREER Capacity 1500 Gal. Surface water 100'+ -- Material HDPE Number of compartments 2 Lot Line 5'+ -_ NA Foundation 10'+ __ LIFT STATION Manufacturer GREER / ORENCO Capacity 1500 Gal. Remarks Alarm location BACK SW ROOM Electrical installed by CAPSTONE PIPE MATERIAL House to tank 3034 Tank to 3034 Installer A+ drainfield Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspdection 1" 9/28/21 9/28/21 Location and description 2nd 3`d 10/15/21 4'h TOP OF MANHOLE ON-SITE WATER AND WASTEWATER SECTION APPROVAL ;���\ ,� • !°!Cq�\l Conditional Approval: Date � TH • Curtis Huffman / Septic System Approved - Date / %� ��if �'•, F CE 128991 `4 ��'s'l ' • . 1//12/22 •��i '�C •.... F�PROFESSI�NP �'� Note: this approval does not include well permit requirements. O\RO•`W* (Kev U5/U2/16) PID: 015-234-22 PERMIT: OSP211279 ., o �� �N37 0 C V ` APPROX. C. A C �� WATERLINE 2201 FCO 0 DECOMMISSIONED EXISTING SEPTI0 & INSTALLED NEW C TANK &LIFT STATION 01 HDE STEP TANK WITHON WLDCOP RECONNECTED OF TO EXISTING SERVICE LINE C'� TO EXISTING FIELDS. c / C (� O D DCO E : MH MH \ EXISTING EXISTING TRENCH BED A—C=49.4' B—C=39.2' A—D=53.5' B—D=41.7' A—E=57.4' B—E=44.7' LOT 14 BLK 2 ALPINE WOODS BLOCK 2, LOT 14 SUPPORT, SERVICES:low - F�\ PREPARED FOR: ��`�� `4 1 MICHAEL & JULIE LINA F W. C. S 1 11831 MOOSE ROAD * 9 T14 ANCHORAGE, AK 99516 FIRST WATER CONSULTING DATE: 1/12/22 /` rtis Huffman / SURVEY: JLSf�, CE 128991 `� 13030 SUES WAY DRAWN: FWCS 11 1/12/2022 �At ANCHORAGE, AK 99516 SCALE: 1" = 30' \ p1ppSSIO�AS' 907-350-9566 FirstWaterAK@gmail.com \�_'t it i i I s 7 V r �a t U-) 0! z I ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: ALPINE WOODS SUBDIVISION Q = FND 5/8" REBAR LOT 14 BLOCK 2 PLAT 83-210 SURVEY CERTIFICATE: I John L. Schuller, Have conducted a .•� � � j � �� LAX ' p O 1?� D, fir► � , ...... � ;V physical surveyof this property as shown on this drawing and that the � '` .. improvements situated hereon are within the property lines and no �,,, � � � ,�,JA i �a �, enchroachments exist other than noted. Under no circumstance should0 / 4 CATH �' � �,,� o� ,� � anv information on this drawing be used for construction of :fences, 0 * � .. .. . ....... ....:. � .� R.......... structures, improvements, or for establishing boundary lines. ... .. EXCLUSIO NOTES: It is the owners responsibility to determe VIA a / ' '4 q� 0 he existence of an easenients covenants or restrictions which o '* "" I L. SCHULLER. ; w' m t s y � � t • . LS -10408 .•� •` . . . do not appear. on the recorded subdivision plat. � .• i ��AW 1831 Talkeetna Street _ � '` .'•fes • • .�. �� WORK ORDER NUMBER: DATE: SCALE: ii MAIL k L°Q, . , , • 1,�. • a � Anchorage, Alaska 99508 OCT 16, 2021 1 =50' schuller0ak.net Ar d� ,®► DRAWN BY: CHECKED BY GRID NUMBER: BOOK/PAGE: C �e n& AMW (907) 227--1455 office --- $� JLS SW2738 210327 ����S1�*pd��°' (907) 274--4992 fax MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater program { p4 Box 196650 4700 Elmore Road ee Anchorage. Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343.7997 !' hltp!llwww.muni.orglonsita �'�'Ch❑RR6R On -Site Wastewater Disposal System Permit Permit Number: OSP211279 Effective Date Work Type: SepticTank Upgrade Tax Code Number: 01523422000 Site Legal Address: ALPINE WOODS BILK 2 LT 14 G:2738 Site Mailing Address: 11831 MOOSE RD, Anchorage Owner: LINA MICHAEL J JR & JULIE A Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: ❑ Disposal Field El septic Tank ❑ Holding Tank ❑ Privy Expiration Date: went S a � 4 r, e epau•nncnr 712912021 7129!2022 Lot Size in Sq Ft- 94566 Total Bedrooms ❑ Private Well ❑ Water storage All construction shall be in accordance with: 1. The attached approved design. 2- All requirements speoified in Anchorage Municipal cede Chapters 15.55 and 15.55 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) :i. I he wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing LSpecial Provisions- The water service line shall be located prior to installation of the septic tank to confirm minimum 10 ft separation. Received By: Issued By: 7/29/2021 Date: nate: UNICIPALITY OF Development Services Department r` On-Site Water & Wastewater Section Parcel I.D. 015-234-22 ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) MICHAEL & JULIE LINA Day phone Mailina address 11831 MOOSE ROAD, ANCHORAGE, AK 99516 Site address 11831 MOOSE ROAD, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) ALPINE WOODS BLOCK 2, LOT 14 Legal description (Township, Range & Section) Lot Size 94,566 Sq. Ft. Number of Bedrooms 4 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field F-1 InitialEl Single Family (SF) (w/wo ADU) Septic Tank El Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. nature of property owner or autnorizea agent) Permit/Rush Fees: _0-2-Z57 Waiver Fees: Date of Payment: 7Z12.I2 / Date of Payment: Receipt Number: 3 ! 2 14 L( Receipt Number: Permit,No. 1 /279 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com July 20, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: ALPINE WOODS BLOCK 2, LOT 14 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank and lift station on the above referenced lot. We propose to install a 1500-gallon HDPE tank with lift station per the attached design to serve the existing 4-bedroom residence. The lot and area are served by a Community Class A Water system. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211279, Rebecca Carroll, 07/29/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211279, Rebecca Carroll, 07/29/21 Municipality of Anchorage Page I of --~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~f.~O ~llJ Z-- PID Number: Name: "~l/ll~l~, '~.r ~ Wastewater System: ~ New ~ Upgrade Address: ~D. ~ I~ o~ ~ ABSORPTION FIELD Phone: ~ No. of Bedrooms:  ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other I LEGAL DESCRIPTION 'so, Rating: Total Depth from o~inal grade: /. ~ GPD/Sq. Ft. Lot: Block: Subdiv~ion: ~Depth to pipe bo~om from original grade: Gravel depth beneath pipe Township: I Range: I Section: : Fill added above original grade: Gravel length: / ~ Ft. ~ ~ Ft. WELL: D New ~ Upgrade Gravel width: Number of lines: DiE.nm ~n lines: Clarification (Pri~te, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. ~ SO. Ft. S~~ Ve P~ Driller: Date Drilled: Static Water Levek Ins~lier: ~ Date installed: ~t. ~ 1~. Yield: GPM IPump Set at: Ft. I~ing HeightA'veGr°und:Ft. TANK SEPARATION DISTANCES ~ Septic ~ Holding ~ S.T.E.P. TO Septic A~tion Lift Holding Publi~Private Manufacturer: ~1~ ~apacity in gallons: From Tank Field Station Tank ~wer Lin~ , Material: ~ ' Numar of Compa~ments: Suda~ Water ~ I ~ ~ ~ LIFT STATION LOt Size in gallons: ~ Manufacturer: ~ "Pump on" level at: I "Pump o~' level at: I High water alarm at: Foundation ~ JT~ I I Cu~ain Pump Make & Model ~ El~tri~l I ns~ions parleyed by: Drain N! O ~ ~ I Remarks: BENCH MARK Lo~tion and Description: ~um~ Elevation: E~INEE~'S Depadment of Health and Human Se~ices approval Reviewed and approved by: . C Date: ~ '~ ~ 72-013 (Rev. 9/91) MOA 25 Well SPURKLANI~ No, CE-2225 // '~ £5 0 £5 50 75 ~00 BENCH MA, SCALE, I' = SO F?, RESIDENCE C L S.T OX50 ~ o 125 BOTTOM SIDING TOBBEN SPURKLAND P.E. 203 W 15TH. AVENUE ANCH. AK. 9950! (907) 279-3916 II LOT 14, ItLOUI< ~, ALPINE 11831 MOOSE ROAD DONNA BARBOSA SEPTIC SYSTE/~' AS BUILT DATE:NOK 24, 1998 SHEET: 2/3 GRID: 2738 PERMIT ~ 5W9804i2 PID 015-234-22 ALWO2141.DWG r --]-2'- ~ ~% No, CE-222~ v~'~-,. ..... ,* ~tand~rd ~rench; 5~' L on9 9' ~eep 6,0' Se~er rock 2' Cover FO EXIST BED ~ O B~LL V~LVE ND SCALE 500 5AL STEP TANK ~~ ~on~~oF' - 3 ~over ~95.7z 8&5 8&5 / ' 500 5AL ~ TEP Effec#ve BENCH T~EN ~PU~KL~ND P,E, ~0~ ]~, ~ 2 ~[~ ~00~ ~EPT~C Anchomo. ge Ak 99501 11831 NOOSE ROAD DATE, NOK 24, 1998 PE~IT ~ ~980~2 PID 0~5-234-22 ALWO2~4J. DWG Municip'ality of Anchorage Page i of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~'~f'/ (:~1 OO~i'...~ PID Number: O I~ - ~ ~ - ~ ~ Name: ~L¢ ~ ~~ Wastewater System: ~ew ~ Upgrade Address:~.O - ~ ~ ! ~ O ~V ~ ABSORPTION FIELD Phone: ~ No. of Bedrooms: ~ D Deep Trench D Shallow Trench ~Bed D Mound ~ Other I LEGAL DESCRIPTION so, Rating: O, ~ C2D.%q. Ft. Total Depth from ori~al grade: Lot: Block: Subdiv~ion: Depth to pipe bottom f'om original grade: Gravel depth beneath pipe Township: Range: ~ Section: Fill added above original grade: Gravel length: I WELL: ~ New ~ Upgrade Gravel width: ~O Ft. Number of~lines: Distance~ween lines:Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Driller:co ~~[ Date Drilled: Static Water Level: Installer: ~ Date installed: Yield: GPM Pump Setat: Ft. lCasingHeightAb°veGr°und:Ft, TANK I SEPARATION DISTAN(;ES ~s~t~c ~ Holding ~ S.T.E.P. To Septic Absorption Lift Ho,ding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~ ~ / ~ ~ · Material: Well' C, ~ ~ ,~ q ~ O ~[ Number°fC°mpartments:~ Surf~O.wat~ N ~ f ~ LIFT STATIO N Lot Size in gallons: ~ ~anufacturer: "~ump on' ~eve~ a~: ~ "Pump off" ~eve~ at: H~gh wa~e~ a~a~m CdrtainDrain ~ 0 ~ ~ PumpMake&Modeloe~O 1Electrical I~'P~~by: Remarks: BENCH MARK Location and Description: ~, ~ Assumed Elevation: ENGINEER'S SEAL ~n~ecfion~ ~edorme~ by: ~ /z ~ ~ate~: ~t / Department of Health and Human Services approval Reviewed and approved by: ~~ ~~ Date: 10,¢0'~ 72~013 {Rev 9191) MOA 25 /J o SWING TIES: ~ C..).oo Oo / o TOBBEN SPUNKLAND P.C LO7' 14, BLOCK & ALPIne' ~OObb SEPT/C SYSTEU ASBU/LT ~z5~ w. o/uoNa BLVD. SECtiON 2X, n2N, RZW OATE.'~AW X~, ~99~ ~NC~ AK. ~9502-~904 07)' 24~-~0~ ABRAHA~ ~ DONNA GALLO SHEEr: 2/~ 5O ~ 30 ~ TEP ROCK 9].0~+ l, ~ schorge Mira F; ]40 500 GAL L/Ffs~o f/on ~5~52 ~,~ i500 GAL, SEPTIC TANK GREER TBBBEN SPURKLAND P,E, 6751 W, DIMBND BLVD, ANCH, AK, 9950~-3904 LET Jd~ ?LMC/( £ ALPI/VE SEC TIEN £3, Ti2N R3 V ABRAHAM S DENNA 5ALLZ7 ~/~-~'1 I'' SEPTIC SYSTEM AS BUILT II ]]ATE: MAY ~, ]~?~71 SHEET~ ,~'/~' GRID: F~tO: 1 : 131,.,II.~LT f.~E 'F ?..:Gb..ll.qL Tr' ~E"¥ ?,~,,g(~:.¢.,~ INS TI N R cRT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 3500 EAST TUDOR ROAD I_N_$PECTI,ONS (907) 568--3464 INFORMATION (907) 786-8211 FOOTING Fi ELEC. TEMP, [] PLBG. UNDGR. ~, [] FOUNDATION J~ ELEC. ,<::ERVlOE [] PLBG. ROUGH ~ [] BOND BEAM ~ ELEC. ROUGH ____ [] GAS TEMP. [] FRAMING [] ELEC. FINAL [~'""' GAS [] INSULATION ' [] OTHER __ ' [~ MECHANICAL SHEETROCK ~ [] MECH. FINAL~ E~ 8TRUCT. FINAL __ ]~ FIRE FINAL [] PLBG. FINAL OTHER .. [~ ZONING [] OTHER [] ;[~NO NONCOMPLIANCE OBSERVED [] CORRECTIONS ESSENTIAL AS EXPLAINED BELOW [] DO NOT CONCEAL UNTIL REIN.SPI'CTED ~ WILL REE.Y,.AMINE AT NEXT iNSPECTION COMMENTS ' I [' ;r~spEc"I'OR / ' ' ' DATE ? i '%'"',------.~'-"*'~ / WHE~N .OORR ,ECTIONS ARE MADE, PLEASE CALL FOR INSPEO]-rON 11/$?} DO NOT REMOVE THIs.. NOTICE "" ..... ~ ('-' / '" ............................................................. CALL MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P 0. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 20, 1998 Expiration Date: Oct 20, 1999 Permit Number: SW9804t2 Legal Description: ALPINE WOODS BLK 2 LT 14 Design Engineer: 0007 Tobben Spurkland, P.E. Owner Name: Donna Barbosa Owner Address: PO BOX 110366 Anchorage, AK 99511-0366 Parcel ID: 015-234-22 Site Address: 011831 MOOSE RD Lot Size: 94566 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [~ SepticTank [] 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. Issued By: Date: 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 14 BLOCK 2 ALPINE WOODS S/D DONNA BARBOSA Municipality of Anchorage Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 October 6, 1998 We are submitting an application for the installation septic system upgrade for this lot. The original system was installed by the property owner in 1991. The property owner also built the house which was completed in August 1994. The installation of the septic system was inspected, but the as builts were never submitted to the DHSS. At this time the as builts and a final electrical inspection report is submitted. During an inspection on in May of 1998 is was observed that the liquid levels in the monitors were 18 inches. According to Municipal policy this amount of water in the drainfield is unacceptable for approval. A replacement drainfield is required. A testhole was excavated adjacent to the existing bed on Sept. 30 1998. The material exposed consisted of a frae silty sand that will compact easily. This may explain the premature failure of the bed. A backhoe, dozer was most likely used to excavate the bed. The excavationb proceedure compacted the surface of the exposed material, thereby limiting the percolation. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: No Ground Water or Impervious Layer to 15 ft. Use Standard Trench Soil Rating. From Testholes Sept. 30, 1998 1> min/in = 1.2 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 150/1.2 = 125 sq.ft. Total area required: 4 x 125 = 500 sqft Testhole depth 15 feet Bottom Rock At 9 feet Top Rock At 3 feet Rock Depth 6 feet Total Trench Length 500 / 12 = 42 ft. SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 50 FT TOTAL WIDTH 2 FT TOTAL DEPTH 9 FT ROCK DEPTH 6 FT COVER 3 FT SEPTIC TANK Existing 1500 gal. The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. Muni",ir ality o! Anchorage DEPARTMENT OF .~EALTH & HUMAN SERVIC'.F_S 825 "L" Street, Ai,..'.horage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 3 4 7 8 9 10 12 13 14 19 20 DISCLAIMFR: Grnundwater Past and future presence from these . L. '.~% CE-2>:~'5 / ,~:-'~ ALPINE Township, Range, Section: ~0~ ~ SLOPE ~:?.. SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O D :~'TH ? p E Dep,h 1o Waler AIterdt..] Monitoring? Dam: I Gross Net Depth to Net Peading Date Time Time Water Drop Pr.,qCOLATION RATE ~/'~min. ties/inch) pERC HOLE DIAMETER T~.ST RUN BETWEEN ~ FTAND ~ · FT (anditions indicate~ are for the dates shown on]y. ~nd/or depth of groundwatq~ can not be predicted Ob~va~lons . ~ ~ PERFORMED BY: I, I ~ CERTIF~ THAT THIS TEST WAS PERFORMED IN 72-008 (Rev. 4/85) PERFORMED FOR: Munlcil;ality of Anchorage DEPARTMENT Or -~EALTH & HUMAN SERVICES 825 "L" Street, Aimhorage, Alaska 99502-0650 SOILS LOG -,~ PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 A- L..P I N ~ VOooO~ WAS GROUND WATER ENCOUNTERED? Township, Range, Section: SLOPE IF 'F'ES, AT WHAT DEPTH? Monit0ring7 Dale; __ SITE PLAN Gross Net 'ii Depth to Net Peading Date Time Time ? Water Drop · ,,.:.~I ',~,"~i~,,~t DISCLAIMFR: Groundwater Past and future presence trom these O~.vatlons. PERFORMED BY: I ~"~' '~ ACCORDANCE WITH ALL STATE AND MUNICtPAL GUi£ FLINES tN EFFECT ON THIS DATE, 72-008 (Rev. 4/85) PERCOLATION RATE ~ ~ tm,nutes/,nch) PERc HoLE DIAMETER TEST RUN BETWEEN ~ F~AND ,FT conditions indicated are for the dates and/or depth of groundwater can not be $hown only. predicted CERT?Y THAT TH, IS TEST WAS PERFORMED IN ~EPTIO ~:~:E~ ~:AM~PIPE 0 50 ]00 ]58 BOO ~50 300 350 SCALL' Y = lO0 F~ TOBBEN 'SPURKLAND P.L LU~' ld, ~LOC~ ~, AL~' ~00Db SEPTIC SYSTEW DESIGN 203 W 15TH. AVE. ~203 ~83~ NOOSE ROAD DATE:OCT. 5, 1998 gNCORAOE AK 9950~ DONNA BARBOSA SHEET: ~/~ OR/D: 27~ PENWIT ~ SW980XXX PID 0~ ~-2~4-22 ALW02 ~ 4 ~.DWG ~ ~ ~:6,~ ~~~ .... ~.~..~..~ ~ ~ ~ ~ -- . ~ ~ ~ ~ ~ ~ ~. '*~Fe?" ................ '~ ~;~ , ' /~ ~ ~ EFFECTIVE ROCK 6 FT ~ I //~ I  ~o~o V ~ ~ ~ ~ o 205 W 15m. AVENUE l~8S{ UOOSE ROAD DATE:OCT. 5, ~998 ANCH. AK. 9950~ (907~ 279-59~6 DONNA BARBOSA SHEET: 2~5 GRID: z7~8 PER~IT ~ $WgBOXXX PID 0 ~ 5-2~-22 AL W02 ~ ~ h DWG o ~,/8" HOL£S ~) ol S~condord trench; £' W/cle SO' LonE? 9' Deep 6,0' Sewer rock 3' Co vet NO SCALE 3 Cover / 5,0 £t 0£ Septic Rock --/ Effective ND SCALE TO EXIST BED BALL VALVE Oo 500 6AL STEP TmNK SO0 JAL STEP TANK TgBBEN SPURKLAND P,E. 203 WlSth Ave Anchopc9e Ak 99501 LOT 14, BK. 2 ALPINE ~YOODS 11851 MOOSE ROAD SEPTIC SYSTE~ DESIGN SATE', OCT, 5, i998 SHEET, .jz/.~' GRID: 2775 PER,fIT ii/ SW9800XX PID 015-254-22 ALWO2145. DWG $751N. DIMOND BLVD. ANCHORAGE~ ALASKA ?9502-39©4 (~07) 248-50?5 i"lL.tr'~ :i ,.::: :i. ,r.::, a 1 ~. '[:v c:,-F E:, :i. v :i. ~i. :i. on r-',-f E n v :i. r" c:, n m e:,r'~ 't:. a 1 H De:.:,par"'t:mrer'i'~: c:~.f: He,:~iL'l::h and S?O ;i; '..:ii;'i:' r" May RECEIVED MAY 1 9 1992 ['vi u~l ici pal~ ~.'y of A.~ ~chorage Dept. Health & Human Services Municipality of Anchorage Department of Health and Human Services 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 May 13, 1992 Abraham & Donna J. Gallo PO Box 110846 Anchorage, Alaska 99511 Subject: Lot 14 Block 2 Alpine Woods Subdivision Permit #SW910095, PID #015-234-22 The subject permit, issued May 13, 1991 by this office for a single family well and/or on-site wastewater system, has expired as of May 13, 1992. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $200.00 for an on-site wastewater permit; $75.00 for a well permit and $275.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. ~roh~raS~i~Zg~rE' v On-site Services enc: Copy of Permit PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910095 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:GALLO ABRAHAM & DONNA J OWNER ADDRESS: PO BOX 110846 ANCHORAGE, AK 99511 DATE ISSUED: 5/13/91 EXPIRATION DATE: 5/13/92 PARCEL ID:01523422 LEGAL DESCRIPTION: ALPINE WOODS BLK 2 LT SEC. 23, T12N, R3W, SM. 14 LOT SIZE: 94566 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ABSORPTION BED LOCATION TO BE ALTERED SO AS TO AVOID TEST HOLE LOCATIONS. AN ELECRICAL PERMIT AND INSPECTION IS REQUIRED FRO"~IC WORKS. DATE: DATE: T'ebben Spurkland P.E. WDo~D _~ 12-.5o Bo. 5'0 ~..~_~ ~q Tobben Spurkland P.E. T~)bben Spurkland P.E. PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ,,~* (ENGINEER'S SEAL)~, $ DATE PERFORMED.N-]-'- ...... LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? NO S L IF YES, AT WHAT O DEPTH? p E Depth to Water Afterj.,,/)/ Monitorino? f~L/-/... Date: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 7 FT AND 7~ FT PERFORMED BY: I CERTIFY ^ooo,,,:,,,,,,o~,,,,,¥,~,,,,_ s.,,,,~,,,,,,:,,,u,,,,o,,~,,, ~,.,,,:,~,,,,,~s,&~/~ o,.,,-,-,,s o,,-,-~. ,~,,-,-~: .~_.,-,: ~ ,~ .~, ,~ ~ / 72-008 (Rev. 4/85) PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) WAS GROUND WATER ENCOUNTERED7 S L IF YES, AT WHAT O DEPTH? p E Depth to Water Alter Monitoring? Date: DATE PERFORMED: Township, Range, Section: '~'l~t~.~ SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER COMMENTS TEST RUN BETWEEN __ PERFORMED BY: I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) DATE: IN Tn~EN :'~PURI<LAND P,E, ~'?D1 W. 9IMDN~ I::LVIX ANCH, ~K. 9'¢~J ~.- 3904 .j" .- · L...~r ,5 ---7 o \ I 6751W. DIMOND BLVD. ANCHORAGE, ALASKA 9950?5904 (907> 248-5095 SPECIFICATIONS FOR SEPTIC SYSTEM INSTALLATION LOT 14, BLOCK 2, ALPINE WOODS SEC 25, T12N RSW 1.0 GENERAL Owner is Abraham and Dc.,nna GallLo, Anchc)rage, Ak. 995tl i.2 Engineer :Ls the per'sot-., or entity hired by the Owner inspect t'his project. The Engineer must be recognized by t. he Municipalit'y of Ancl"~(:)rage, Department. of Health and Human Servi c:es. 1.3 Contractor is:. 'L-hc~ persor~ or enti'!:.y hir'ed b,/ the Owner to instalL 1 this project. The Contractor mList be rec:ogni zed by the Municipal:Lty of Anc:lnorage~ Department c)f Health and F.tL~mar~ Serv:i. ces. 1.4 The Drawl rigs ~ sheet's 1 '[':.hroLJgh ~];.!;~ shal t be part. o.f tJ']:i, s sp e(::: i .F i c .a t i c:)n. 1.5 Al 1 mat. er':Lals and work;manship shall meet the r'eclL~ir"c~' ..... mer'~tis of the Munici pal i ty o.F Ar]c:l"~or-age, Department (:)f Heal th and Human Serv:i. c:es ~ the concl:i, t :i. OhS o.f: tJ"iE~ permi i: ~ and al :l. applicable rules and regulations c:urrently in e.F.Fec:t. 1 ,, 6 A ]. ] e x c: a v a t i o n cl e p t h s a r e a d v :i. s o r- y ~ a n d a r' e t ,,::) b ,,.;.:~ v,:.::.:r:i.',:ied and ma,,v be modi.Fied in the .i:ield b'y the Engineer. t.7 It is tine respc~nsib:i, lity o¥ the Owner or the Contractor i:c) adhere to the approved design~ to verify that the spec:i ..... ~:iecl separattion distances are met, ancl tl"~at t. he r"e)clL~ired i I"ISIDIL~IZ'Iz 1[ (:;ir'is are per'F Ol"med. 1.8 The Contractor of t'.he Owner sha].l report to the neer any obser'ved cc)nd J. t i Ol"i wh J. c'h l~OLl]. CI l::)ut', thE' system. :Ln vi o].,ai': :i. on of o""H_~:.~,..r',~:~.;, or Municipal reqLl], al': i ¢:~r]'.s. . ,, Engi - se:,p 'l~ :L c: SEPTIC TANK 2.1 I-F 'Lher'e is an ex i si: :L rtql sepiz:Lc tank~ :i.t may be used ii: meets the capacity requirement for the r'es:i, der~ce. The tanl.:: sha].l be inspec:ted l:)'y 'the Engineer, ar'~d its water' t:iqhi:riess and str'ucztL.lr"~3:L ir]tze~c.:tr'ii:¥' sh~all k:,/e verified. 2.2 A new septic: tanl:: shall be one Yabr:i.c:at. ed by eitl"~(-:~.l'" Anchorage Tank and Welding c)r by Greet Tank 'i"he septic: tank ishall be a lJF:'C.--apt~roved two--compar'i:ment i::anl-::, C::(::)II~'Lr'LlC:ti::(,Cl 0'{ 12 gat.l~e ~ or' bet. t. er', steel wi th bi tu mastic: (::(:)at:i.n(~l,, The tank sl'qa].]. I:)e set level. (:)lq Llndistut'-l:)ed s~;):i.]. ,, "Fh(~; tank ?-,hal 1 l;)e (:(::)vered wi'!:.h the equivalent -~ c~(:::, t ~ (::)r'" m (::)r e .~ c) ~,: ~..:..(:) i ]. ,, · i:eet 't:r'om the h(:)L,'.se ~::ciuridatic.)n and a mir'~i~,~.~r,, (:',~.F .Five ~:,~.:~e'!: ~:~e:[:[ servinq a single resident:e; 100 ~eet .l:rc)m any b(:)d¥ (:).F ~,~.~'~t::er ~ c.:re[~ks c)r dra:i, nag(~, di tc:!"~,s ~,~J. t:h ~ 1 (::,~i n~! ~at.~:~,r ~ :1. 2.5 Al. ]. [):i. pc c::~3nr"~?:.:,c:ti ohs to:, t:he rani-:: ~a'[:ert :L ~l'lt c:a~ der (:::(::!L~pl :i. as ~:l~::~3:i(;;!~"~l:.(-:~'~::! and c::a!:::~ped ~,~:['t.'.h aJ.~ ........ I:i(/!l"it rain caps, C].[~n .... (:)u'l:.~e shai Z e::.~tend a r~'~J, ni mum a.f: if;:]~ :inches abc~ve -f: J. rial qround (~:~.]. ~z~'.,.'at :i. c,n ,, Pr"c,v:i. ~:i. c::,ns ~l-~a]. :I k)(:.:~ madc~ ~: (:)r ]. ~ric:lscap i ng ~::~'~.:' i mporta'~.i or] i -f t.(::ips(:)i ]. 2. ~:, I...~. ~:'h stati(::)n shai ]. be a~::. ~]'~anu~:ac:turecl t:)y Anchorage Tank and Wel di ng~ OREIq[:i] SYSTE~.IS ~, c:,r as ~ urn:[ sl"',ecJ by Acreage Systems ~.0 ABSORPTION FIELD 3. :1. (:ar"ave:l. L~sed :in t'.he ab~:_'..c)rpti(or~ ¥:ielc:f !shal ]. be O. 5 to) 2.5 :inch '..~Cl'-eer]ed and ~a~-;t'~e(:J rock~ ~,-~ith :l.e'..~'...=. than 37~ pas.~;~.:ing th(-:~: Nc),, 2()() ~:[ er(-::(,, 3, 2 Sar'~d, u!~,ed -i:o~'" ].eve]. :i~'"~(:;l (:)r" .~(::)r 4::i lter:i, ng,, shal 1 have an e.l:~:e(::tJ, vr~ graJ. n ?:;:i. ze between No, 40 sieve and N(:~. :[~ si~z~v(:a. Un J. ~:: (:)I-'mi t:'--/ (:::(:)e~: ~: :[ {:: i ~:a:nt '..i~.ha]. ]. b~-:, :t. ,ass than 4. !qc)t mc2re '('.h~:~n 5;'; by ~-~eig!'-~t shall pa~.s the Iq(3. 200 si(-:-:ve, .];.:':'.; Per~o~"a'l:.ed pipe sl"'~a].l 1::)[?~ [~c::hedL~le 40 I:::'VC of ABS. ::~;.4. iF~(:)!id 4..-.inch pipe ~.:,ha!l be Cast I i'-or'~ 3.5 M~::)rl:i.'t(:)r standpil:)es~ shall, be installed as shc)wn. ]"hat .~ie(:::'l:.:ic)n c:,.F the pJ. pe p~,ne:~trat:[n(;; the gravel sha]L:L be pel"'i:O .... ri.t~t~?d ~ e:i th(.~:,r by dr i I ! :ing O. [5" l"i[]l es tin 6--.-:i. ric::l"i (::~:~['f'L~,~'"~z~ .j (:) :[ n :[ r~ g a !~:K:tic)n (:).1:: F'~:[() per-i:(]rated pile to a solid ~:::'~ [::' J. !:) ['~ - 2!;,, 6 Ger)te).i 'ti. :1. i.~:, !~-;l'"~a]. 1 be Mi fa.i: i :1. 40. 3,7 ]Zns,'...~iI. atic;n sha].l be e::.,'truded direct burial polystyrene, [)(:::,w CI'"~ (.-':.~ m :i. c: a ! ,~ t: y r (::i ~: (::)am H :[ 4 O. :::.~ ,, ~i!.) ]"op~.--.c:,i ]. -.:~ff-,a:i 1 be a mi ).,' ture (:).F 20-..-3().'..'; ~i!.ar'~(:] and :'?.()].". (::ir mc)r~:-:, Silt. A:L]. measure:,d by :i,,9 Grass seed shall be Kentuc:k¥ I:)luegra~ss. 4.0 I NSTALLAT I [IN ~:i[iF)e(:: i 'f: i cat :i. c:)n:~:~ -i.': er ?~et::)t :L (:: sy~.~tem J. nsf_al ]. a't::, i on l....c~t :1. -':1. ~ ][:(:]. i::~l:;: t:; ?. ,~ A1 p ;i. nc-..;, ~::) g. · !::u'ic. ure dr i. vL::.:.:ways ? e::..' J. st :i. ng or propcn~sed ~;~at:.er wel I s, water' c, onds,~ ancl all cx[::l'"~e:,r- .Fa(:::il~ties requiring separ"a'[:ion dis ..... tar",c:e:,s ~:r"c)m the pr(:.)posed sept i c: system. Nc)'~.i ~:y Owner or Engineer ch~ any obser'v~;:~d pc, ss:[ hie c:on-]:l :i. c:t:. 4,, 2 Stake al ignment o~: sys'Lem w:i. 'Lh markers showing p r (:) t' e c: t i v ecl :i. s t: a n c:,,-.'-:e s ¥ r o m w e 11 s a n d w a t e r' b o d :i. e ss. 4. 3 Establish an e].evation benc:hmark. ]"l'-~is BM c:~a.'...:¢ i 1 y i clc~nt i ¥ i ab 1 e ~ st'.ab I e anti permaner~t:. An e].eYati(::~r'., (:)~: 100 can lie assigned. shal 1 be arbitrary · '.':1..4 Ir~sta].l 't:.he t'.ank as showri c:,n the drawirigs. Record the in].et and outl(ca't: e].evatioris o-~: t. he tank. ]"ank sha].l be placed c:)n undistur'l:)ecl nat::Lve soil.. 4.5 E,xcavate t'.he a :~'sc)rpt i on -F i el d ,, Bottom o~: excavat, i or-~ sha].l be level and sc:ar~.~ied. Record elevat:ion o.~: each corner and c:enter i:)o:int o.F bed. Constructic)n equipment shall not oper'a'Ee on the -Floor o.~ the excavation. Any mater'ial c:c~mpacted by 't:he cu:)er'ation o~: t. he c:enstruc:ti,:)r~ equipment shall, r--emc)vect arid rep]. aced with uncompacted mater':i.a].s. 4.6 Place the rock to the depth Sl:)eci'Fied. Do not. contami ..... nate r'oc:l.:: with nat~ive materia].s or spoi].s ~r(:)m the excava-- '~.i(:)n. [..[eve]. the l.'-o(:k sur-~a(::e (+-- 1 ") be.~or-e instal lil]q thee pe:,r'~ orated p :i. l:)e. 4.7 ]:nstal:l the distribLr~.:[c)r~ pipe. Record the elevation eac:h joint. F'(]r pressure system sol. vent we].d t..he joint...s. 4.8 Cover' the cl:i. str:i, bu'~.'i, on pipe with r" c) c: l.:: ~ and e::.,'(:::avat i ,::::,r-~ wi th ge:.:,c)t'.ex ti ]. e be~:c, re back~,: i 11 ing. st..tr'~ac:(::~. ~:(::, i::)r'ovicie:, dr-'aina(~]e. c: o v e r 't:. h e:, G r a d e t h e 4,,9 Recor'd the ~:inish grour-~d el evatic~n at each corner and a t. t h e m :i. cl p (::) :i. n t o ~c '!:: h e b e:, d ,, 4. 1() F"l.a(:::(.? '[opsoil 'Lo a to'Lal uncc~mpac:t:ed depth c)'{ 4 inches. Ral<e arid roZ~ tc)l:)soil ,, Spread see,:::ls ar-~d ~at. er as r~eeded. 4.. 1! Furn:i. sha c:c;py c)-F a].l sucvey notes to t. he Engineer. INSPECTIONS ...~. 1 A m:i.r~imum c::,.~: t. hr'ee i~ ._.~F[..c.~.ions are ~:ir"st inspection will be o-f: the oper~ excavati(]n,, At this t:i. me the soil c:onclitions w:i. ll be obser'ved and compared t'.o the design assumptic:)ns. Gr'c)ur~d water (:(:)r]ditior~s c~r' i:)r"esence (:)-f be(::lrc)c:l.:: will t:)e veri.Fiecl. 'T'he second inspection will be a.Fter placement s'['ar~(::lp:i, pe's~ i::!:i, str:i, bL~tJ.c)F~ pip:i, ng~ t'.ank (s) anti o'l:he':,r' r"~er-~'!':s ?~s -.spec:i~:ied. gravel , c: c:, m p (::~-. P-~l'~¥ d~..:~,f:i.c:Ler-~::::::i.e.-'.s-; t.~:i, ll be:, note.,d and the:, Contractor 5,2 A1 1 e] ec'i':r'ic~?~l wor'I.:: r'eq~..~,:i.r'.e:,~:.-'; e:i. ther' an MOA e].ect, r:~c,'~l :-:ii;L.~.bm:[ '{:: [:)r'.,:)of (::).f i r'[.~!::)(.:?c:t, i ~:)r'i or' c~,r-'/: ~ f :i. cat. :[ c~r'i to the':, Engineer. 5.:::.!: ~Subm:i.t c:ata].og data of all mec. har~ic:al e(:luipmer'[t. 5./.[ I'.~ot.:i.¥y Engineer at l(:{:,as;t 24 hoL~r'!s in advar"~c::{a o¥ ri:i. r't,.:j ar'~¥ w(::)r-[::. I:] eg J. r"~- S;!::)ec:i. f i cat i (::)~"~s ¥ (:::q'- s~,ep't :~ c: s;ys;t:em :i. r'~s'[:a:l. 1 at i or"~ l....ot :1. 4 ~, [-):I. c~<::k 2. ~ P~:L p:i i"~a P C:! - 4 MUNICIPALITY OF ANCHO~GE MEMORANDUM Date: TO: FROM: SUBJECT: July 19, 1991 Accounting and Budget Fourth Floor On-site Services, ESD Fifth Floor Request for Refund - Account ~ 2570-9426 The applicant applied and paid for a sewer permit on March 4, 1991 ($90.00). The civil engineer applied and paid for a sewer and well permit ($140.00). All that was required of the engineer to pay was for the well permit ($50.00) so that between the two there was ONE sewer and well permit application. Please make arrangements for the $90.00 overpayment to be refunded to the civil engineer. Thank you. Tobben Spurkland, P. E. 6751 West Dimond Boulevard Anchorage, Alaska 99502 Receipt~22689/6456 Amount $90.00 Account ~ 2570-9426 Lot 14 Block 2 Alpine Woods Subdivision Permit ~ SW910095 Laura J. Montgomery On-site Services cc: File Customer Services ~'~' MUNICIPALITY OF ANCHORAGE -" Department of Health & Human Services ~,?~J" _~X,, ,t, On-Site Sewer/Well Permit Application NOTE: '~catio~ taus! ~ out comp e ey SI NGLE FAMILY DWELLING Legal Description Lo1 Lot Size ~' ' ! '-''] ~ r~'% Acres/Sc!. Ft Number of Bedrooms: /'IL Parcel tdentihcation Number Day Phone 5¢-/61/- ~7'-:~,.- zip Code Q /S BlocI~ Township Inspections will be conducted by: Approved Engineering Firm "~' Municipality (permit fee included) Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, Jacuzzi, or Water Softener Unit? j"~O If yes, which one? Subdivision Range This application is for: Sewer Only ~' Sewer and Well ~ Sewer Upgrade __ Well Only I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and in accordance with applicable Municipal codes. /' Receipt # ~, ~ Prop'l~y Owner/Well Driller Fees: 72-012 fRev. 10/86) Legal Description Parcel Identification Number ' . ..? MUNICIPALITY OF ANCHORAGE ' -':'* Department of Health & Human Services · ' '~,':~ -.ck~'~' On-Site Sewer/Well Permit Application ,"-"q'~'- ¥~ SINGLE FAMILY DWELL NG Mailing ~ss ~ 0 · ~* % ! IOE W b A ~ 9 Zip Code ~q~// Block ' Subdivision Township Inspections will be conducted by: Approved Engineering Firm Municipality (permit fee included) Section Lot Size ~ 'f' q LI , 5LM-P _ ¢~i~l~/Sq ft Number of Bedrooms: /7/ Range Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, Jacuzzi, or Water Softener Unit'?. If yes, which one? This application is for: Sewer Only Sewer and Well 7~ Sewer Upgrade __ Well Only I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling Fees: ~.~,, ¢ 0 Receipt# _ ~ L/~~ L~~Permit #. '~/~)~'~'~', 72-012 IRev 10186) Municipality of Anchorage ~  DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Services Division Telephone: 343-4744 · ~ ON-SITE SERVICES FEE DOCUMENTATION , f -~ Permit Number: Legal Description(s): ~ .~ Type of Payment: (Indicate Amount Paid) -.Health Authority: Excavator Permit: ~ewer & Well Permit: Engineer Permit: "" · ~0~j'- Pumper Permit: Well Permit: VI(~~ Well Driller Permit: Sewer Permit: Tank Manufacturer: Copy Request: 72-034 (Rev. 10/87) (Waste Treatment) DISTRIBUTION: WAIVERS: Lot Line: Well to Tank: Well to Field Field to Surface Water Tank to Surface Water WHITE--MASTER FILE CANARY--PROGRAM FILE  Municipality of Anchorage ~ DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Services Division ' Telephone: 343-4744 ...................... '~" f ON-SITE SERVICES FEE DOCUMENTATION Date Paid: 5 ~- f '~/ Permit Number: N~.me o,t/Pay~r:,(Name~n"n/Check) / /~ - ~' ~ ,Z~Z~-~7~/~7~.~',c/~ Fo'" Receipt ~: Maili~gA~dress:(Of~ofc~ ~ ~ / ~~~ ~/ Legal Description(s): ~/~ ~ / ' ~'~ ~~ OS-- 22689 Type of Payment: (Indicate Amount Paid) ealth Authority: Sewer & Well Permit: 5-0/o--0 e/to/¢o Well Permit: Sewer Permit: Copy Request: 72-034 (Rev. 10/87) Excavator Permit: Engineer Permit: Pumper Permit: Well Driller Permit: Tank Manufacturer: (Waste Treatment) DISTRIBUTION: WAIVERS: Lot Line: Well to Tank: Well to Field Field to Surface Water Tank to Surface Water WHITE--MASTER FILE CANARY--PROGRAM FILE Tom Fink, Mayor ] unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 January 8, 1991 Abraham Gallo PO Box 11846 Anchorage, Alaska 99511 Subject: Lot 14 Block 2 Alpine Woods Subdivision Permit #900147, PID #015-234-22 The subject permit, issued by this office ~fo.r a single family well and/or on-site wasteWater system has expired as of December 31, 1990. A new permit must be obtained from this office for a well and/or on-site wastewater system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as-built inspection report (three-part form) must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the f, ees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. JoSh Smith, ~P.E. PrOgram Manager On-site Services JW/ljm:200 enc: Copy of Permit "Kids Are Our Future" / L. oT' ~ .tg go goq~ ~& \ / / bof SEWER SYSTEM LOCATION PLAN- LOT ] BLOCK I SUBDIVISION 14 ~__ ALPI KIE NOoO~ SECTION / TOWNSHIP/RANGE $23 T 12M E,3k, i SCALE s NOTE. THE: ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, WELL. S~ AND SEPTIC SYSTEMS INOICATED IS NOT EXACT. DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. ~REPARED FOR, ACREACE SYgTEM£ PERFORMED FOR: LEGAL DESCRIPTION: L_ b. bo ') 5VV' Township. Range, Section: SLOPE Ttz N F__ ~ 6) 5~ 5 SITE PLAN ; lO 11 12 13 14 15 1G 17 18 19 20 WAS GROUND WATER ENCOUNTERED? ~5 IF YES, AT WHAT r..)) O DEPTH? (~ p E 0epth tO Warn' Aller 7j ~'/2~/,aO~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inchj PERC HOLE DIAMETER COMMENTS PERFORMED BY: /~. ~l ~' ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/851 TEST RUN, BETWEEN ~ FT AND I __Y'~L,~_./ , ERTIFY THAT THIS TEST WAS PERFORMED IN MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION ~Complete legal description Location (site address or directions) Property owner Mailing address Day phone ~ ~-'-- ~I L~_.% Lending agency Day phone Mailing address Agent Address 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 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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. Phone Name of Firm "'~/o/~ ,,, ~ Address ~D Engineer's signature bedrooms. D~/$ SIGNATURE Approved for Date Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91] Back MOA #21 KI::C E I V I:L., Municipality of Anchorage MAR 2 6 1999/ DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNI(.IPALI~Y OF ANCH( 825 L Street, Room 502 · Anchorage, Alaska 99501 · (90r~v:~-~'~sERwcEs Legal Description: Health Authority Approval Checklist A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date comptete~/. / Total depth Cased to // / Sanitary seal (Y/N) Date of test FROM WELL LOG/ Static water level Well production / g.p.m / WATER SAMPLE RESULTS: Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~//~'~o/~' / Tank size /,~o'~P Number of Compartments ~ Cleanouts (Y/N) Foundation cleanout (Y/N) "/ Depression (Y/N) l"-I High water alarm (Y/N) ~"'-I Date of Pumping '~///~'5/~ '7 Pumper A t C. ABSORPTION FIELD DATA Date installed IO/~.,~/c~ ~ Length ~' 0 ~ Width Effective absorption area ~, ~ Date of adequacy test I',/,/,,~, Fluid depth in absorption field before test (in.); Fluid depth -"/ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) Soil rating (g.p.d./ft~ ~) J, 2 System type Gravel thickness below pipe L/o I Total depth C~ ! Monitoring Tube present (Y/N)__~___ Depression over field (Y/N) Results (Pass/Fail) v'/ For ~ bedrooms v'/ Immediately after '/"gal. water added (in.): / Absorption rate = /' g.p.d. If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* ~--~' *Datum ~ ~"/~ Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line SEPARATION DISTANCES FROM WELL ON LOT TO: ~ ~ adjacent lots ~ On adjacent lots ~ Public sewer manhole/cleanout ,~"~ Lift 'station "Pump off" level at* J/ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~ ~ Property line (~ ~ Absorption field Water main/service line J ~ Surface water/drainage r,-I l O Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~----~ Building foundation I "7 ~-/ Water main/service line '~ / ~ Surface water l'J l ~ Driveway, parking/vehicle storage area ~> /~-,,--~._~ Curtain drain I'- [ ) O Wells on adjacent lots J ~ ~ ENGINEER'S CERTIFICATION recorcl~hat t~e above sys~ ~re I ce~i~ that I have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signature ~. ~ Engineer's Name I"t ~ ~ -~ ~1 0 ~' )/'-L ~ ~ ~ Date ~//~ HAA Fee $. Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)*