HomeMy WebLinkAboutALPINE WOODS BLK 3 LT 2Alpine Woods
Block 3
Lot 2
#015-234-24
. I G�-c3aN ou?5. 13.0 4.0 • C
2.ax "pry. S ah'sr -
�OLF..p-
-- +Z {jLVH.tW LLCs'aNO.xT t i.axl.a izec�3a0p_Wtrr
j-
2. N
r r - Llf:r 'SrPTioN 00
Lor 2 9 50 �•��, -
anS�rtiaIL
gk� WT -
V's IwL
A.
Al
rr r, Kenneth G- Legg ` �� g
D, !
. Ls - 5202� 1;%(7 Z-aT�
c
s -r 7s•x3eCeab-
PLOT PLAN AS BDILT
� SCALE
KENNETH G. LANGF L.S. 1731 GEORGE BELL CIRCLE, ANCHORAGE, AL;$= 99515 (907) 345-6476
I HEREBY CERTIFY THAT I HAVE SURVEYED- THE FOLL014ING DESCRIBED
PROPERTY: LOT 'ii $#
LOCK r �aLPl1�1 ooc� 6 i�IC7 e s OF A f 7444
C-4of'-FaX=r6 RECORDING DISTRICTr ALASKA, AND THAT.THE IMPROVE � ���.•'•"•••a«3 (,�4
TENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND DO NOT � � • •'� �¢
ENCROACH ONTO THE PROPERTY ADJACENT THERETO, THAT NO IMPROVEMENT'S •' *�'•49;��
ON THE PROPERTY LYING ADJACENT THERETO ENCROACH ON THE SURVEYED ���"•' "' ' "•"•*•�
PREMISES ARID THAT THERE ARE NO ROAD�IAYS TRANSMISSION LINES OR � �
OTHER VISIBLE EASZMENTS ON SAID PROPERTY EXCEPT AS INDICED
AT�*''� •Keatr¢t�� ten•• �
HEREON. s �� • ti 3
�'. L5
DATED THIS THE }`h.�•••,....••'-•,S'o
ALASKA. DAY OFTetZ AT ANCHORAGE,
��
CUBM17`TAI
Municipality of Anchorage
JR
On -Site Water and Wastewater Program • (907) 343-7904 ppy 01TICIZ of
ON-SITE WASTEWATER INSPECTION REPORT
OI JS -2;k -Z9
Permit Number: OSP121278 PID Number:
Dwelling: N Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑Q Upgrade
Name:
TED CAHALANE
ABSORPTION FIELD
0 Deep Trench Shallow Trench ❑ Bed ❑ Mound
Address
11820 MOOSE RD., ANCHORAGE, AK
_ _
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
1.2 GPD/SF
10!1 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3,5 Ft.
I Gravel depth beneath pipe
7.1 Ft.
Subdivision Block Lot
ALPINE WOODS 3 2
Fill added above original grade
0-1 Ft. 1
Gravel length
40 Ft
Township Range Section
Gravel width
2f Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
TO
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
9!6 46$ Ftz
1
NA Ft.
Well
>100'
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Capacity
Surface Water
>100'
Gal.
Material
Number of compartments
Lot Line
>10'
NA
Foundation>10
LIFT STATION
Manufacturer
Capacity
Curtain Drain
>20'
Gal.
Remarks
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank rank to SCH40
drainfield
Installer
A+ HOME SERVICES
Drainfield SCH40 COJMT F810
Inspector LARS SPURKLAND & ANSON MOXNESS
BENCH MARK (Assumed elevation)100 ft
Inspection 1� 10/4/12 10/5/12
lLccationandde�scriirtion
2m
s" a�
BOTTOM SIDING NW CORNER HOUSE
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
_En-�eWtamp
Conditional Approval: Date
' 1�
% LQ -K-
CO K-
49 T
.. ... ...
....c04.. ..
PURKLAND;;r /
/I
C ••. 115P���0,� �//
+lll\\FE`SNs
ApproveAAWV�Date B ( 1
S
Inspection Repd -Y1-12.doc
SLOP
B
WA� -
II
PE 30 3yi
�v
/SLOPDOO
-
LOT 3
l LOT 1
/ Septic!)/ Area
SWING TIES LOT 2
b ,
C 39' 80'
D 37.5' 1I0
/
CE—� l /
SID
S
W 3
A�PIBL�CK
INSTALLED 3 -BEDROOM �BIlW
INSPECTED AND VERIFIED TANK INTEGRITY
TRENCH LENGTH 40 FEET
WIDTH 2 FEET
MAX EXCIVATTON DEPTH 10 FEET
ROCK DEPTH 7 FEET
COVER 3 FEET MIN
NOTE: ALPINE WOODS SU60IVISION SERVICED BY A
COMMUNITY WELL. NO PRIVATE WELLS ARE WITHIN 100' Of
THE PROPERY IN QUESTION
NOTE: THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC
LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER
DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE
APPROXIMATEE,
Nol: Pc:hk ISis Io+ corner
'
qr-* CL
25 0 25 50 75 100 125 150
SCALE, 1' = 50 FT
I51'UKKLANY LNERNELNINU (( ALPINE WOODS BLIT 3 LT 2 I I SEPTIC SYSTEM ASSUILT
203 W 15TH, AVENUE
ANCH. AK, 99501 TED CAHALANE BATE,1)CT 12, 2012
(907) 279-3916 11820 HOGS£ RB ANCHORAGE, AK 99516 SHEER 213 DRIB, 2738
9
Deep Trench:
2' Vide
40' Long
10' Max. Depth
7 ' Sewer Rock
Distribution Line (typJ
3/16' Hole 30' on Center
Trench Devation
Monitor
Slit Barrier
Z(Ft of Septic Rock
00
Existing 1250 STEP Tank
Verified Tank Integrity
BENCHMARK 80770M SIDING NW COMER
ASSUMED ELEVATKAY 100'
Test Hole (1
B.O.H. ELEV = 104'
Q
c
0
w
a
3
131'UKAIA IJ tNUINEEKI E, I I ALPINE WOODS BLK 3 LOT 2 I I SEPTIC SYSTEM ASBUILT I
203 orue Ave TED CAHALANE DATE, OCT 12, 2012
279-39, Ak 99501 11820 MOLTS£ RD.. ANCHORAGE AK 99516 SHEET, 3/3 GRID: 2738
PERMIT If OSP121278
PARCEL IB B 015-234-24
ALPIN£VOODSB2L3D3-ASB.DVG
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP121278
Tax Code Number: 01523424000
Work Type: Septic Upgrade
Permit Effective Dates: September 21, 2012 to September 21, 2013
Design Engineer: SPURKLAND ENGINEERING
Subdivision: ALPINE WOODS
Site Legal Address: ALPINE WOODS BLK 3 LT 2 G:2738
Owner/Address: CAHALANE TED W &
MONTAGUE-CAHALANE DONNA K 11820 MOOSE RD ANCHORAGE AK 995162470
Site Mailing Address: 11820 MOOSE RD, Anchorage Lot Size in Sq Ft: 34488
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
IL
)l
Issued By: Date:
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage Alaska 99519-6650 s (907) 343-7904 • Fax (907) 343-7997
http://www.muni.orm/Onsite
Development Services Division
On -Site Water and Wastewater Program
ft,_P"t",e�n
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSP121279 COSA#: _ Permit#: OSP121278
PID#: 015-234-24
Legal Description: Alpine Woods Block 3 Lot 2
Engineer: Spurkland Engineering
Applicant: Ted Cahalane
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 20.0 feet.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
...............................................................................
Waiver is Granted: X Waiver is not Granted:
Date: C1 Z -7— Approved by: / //
Name of Rev' er
.............................. 0......................... '.....................
Ree#: 00712G Amount: $200.00 Date Paid: 8/28/12
**** VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
Community Development Department "<} Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. Ois- 234- 74
Property owner(s) IED CAhAtANE Day phone 345 bicgl
Mailingaddress (1920 fvlc,ose ikd., Alca-mAGG, Av 9`15(6
Site address S AMe
Legal description (Sub'd., Block & Lot) Ai�wt Wcmo% 13ir Lo'T a
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR:
THIS APPLICATION IS AN -
N:(®all
(Z allthat apply)
Initial ❑
Absorption Field
Septic Tank
❑
Upgrade 9
Holding Tank
❑
Renewal ❑
Privy
❑
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature bf property owner or
Permit/Rush Fees: 5 Waiver Fees: 90''01
Date of Payment: W't Date of Payment:
Receipt Number: 0-- -5U G Receipt Number:
Permit No. OJf 10V)-�9 Waiver No. OSV 1'a.1"a,10X
G:\Building\On Site\Forms\Client Forms\Permit App_010411 A00 (Rev. 1 /11)
SpoNand Engopne going
Environmental Consulting and Design
go I
SEPTIC SYSTEM DESIGN
Municipality of Anchorage August 23, 2012
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519
Subject: Septic System Installation Permit
Alpine Woods Block 3 Lot 2
Ladies and Gentlemen:
I am writing to request a septic system upgrade permit for the above referenced property. The
existing drain field is no longer functioning adequately. The proposed system will serve a 3 -
bedroom single-family residence. Soil logs, design calculations, a site plan, design drawings and
construction specifications are enclosed for your review.
Design Calcs: No groundwater observed up to a depth of 18 feet below ground surface
(8/21/2012).
Soil Rating. From test hole 8/14/12
3 min/in = 1.2 gal per sq.ft./day
2.5 min/in = 1.2 gal per sq.ft./day
No. of bedrooms
Required area per bedroom: 150/ 1.2 =125 sq.ft.
Minimum area required: 125 x 3 = 375 sq.ft.
System: We are proposing a deep trench absorption field connecting to the existing 1000 gallon
tank and lift station. The absorption field will be 40 feet long and 2 feet wide and contain 7 feet
(560 sq.ft. effective) of sewer rock.
Soils: Two Test holes were excavated on August 14th, 2012. See the attached soil logs. No
groundwater was observed up to a depth of 18 feet below ground surface on August 21, 2012.
Ground water monitoring will continue through construction of the septic system.
Surface Water: There are no surface waters within one hundred feet of the proposed septic
system upgrade. Intermittent surface water was observed in the west ditch along Moose Road.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland@gci.net
spuMand
Environmental Consulting and Design
Topography: The test holes are located on top of a hill in a generally level area. The hill slopes
down towards the south-east at grades ranging between 30 to 40%.
Waivers: Slope Waiver- The absorption field is located on the top of a hill approximately
16 — 20 feet above the elevation of the house. The maximum slope of the hill approaches 40%.
See attached profile. We are requesting a slope distance waiver of 20 feet. The slope is heavily
vegetated and no adverse impacts are anticipated from granting the waiver.
The installation of this septic system will not prevent wells and septic systems from being
installed on 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.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely,
LjP --
Lars Spurkland, P.E.
Civil Engineer
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland@gci.net
I �---
Q
GRIM Y AVE _ I LOT 4
I / �-
QI I VACANT
th
RA VEN III TRD
W Q O D S S D I I VACANT
I I O LOT 3 I
i
LOT 5
G P1 I
Q' LOT 12
V
LOT 2
BL OCK 4
/ q
LOT 6 (:;Ae c�
/ LOT 13
/
/—Sderenl .
J / /
/ll/
LOT
7
+o / /
NOTE• ALPINE WOODS SUBDIVISION SERVICED BY A
COMMUNITY WELL. NO PRIVATE WELLS ARE WITHIN 100' OF
TH£ PROPFRY IN QUESTION
NOTE.- THIS IS NOT A SURVEYED PUT. WELL & SEPTIC
LOCATIONS TAKEN FROM ON-SITF WATER AND WASTE WATER
DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE
APPROXIMATE.
50 0 50 100 150 200 250 300
SCALE, I' = 100 FL
:PTIC SYSTEM DESIGN
DA TE,- AUGUST 10, 2012
SHEET' 1/3 GRID, SW 2738
PERMIT # L77111OXX PID # 015-234-24 ALPINEW00DSB3L2SC100.DWG
i
SLOPE 0-5Z
LOT 1
Septic!
/ Area
WDD
A ►- P B �- N �%
INSTALL 3 -BEDROOM SEPTIC SYSTEM
INSPECT AND VERIFY TANK INTEGRITY
TRENCH LENGTH 40 FEET
WIDTH 2 FEET
MAX EXCIVATION DEPTH 10 FEET
ROCK DEPTH 7 FEET
COVER 3 FEET MIN
NOTE.: ALPINE WOODS SUBDIVISION SERVICED BY A
COMMUNITY WELL NO PRIVATE WELLS ARE WITHIN 100' OF
THE PROPERY IN OUESTION
NOTE.• THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC
LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER
DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE
APPROXIMATE.
25 0 25 50 75 100 125 150
SCALE I' = 50 FT
STUNKLANU LNUINLLNINU I I ALPINE FOODS BU 3 LT 2 I I SEPTIC SYSTEM DESIGN
203 W 15TH. AVENUE TED CAHALANf DATE. SEPT 12, 2012
ANCH. AK. 99501
(907) 279-3918 11820 MOOSE RD ANCHORAGE, AK 99516 SHEET.- 2/3 GRID: 2738
PERMIT # 3SP1210XX PID # 015-234-24 ALPINEVO3DS83L2SC50.DVG
N
Monitor.
Deep Trench:
2' Wide
40' Long
10' Max, Depth
7 ' Sewer Rock
3' Cover Min,
Distribution Line (typ.)
3/16' Hole 30' on Center
Trench Elevation
Silt Barrier
3' Cover
7 ft of Septic Rock
00
Existing 1250 STEP Tank
Verify Tank Integrity
SPURKLAIVD ENGINEERINGI I ALPINE WOODS RIK 3 LOT 2 I I SEPTIC SYSTEM SCHEMATIC
203 W15th Ave TED CANALAN£ DATES SEPT 12, 2012
?7ghoIgla Ak 99501 11820 NOOSE RD,. ANCHORAGE. AK 99516 SHEET- 3/3 GRID: 2738
PERMIT # OSPI210XX PARCEL ID # 015-234-24
AL PINEVOODSB2L 3D3. DWG
s
W
v
O
ti
W
ti
Q
2
W
W
2
Qr
2
Q
LQ
U
2
O
�i
0
rl
I
a2
LO
N rn
rn
� Y
O a
W
C7
a
W 0
�Csx
m=a
Q
O"o
Oo� v
N �
O d'
O ti
0 O
Q
CD
0 o
; Un
o
0
0
0
L6
I,
I toV
(U
Q
O
I V -
J
i
m
a2
LO
N rn
rn
� Y
O a
W
C7
a
W 0
�Csx
m=a
Q
O"o
Oo� v
N �
O d'
O ti
0 O
Q
0 o
O
o
0
0
0
co
I,
Municipality of Anchorage
Development Services Department
Building Safety Division
�r On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507
www. ci. anch orage.a k. us
(907) 343-7904
Soils Log - Percolation Test
49
l P�f
/ ..
LABS E. SPURKLAND, !
Performed For: TED CAHALANE Date Performed:
Legal Description: ALPINE WOODS BLK 3 LT 2 Township, Range, Section: _
�j
Depth
1-
Date
LDAr�
2-
op
S
S; lE w j
(5aii�
L
I
0
P
iraik
4-
I
n
1:44 PM
10 MIN
8.563"
3.313"
\�t�a��l
CSL)
8/14/12
Dc
I
8.500"
5-
f I
8/14/12
2:04 PM
30 MIN
6-
o0
5.187"
8/14/12
2:14 PM
40 MIN
8-
3.313"
5.250
lay�n5
9-
50 MIN
C�wJ 6nL�
10-
�
8/14/12
11-
�.`�,
W��fPQ
12-
I11�
GC qe,�
13-,)
14- fJ;
15-
16- p�,
17-
18-
19-'� N
Site Plan
WAS GROUND WATER
Date
ENCOUNTERED? NO
Net Time
Depth to Water
S
IF YES, AT WHAT DEPTH? -
L
Depth to Water After
0
P
Monitoring? 1$+
E
Date: 8/21112
8/14112
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
8/14/12
1:34 PM
0 MIN
8.500"
5.187"
8/14112
1:44 PM
10 MIN
8.563"
3.313"
5.187"
8/14/12
1:54 PM
20 MIN
8.500"
3.375"
5.125"
8/14/12
2:04 PM
30 MIN
8.500"
3.375"
5.187"
8/14/12
2:14 PM
40 MIN
8.500"
3.313"
5.250
8/14/12
2:24 PM
50 MIN
8.563"
3.250"
5.250
8/14/12
2734 PM
60 MIN
3.13
PERCOLATION RATE 3 (minutes7inch) PERC HOLE DIAMETER 6
TEST RUN BETWEEN 4.0 FT AND 5 FT
COMMENTS PRE-SOAKED.
PERFORMED BY: ANSON MOXNESS I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 8/27/12
Municipality of AnchorageN
Development Services DepartmentQ� . I i
Building Safety Division -f- g
yam. On -Site Water and Wastewater Program / I
4700 Elmore Road ; 49 TI r � P.O. Box 196650 Anchorage, AK 99507 10
www.ci.anchoraoe.ak.us
(907)343-7904 p .SPURKLAND;54c'
1150
Soils Log - Percolation Test i' •.a3 iz • ��
Performed For: TED CAHALANE Date Performed:8
Legal Description: ALPINE WOODS BLK 3 LT 2 Township, Range, Section:
Depth
;Feet)
bJti,, 0*AAC5
i
12-
o ,
13-'
14-
15-
16-
17-
18-
19-
S"� wj11 ,me
�rgMMJ t \
P
C5�1 ML.)
5.Di N
WAS GROUND WATER
Date
ENCOUNTERED? NO
Net Time
Depth to Water
s
IF YES, AT WHAT DEPTH? -
L
Depth to Water After
o
P
Monitoring? 13'+
E
Date: 8/21/12
8/14/12
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
8/14/12
1:40 PM
0 MIN
6.000"
2.000"
8/14/12
1:50 PM
10 MIN
6.000"
4.000"
2.125"
8/14/12
2:00 PM
20 MIN
6.000"
3.875"
1.937"
8/14/12
2:10 PM
30 MIN
6.000"
4.063"
2.063" 1
8/14/12
2:20 PM
40 MIN
1 6.000"
1 3.937"
1.937"
8/14/12
2:30 PM
50 MIN
6.000"
4.063"
2.000"
8114/12
2:40 PM
60 MIN
4.000"
PERCOLATION RATE 2.5 (minulesAnch) PERC HOLE DIAMETER 6
TEST RUN BETWEEN 4.0 FT AND 5 FT
COMMENTS PRE-SOAKED.
PERFORMED BY: ANSON MOXNESS I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 8/27/12
a
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name
_r9 ICA
&71/5 11,
❑ BED 'A W. DRAIN ❑ OTHER
DISTANCES
TO
FROM
SEPTIC
TANK
ABSORPTION
FIELD
WELL
Address
aox 3' 89
?&g iae A1r i !o
WELL
0.00
h $' + FT
Phone(s)
Cbz - X8'8'/
Gravel length
Permit No.
8" 8'u078
No. of Bedrooms
3
LOT LINE
!
'
FT
Total absorption area
4.1r-6
LEGAL DESCRIPTION
Lot
Z
Block
FT
Subdivision II7-5-
/gLP��� IW��S
FOUNDATION
1
�70 SQ FT
Township, Range, Section
I vN
rp 3 t`� ry _2—
/" I�
AS -BUILT DIAGRAM
driveway, water bodies,
(Show location of well, septic system, property lines, foundation,
etc.)
TANKS
SEPTICI,4f07- ❑ HOLDING
Manufacturer Capacity in gallons
Cd 7`W K 1 IX5_0
Material I No. of Compartments
WELLS
❑ PRIVATE "g OTHER (Identify)
Classification (A,B,C) Total Depth JCased to
AFT FT
Installer Date Installed:
REMARKS:
~ /) ENGINEER'S SEAL
Inspections Performed by -
Date:
certify that this inspection was performed according to all
Municipal and Slate guidelines in effect on this dal •
Health Department Approval: Date:
72-()13 (3/85)
TYPE OF SYSTEM
❑ TRENCH
❑ BED 'A W. DRAIN ❑ OTHER
Depth to pipe bottom from
Total depth from original grade
original grade
FT
FT
Fill added above original
grade
Gravel depth beneath pipe
h $' + FT
2
/ FT
Gravel length
3r)
Gravel width
�
FT
FT
Total absorption area
4.1r-6
Distance between lines
SQ FT
FT
Number of lines
Soil ratings
Pipe material
�70 SQ FT
`
f%/d D�o3
Installer L
Date Installed
WELLS
❑ PRIVATE "g OTHER (Identify)
Classification (A,B,C) Total Depth JCased to
AFT FT
Installer Date Installed:
REMARKS:
~ /) ENGINEER'S SEAL
Inspections Performed by -
Date:
certify that this inspection was performed according to all
Municipal and Slate guidelines in effect on this dal •
Health Department Approval: Date:
72-()13 (3/85)
INSPECTION REPORT.
MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION
3500 EAST TUDOR ROAD
INSPECTIONS (907) 563-3464 INFORMATION (907) 786-8211
1 � i
NAME 1 ' ���� �L / PERMIT No
STREET ADDRESS pHONE3
LOT / BLOCK / SUBDIV.O9 DATE_
FOOTING - ❑ ELEC. TEMP:/ ❑ PLBG. UNDGR. ❑
FOUNDATION ❑ ELEC. SERVICE ❑ PLBG. ROUGH ❑
BOND BEAM ❑ ELEC. ROUGH ❑ GAS TEMP. ❑
FRAMING ❑ ELEC. FINAL GAS ❑
INSULATION ❑ OTHER ❑ MECHANICAL ❑
SHEETROCK ❑ MECH. FINAL ❑
STRUCT. FINAL ❑ FIRE FINAL ❑ PLBG. FINAL Cl
OTHER ❑ ZONING ❑ OTHER ❑
?q
NO NONCOMPLIANCE OBSERVED ❑ CORRECTIONS ESSENTIAL AS
EXPLAINED BELOW
❑ WILL REEXAMINE AT NEXT INSPECTION ❑ DO NOT CONCFAl I INTn 0=l KlQoc^,l i '
INSPECTOR 1 I -J u
DATE
WHEN CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION
84-002 (Rev. 11/87) DO NOT REMOVE THIS NOTICE
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
825 L Street, Anchorage, Alaska 99501 343-4720
ON - SITE SEWER PERMIT
Permit Number: 880078
Date Issued: 06/09/88 Engineer Designed
Owner Name: TURNER CONSTRUCTION Day Phone:
Owner Address: P O BOX 3489 562-5881
PALMER, AK 99645
Parcel Id: 015-234-24
Lot Legal: Subdivision: ALPINE WOODS Lot: 2 Block: 3
Section: 23 Township: 12N Range: 3W
Lot Size 34488 (sq.{t. or acres)
Max Bedrooms: This Permit: 3 Total Capacity: 3
SEPTIC TANK: Minimum total septic tank capacity: 1,000 gallons. Each septic
tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.0
feet requires insulation over tank(s).
BACKFILL OVER FINAL GRAVEL LAYER AND SILT LAYER 10
THIS PERMIT EXPIRES ON DECEMBER 31, 1988.
SUBDIVISION SERVED BY CLASS A WELL.
I CERTIFY THAT:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for a maximum of 3 bedrooms. I
also understand that the capacity of the total system is 3 bedrooms and
any enlargement will require an additional permit.
Signed: DATE:
f�__________ _ _________�___________ __________
(Owner) TURNER CONSTRU�TION
Issued By: DATE:
-`------------------------- -------
l �
T111'. TUR\1:R CONIPANA
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
JUN 141988
RECEIVED June 10, 1988
I, Rexford L. Turner of Turner Construction Co., Inc.
of Alaska, designate Alice A. Smith as by company representative
to sign for and pick-up the sewer permit for Lot 2, Block 3
Alpine woods Subdivision.
Rexford L. Turner
June 10, 1988
Date
4155 Tudor Centre Anchorage, Alaska 99508-4155 (907) 562-5881
P. O. Box 3489 Palmer, Alaska 99645-3489 (907) 745-8334
e �
A
EC s ALASKA CnUIROWnTAL WOOL OURS, InC.
o Enqineerinq & Enuironmental Studies
SPECIFICATIONS FOR A FIVE -WIDE WASTEWATER TREATMENT SYSTEM WITH LIFT STATIO,
LOT 2, BLOCK 3, ALPINE WOODS SUBDIVISION
1.0 GENERAL
1.1 The drawings, sheets 1 through 4, shall be a part of this
specification.
1.2 All materials and workmanshop 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 elevations 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, maintain the specified separation
distances, and have the appropriate inspections.
1.5 If the installation is not inspected by an AECS engineer, AECS will
not be responsible for the installed 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
2.1 The existing septic tank may be used, if it meets the capacity
requirem, s or e rest once and the approval of DHHS. If not,
then specifications 2.2 through 2.6 apply.
2.2 The septic tank shall be a UPC approved two-compartment tank,
constructed of 12 --gauge steel with bitumastic coating, set level
on undisturbed soil and insulated with overlying layer of 2 inch
burial type polystyrene.
2.3 The septic tank shall be a minimum of 5 feet from the house
foundation, and a minimum of 5 feet from the absorption area.
2.4 The septic tank and drainfield shall be a minimum of 100 feet from
any private well or body of water, 150 feet from Class C wells, and
200 feet from Class A or B wells, unless otherwise specified. Less
than the required separation distance must have prior approval or
waiver by Alaska Department of Environmental Conservation (ADEC).
2.5 Piping shall be fitted with a mechanical watertight caller coupling
of the inlet and outlet of the septic tank. Piping shall be 4 -inch
ASTM D3034 or cast iron, sloped a minimum of 1/4 inch per foot..
2.6 Cleanouts shall be installed as designated, capped with air -tight
1200 West 33rd Auenue, Suite 6 • Anchorage. Alaska 99503 • (901) 561-5040
rain caps (.Jim caps or equivalent), and extend a minimum of 2 feet
above ground level.
2.7 If lift station is required it shall be combination lift station
septic tank per Anchorage Tank and Welding, Inc. design.
Specifications are attached.
3.0 DRAINFIELD BED SYSTEM
3.1 The gravel for the drainfield shall be 0.5 to 2.5 inch, screened rock
with less than 3% passing the #200 sieve. All substitutes must have
prior DHHS approval.
3.2 The bottom and side of the excavation shall be raked with the backhoe
blade to ensure that it has not been compacted during excavation.
The bottom elevation shall be level.
3.3 Monitor standpipe(s) shall be placed as shown in the drawings, and
shall be rigid PVC ASTM D3034, or 4 -inch cast. iron. The section
shown with holes may be drilled 0.5 inch holes on the 6 -inch centers
on opposite sides of the pipe, or a regular section of perforated
sewer pipe, clamped to a solid section, with either a no -hub coupling
or a solvent joint. A rubber rain cap (.Jim cap or equivalent) shall
be placed over the top of the pipe.
3.4 The distribution pipe shall be 4 -inch rigid FVC with a minimum crush
strength of 1500 lbs. All distribution pipes shall be laid level.
3.5 If the final grade of the drainfield is less than 4 feet above the
gravel, insulation is required using dow extruded blue styrofoam
board. There shall be 1 inch of insulation for every foot of soil
less than the required 4 feet of cover, but there must be at least 18
inches of soil cover 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 to prevent
freezing of the line.
3.6 If insulation is not necessary, the gravel shall be covered with a
layer of nonwoven engineering fabric.
3.7 It is recommended that the area excavated in the vicinity of the
drainfield shall be planted with a white clover, red fescue mix and
Kentucky blue grass.
4.0 INSPECTIONS
4.1 A minimum of two inspections are required for installation of the
bed. The first inspection will be of the excavation to verify that
the installation will be in the proper soil.
4.1.2 The second inspection will be after placement of the gravel. monitor
standpipe(s) and distribution pipe to verify proper installation
before backfi_11.
Anchorage Tank & welding, Inc.
2700 Porcupine Dr.
Anchorage, Alaska 99501
(9071 272-3543
TANK FOR LIFT SYSTEMS
A, SEPT... TANK SHALL BE A MODIFIED Ar-'CYORAGE TANK
STEEL EL TANK , THE:: DESIGN OR ANALYSIS :SHALL BE IN
ACCORDANCE WITH ACCE: PI ED ENGINEERING PRACTICE
AND LOCAL, REGULATORY LATORY AGENCIES,
B, THE TANKS SHALL BE DESIGNED FOR LOADING
CONDITIONS AS REQUIRED BY MUNICIPAL AND STATE.
REGULATIONS.
C. Alk WELDING DING SHAL.,L BE IN ACCORDANCE WITH
APPLICABLE CODES AND STANDARDS.
D. COATING SHALL BE TNEMEC: 46-465 HI -BUILD
TANK COATING AND APPLIED AS FOL LOWS ;
1. SURFACE PRE:PARATIC:r - ALL SURFACES MUST BE
DRY, CLEAN, AND REASONABLY FREE OF RUST ANI:
MILL SCAL4F" EXCESS RUST, MILL SCALE AND
WELDING SLAG SHALL BE: VKMOVED BY WIRE BRUSH
OR OTHER MEANS AS NECESSARY,
2. APPLICATION SHALL BE AIRLESS SPRAY TOUCH UP
WITH BRUSH OR ROLLER.
3, THINNING SHALL BE -ACCOMPLISHED WITH
APPROVED MATE::PPAL, AND WILL NOT EXCEED 5%.
4. SURFACE TEMPERATURE SHALL NOT BE BELOW 40F
OR 5 BELOW DEW POINT WHICH EVL:R IS LOWER,
5. INTERIOR SHALL BE COATED TWO TIMCS AND SHALL
BE A MINIMUM OFF 20 DRY MILLS EXTERIOR SHALL
BE. COATER ONE TIME ANIS SHALL BE A MINIMUM
OF 10 DRY MILLS.
Anchorage Tank & Welding, Inc.
(W,- 2700 Porcupine Dr.
Anchorage, Alaska 99501
(9071 272-3543
2, RISER
A, OUTLET RISERS SHALL BE GALVANIZED STEEL CULVERT,
AND SHALL BE 54 INCHES (MIN:FUM) , HIGH, SHALL
HAVE A MINIMUM NOMIMAL DIAKETER OF 24 INCHES,
AND SHALL BE CAPABLE OF BEING EQUIPPED WITH THE
FOLLOWI NW
A. A JUNCTION ( NEMA 4X) BOX OR EQUAL, BONDED
OR ATTACHEI:I TO THE RISER,
B. UL LISTED ELECTRICAL, CORD GRIPS, INSTALLED
IN THE J -BOX
B, A !.,ID -- SHALL BE FURNISHED WITH SHE RISER, IT
SHALL BE CONSTRUCTED OF FIBERGLASS OR EQUT ALENT
AGGREGATE FINISH,
C. RISER INSTALLATION -- EACH RISER SHALL BE SEALED
OR WELDED TO THE TOP OF THL TANK IN SUCH A MANNER
AS TO PREVENT INFILTRATION OF GROUND WATER
WH(. RE PRESENT.
D. INSULATION -.. 2" RIGID EXTRUDED POLYSTYRENE' -
SHALL BE PLACED IN THE RISER I.IRECTLY BELOW THE
LID,
E. INSULATION - 2" SPRAYED URETHANE ON
CIRCUMFERENCE OF RISER,
d;
Anchorage Tank & Welding, Inc.
2700 Porcupine Dr.
Anchorage, Alaska 99501
(907) 272-3543
3, EFFLUENT PUM'- :CNC: ASSEMBLY
A. EFFLUENT PUAPING ASSEMBLY SHALL BE ORENCO
SYSTEMS (TM) MODEL OSI WE 1.000 FRIES CONSISTING
OF FOLLOWING:
1, 1/3 H. P , MYERS SSM25 115 VOLT OR EWUAI..,
2. SCREENED PUMP VAULT (U.S, PATENT N4439323)
59- DEEP, 3/16" THICK Ha BH --DENSITY PVC
CYCLINDER HOUSES THE PUMP, LEVEL CON F ROLS
AND SCREEN AND SERVES AS A BAFFLE TO PREVENT
THE SCREEN FROM CLOGGING.
.
THE FIE`.TLEN 1--1/2" IIIA. HOLES ARE: DRILLED IN
THE VAULT AT A LEVEL THAT PLACES THEM AT
ABOUT THE MIDWAY POINT IN THL DEPTH OF THE
SEPTIC.
FLAP CHECK: ALLOWS THE VAULT TO DRAIN WHEN
REMOVING FROM TANK
SCREEN: 15" DIA, CYLINDER OF HIGH-DENSITY
POLYETHYLENE 1/8- MESH CAST INTO FIBERGLASS
BOTTOM,
3, AI.,'.., PLUMBING SHALL, BE PVC OR OTHCR NON --
CORRODING MATERIAL,
B, PUMP CONTROLS ANTI r"tLARM SYSTEM -
CONTROL SHALL, BE ORENCO SYSTEMS (TM) ML., --3F
CONS.T.STINC OF:
1, AUDIBLE ALARM PANEL MOUNT WITH A MINIMUM OF
So DB SOUND PRESSURE: AT 24 -INCHES, OP -RATING
TEMPERATURE -•30A`::": TO 65AC, CONTINOUS SOUND.
-
Anchorage Tank & welding, Inc.
�
Anchorage,
(W) 20ISS43
2. OIL -TIGHT VISUAL ALARM WITH PUSH -TO -SILENCE
�
� FLATURE. AUTOMATIC AUDIO -ALARM RESET.
� 3. 15 AMP MOTOR RATED TOGGLE SWITCH, SINGLE
^ POLE, DOUBLE-THROO WITH THREE POSITIONS;
' -
` MANUAL (MAN), AUTOMATIC (AUTO)' AND CENTER
` (OFF) (H.O.A.).
4. NEMA 4X -RATED, FIBERGLASS' OR EQUAL'
ENCLOYdRE WITH HINGED COVER.
�C. LEVEL CONTROL FLOATS SHALL BE ORENCU SYSTEMS (TM)
MF2 CONSISlING OF 2 MERCURY FLOATS ON ADjySTABLE
�
^ PVC STEM WHICH ATTACHES TO VAULT. ONE FLOAT
�
�
SIGNALS ALARM; THE OTHLR SWITCHES PUMP ON-OFF.
�
D. INSTALLATION. ALL PUMPING SYSTEMS SHALL BE
INSTALLED IN ACCORDANCE WITH THE MANUFACTURER'S
RECOMMENDATIONS AND STANDARDS.
'
m °
Reserve Capadty
12 GAUGE
121 1/2'
81'
above Alum
2209 GAL
2P1 GAL
333 GAL
Reserve Capacity
97'
48 1l2'
C4 BEDROOM)
above pump on
260 GAL
319 GAL
415 GAL
pacrty Between
1 t5 a 6 BEDRW
Pump on L Pump off
112 GAL
113 GAL
178 GAL
Atarm
46'
47 1/2'
42'
Float Ltwt
on
43'
44 ill'
39'
Settings
Off
13V
140 IIV
36'
LIFT STATION DATA
Galton per nwuU
TYPICAL PUMP PERFEItMANCE CURVE
SIZE SHELL A 8 C
r•
1250
12 GAUGE
121 1/2'
81'
40 1/2'
C3 BEDROOM?
1500
12 GAUGE
145
97'
48 1l2'
C4 BEDROOM)
2000
0 GAUG4
194'
1129 3
64 5/8•
1 t5 a 6 BEDRW
0
SIZE CHART
NOTE - LIFT STATION TANKS MUST BE 250 GALLON LARGER THAN
STANDARD TAWS FOR SAME APPLICATION
MI ITV_ Trr WrTAMir" rrvo Cn.�+nor..+ �+..-,. sl ••
1berDlass UO r/ C. foan
Lnd retaining nechanism
NEMA U junction box
'VC ball valve
24' ID x 4' 6'Cutvert Manhole
gextbte hose
r sprayed urethane foam
l 1/4' PVC pipe typ
L 1/4' PVC check valve
Adjustable Float Twitch Assembly
Seat with RAM-NEK or Equal
rubber grommet or vetded
sleet i i/4' pipe
1/4' din drain back hole
1 3/8' holes 6' DC
1/6' mesh polyethylene screen
15' da x 39' high
tetnlning angles
1/3 hp effluent pump, various manufactures
memo from the desk of...
LEROY C. REID, JR., Ph D
c�ti`
7e, -e-
14
nV A / `+a
Ir -\:
••1ENLitN��•• L/
/ V
t •
cam: 49TH :9*
Municipality of Anchorage s.;; ... • • • • • • • • • • •
DEPARTMENT OF HEALTH 8 HUMAN SERVICES +
4606 o**egos
825 "L" Street, Anchorage, Alaska 99502-0650 tFROY C. f REID, JR. •: • f
SOILS LOG — PERCOLATION TEST 1 -225 .'`
PERFORMED FOR: 7vrn y (.- c+1 f 71'✓LT /O/; DATE PERFORMED"
LEGAL DESCRIPTION: L a? i33 .qlr�/r,° %!40d/_S.Township, Range, Section: //.2 A� 7K
SLOPE SITE PLAN
DEPTH `
N
2 c 4
3 <^ Sari I°oorl ra"Iec� 711 z
4 'wd 44Srr, a // y r a --c /
5
r
6-
7 7
F
fro—
r "
9
WAS GROUND WATER
10
ENCOUNTERED? Q S
11 -
12-
13
14
15
16
17
18
19
20
S
L
IF YES, AT WHAT O
DEPTH? P
E
Depth to Water Atter ,
Ynnitnrinn? 7, Date:
Depth to
Water
_----MM
-
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS Z �+ I S-0 'cl 0
PERFORMED BY: L �� �� I L - Iad CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / /?'T
72-008 (Flea. 4185)
LOG
A
MUNICIPALITY OF ANCHORAGE
PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
$25 L. Svvo% AnchoraP, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: Bill Btt 4,%- c. DATE PERFORMED: Oct /y 1983
LEGAL DESCRIPTION: _A IT i Whc cls Black 3 4n f ZZ rrLIJ R4 w Md sr 83 02+
SLOPE SITE PLAN
Q PTS
1 -I 'i 1 1 i O` r'
:t�
fitxtui of SeaacS Of -c- 13ct"n 9.a" 1 ac 14.1 aAI S.nlS
4
5 i T1 11T i t"► �- fes.• ,s I+
S
C1C6n �r.i.►t\
WAS GROUND WATER `,o L
ENCOUNTERED? O
P
E
W YES, AT WHAT
DEPTH'
19
IV
moms MEN
woffimmmommm
MEMEN MEMO;;
MENEEMEMEN
ZO . PERCOLATION RATE O (minumfind+)
TEST RUN BETWEEN 6 FT AND FT Ile—
COMMENTS
Sol � $-' /++b -fa;�td t>t, 1{tSt a7W
on s�f� sar h� s Sly, Se'/ 'Ta�+s /i7 ,-1to /S, iS zrfcd es- t7 L
PERFORMED BY: ate` CERTIFIED BY: DATE:
Sol. / 'ni S
hi Z %r -►#d v'.rL'v-!/7 ' 12S 13/4 .
72-006 (6/79)
Gross
Net
Depth to
Net
Data
TWIG
rune
Water
Drop
j,...•.•.. �S, 1�
-y o,
, cly,
3 z
••9 �
3al
� �a
9L�
333
32
.z
•!-z
3 3 1y
v)
06
N •
•3f
3 S -1y
3 21-15
o a 5
ZO . PERCOLATION RATE O (minumfind+)
TEST RUN BETWEEN 6 FT AND FT Ile—
COMMENTS
Sol � $-' /++b -fa;�td t>t, 1{tSt a7W
on s�f� sar h� s Sly, Se'/ 'Ta�+s /i7 ,-1to /S, iS zrfcd es- t7 L
PERFORMED BY: ate` CERTIFIED BY: DATE:
Sol. / 'ni S
hi Z %r -►#d v'.rL'v-!/7 ' 12S 13/4 .
72-006 (6/79)
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
Lot Ki 3 /alpine foods Sd�.
JOB
SHEET NO. /2 OF
CALCULATED BY ' �` Q v DATE
CHECKED BY
SCALE
DATE
JU w
QZ Q
03 1
iW
W
MQU Fi H
H
H> p CF 0
ZW Zo
J h WN Z Q H
J QJ o a IL
3 YO Z 'Zi
o W Q� W
U1 H Q O 4 z -jm
a U N o m
w w Q
H F J W
a > >o
Q J
aF°+ ❑ Q = W
. H -� Y W [� N Q
HQ t!1 Q Q
0z f O
�Ul
° F- w H J 000 0
= w 0 H CRD
HI N N a) IL
cr
>I n Y
Q ! H' N rlF
wl O E'� H W a.
U z zz oz
W I N ° [L H In
LL d
> il. . H i MH
01, Q w N HF'Q WF
i W a U)
w of ao
H O� Qi LJt�A Qm
Jr Q a Cl
iL) Oz i�a(LH H�
w l w W H i Ir �, n O (A
IL Q
H! Na= o w °zi p Q= �O
Q O H U F-
cr; o z w o o a -
° I-- f FQ- H ? F- 0
W' Q_ 1 N Q:
°'; a c
3 U Q °�
W w H
lA i 0 itl
a
}
s
M
Q ^
� J
O �
7
F o
a �
W �
H O
p z
jZ
It
0
H w w
W H `\
f a0
to
M
o a o rl 44 i
p L z W
N
F- M Q U z
N N
Q h.
< M
} L
p O
IL a M
a O
NJ
p H Z
N ? Q to
O O ' z
. z v W
H <
• J �
f U
41
z
H
a
� �I
J U
Z
H
z
UJ
Z
J�
W 14
a
W
�
El
El
Z U
O
m
P
o
Q j
o
a
a H
41
Q
W
tL
Z
W
Q
a
Q J
Ej
tL z
_
tu
Y
i
Z
En
m
Q�
m
i
Z
w
Q O
N
U
O
� �I
J
17K
E3 y
_C
O
m �
3
D E3
A
.O
m �
C
<->
O
o_
C
A O
N
C
Z
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. #G/�5 231/ -may HAA #
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
lwl_ z 164,' 3 lolke rAJ11CD S �2.J ,zja1 SUZY
Location (addressor directions)
(b) Property owner 3 Telephone: (home) -/ Business
Mailing Address
(c) Lending Institution Telephone
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the following address: (or check here if hold for pick up.)
List contact person and day phone number below:
hatS 1,111L T/M R
2. TYPE OF RESIDENCE
Single -Family( Number of bedrooms 3
3. WATER SUPPLY
Individual Well ❑ Community' Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site`% Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm Telephone X 7
Addressy d 33 ry AK ft '3
Date /y ^L
OF At Ott
'C • •.�
0*%•4 H '9
i.... .•...00000 0:000
s
0 •0•. 00..000000• .
• LER C. REID, JR. *•
•
'• E. - 2251 '�I
••....•••��`�:e
6. DHHS APPROVAL i�
Approved for �� bedrooms by Date
Approved 4�2C Disapproved Conditional
Terms of Conditional Approval
CAUTION I
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated 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 isnot responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
iVl[JNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
A. WELL DATA
Well Classification
'kell Log Present (Y/N) Date Completed
Total t'—
h Cased to
Static Water el
Casing Height
Legal Description: 667- z
7—/i.0 ,Z3i-) 566 L z
Depth of Grouting
I(A B, C, D.E.C. Approved((Y )
Pump Set At
Yield
Sanitary Seal on Casing (Y/N)
Electrical Wiring in Condu%FRO
Depression Around Wellhead (Y/N)
SEPARATION DISTANCEELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments
On Adjoining Lots
; On Adjoining Lots
To Near-6st-Public Sewer Cleanout/Manhole
; Date
B. SEPTIC/HOLDING TANK DATA
Date Installed Size ZSO No. of Compartments �—
Standpipest)N) Air -tight Caps Y(�J) Foundation Cleanou (Y N)
Depression over Tank (Y& Date Last Pumped
Pumping/Maintenance Contact on File (Y/N) �� ; for
Holding Tank High -V. pr Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
SEPARATAON �T '4^_ .OM SEPTIC/HOLDING TANK:
To Water -Sul plylllell� To Building Foundation
To Property Line t ?%�S To Disposal Field j
i
To Water Main/Service Line f'
To Stream, Pond, Lake or Major Drainage Course A" fi
Comments `
72-026 (Rev. 7/88) Front Page 1 of 2
G y 83 .'irk
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 15-0 Type of System Design
Date Installed 7��%-Length of Field S3
IMAth of Fiolrl Denth of Field
Gravel Bed Thickness
Square Feet of Absortion Area 73 ` Statndpipes Present6�)N)
Depression over Field (YDate of Last Adequacy Test
Results of Last Adequacy Test A)IX
SEPARATION DISTANCE FROM ABSORPTION FIELD:
/
To Water -Supply Well AVIV -f' / To Property Line Z
r
To Building Foundation ` S To Existing or Abandoned System on
Lot xy x ; On Adjoining Lots
/
To Water Main/Service Line To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
/
D !'
D. LIFT STATION
y
Date Installed 7-�9" Dimensions �-"�Z��l,Of
/�" 7 �b�L
Size in Gallons ��� Manhole/Acces6N) q �/
"Pump On" Level at t(� "Pump Off' Level at j
r/
High Water Alarm Level at Vent&)
Tested for
Meets MOA
Comments
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request"
I certify that I have checked, verified, or conformed to all MOA and
inspection. � %�_
Signedr' !��
Company
Date /Z -L-0,
MOA No. OT -X'
HAA guidelines in effect on the date of this
4Ve4j. OF Al %W
,!�3,:+ NOer's Seal
ii
0`•• ....•...moi : �k
120 1% Receipt No. 0 V Receipt No.
Date of Payment f Waiver Fee: $ —
Amount: $ 7 J Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
Poon • ••il•••+••• i•
•
LEROY C. REID, JR. •
•, CE - 2251 w
00.
,0_ _� w
STEVE COWPER, GOVERNOR
3V e or IL oSK&
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775
3601 C STREET, SUITE 1334
ANCHORAGE, ALASKA 99503
DATE: December 1. 1988
PWSID: 213598
To Whom It May Concern:
According to the records on file in this office, the ALPINE WOODS
SUBDIVISION
Water System is in compliance with the State of
Alaska Drinking Water Regulations.
Sincerely,
!'1.9
'..Pit.. a2 % ,
Vera C. Craig
Environmental Field 0 ficer
