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HomeMy WebLinkAboutALPINE VILLAGE BLK 5 LT 6
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELL INSPECTION REPORT
LOCATION NO. OF B~ROOMS
~ ~ Manufacturer Material ~o. of compartments
Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth
0 Z ~ Manufacturer
=-~ ~ ~ e ~ Materia~~ Liquid capa~~
O Well Foundation Nearest lot line PERMIT NO.
~ ~ DISTANCE TO:
~ No. of lines Length of each line Total length of lines Trench width Distance between lines
inches
~ Top of tile to finish grade Material beneath tile Total effective absorption area
~ inches
Length Width Depth PERMIT NO.
~ p Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot tine PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(s) --
~ DISTANCE TO:
OTHER
",..
REMARKS
/
DATE LEGAL
72-013 (I 3/78)
PERhilT NO.
APPLICANT
LOCATION
LEGAL
SCHACHLE EXCA'v'BTING G~-'.': EAST 81 AVENUE 99507
~'.JO~., II_IR I CH STREET
r.lUN I ,-: Z PRL I T~r' C~F ANCHORAGE I 1',~1 ~
DEF'AF.'.TMENT.~.,~ .. ~"": HEALTH AN[:, ENV I F.'.,DNMENTAL~ , -, . ROTECT I ON ~. ~,~j~~~~
8~ _,TREET. ANCHORRGE., RK. ~;,._,O::L ·
,"',~,.4"~ -"'""FI
li.qr-J--S I TE $EL.~ER LIPGRRE:~E PERP11 T
,.~ . - ..'~ .-.,
( ...00~, .-. ::, j~ ;/~
· '> ,,4. zl. -- ~,~ .1 -t
400C'~0 SQURRE J~,T
TYPE OFSOIL ABSORPTION '-"s~=,T_-~n IS' TRENCH
MR,=.:,II'ILM NUMBER OF BEDROOMS
SOIL RATING (SQ FT/BF.'.)= ~ [~'~]~
THE REL--.!UIRE[:, =,IZE OF THE SOIL ABSORPTION SYSTEM IS
~,EPTH= I LEf~GTH= I laRR%-'EL
DEF'TH= ~'
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
~:E,2U I RED --~--'lm~T---I-C: TRr-~F~: S I ZE= 2000 GRLLOf-IS
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEF'RRTMENT DLIRING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
T[.~O ,:: 2 ::, I f~SPECT I O~lS ARE E~'E[~.LI I EEC,
E:RCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R HELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR 8 PRIVATE WELL OR i50 TO 200 FEET FROM R PUBLIC HELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET 8ND
TO R COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PER~I I 1' E>-~P I RE'~ DECErlBER -~'"l.. i98El
I CERTIFY THAT
i: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEHERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
S I GNE[:, '
APPLICANT SCHRCHLE EXCAVATING
I.:,=,LIED
V4. 0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT
~AILING ADDRESS
L____1657 E. Dowling
349-6641
.............................. l .....................
~ATION 7506 Zurich St.
I~t 6, Block 5, Alpine Village Subdivision
Anchorage, AK 99503
Wetl
DISTANCE TO: 55'
Me~,u facturer
Licl. capacity ha gallons
1000 IF HOMEMADE:
Weld Dwelhng
DISTANCE TO:
Manulaclurer Material
Well
DISTANCE 10:
Top of ~,l~'to finish q;aH~, ' ~.'l. Hm ud
b3
Lenqth [ Width
[)IST,~NCF T() __
[)IS ]-ANC£: 'ri)'.
PIPE MATERIAt S
SOIL 7EST RArlN,:
(} T ~ I E R
I)r:Fh,r
-~-NS]AL_[ EH
As-bu£1t inspection was made on
unexcavated in-place existing system.
The system was built prior to 1965.
The inspection was performed by
R&M Consultants, Inc. on 1.1-5-80
by ~JN J. COOPER, Staff Engineer.
~,o. of
,L,~l~ei~ d ep I h rom top
10.0
PERMIT NO.
L~('luid capacily in gallons
'Liquid capacity
13'
PERMIT NC).
ti uta! ,!ff~,<:t,v~ ai')~orHl,on area
1350 gallons
55'
!
APPROVED DATE LEGAL
I2.013 (Rev. 3t78)
LOT SIZE
SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS:
MAXIMUM NUMBER OF BEDROOMS =
SOIL RATING (SQ FT/'BR)=
THE REQUIRED SIZE OF THE SOIL .ABSORPTION SYSTEM IS:
[:'EF"TH= LEI"-IGTH= GRR%,'EL
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE E×CRVRTION (IN FEET).
REC~.IJ Z RED
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TL-~6~ (2) I [4$PECTIO[4$ I--IRE REt]LI IRE[)
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN 8 WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
i00 FEET FOR A PRIVATE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO' INSURE PROPER INSTALLATION.
PEEr4 I T E×P I RES DECEPIE:ER _--~-,-1 .. 2~80
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL' THE Sb'STEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THBT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INC~JDE MORE THAN ~ BEDROOMS.
/ ~PPL I ~NT /
. / /
L ina ~
m
Parcel ~I.D. #
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
014-132-15 HAA #
GENERAL INFORMATION
Complete legal description
Lot 6, Block 5, Alpine Village
Location (site address or directions)
7506 Zurich Street
Property owner
Mailing address
Lending agency
Mailing address
Andrew Carroll
Day phone
7506 Zurich Streetf Anchorage, AK 99507
National Bank of Alaska/ Randy Rh°q~'phoneu~
PO Box 107025, Anchorage, AK 99510
276-4535
257-3434
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:
XXX
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
xxx %
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 informati from
the Municipality of Anchorage files and from my investigation and ins ~e on-site water
supply and/or wastewater disposal system is in compliance with all Muni( and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm S & S ENGINEERING p .~ (~ cf ,_/ _ ~. ,~ '7 ~/
~0~4 Eagie ~Jver Loop Road NO. 204
Address Eagle River, A
Engineer's signature
__ Date
DHHS SIGNATURE
Approved for
Disapproved.
Conditional
bed rooms.
bedrooms,
with the following stipulations:
Additional
By: Date
The Munk ity of Anchorage Department of 'Health and Human Services (DHHS) issues Health Authority
Approval ;rtificates based only uPon the representations given in paragraph 5 above by an independent
ii 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
RECEIVED
Municipality of Anchorage ...... .~
DEPARTMENT OF HEALTH & HUMAN SERVICES JAN ?-5u
Environmental Services Division ~ur~ICIPAUW OF AN~
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907~8~7.~ S[RViCES Di¥1$1QN
Health Authority Approval Checklist
LegalDescription:[OT- (; Boo c,~ ._~' ~u,~,~ v,~u4~f. ParcelI.D.: 0~- 13~ -I $-
A. WELL DATA
Well type i°p` ~w/t r,~.-
Log present (Y/~_.~ r~ 0
Total depth I I S-' / ( P ¢,~-
Sanitary seal
If A, B, or C, attach ADEC letter. ADEC water system number
Date of test
Static water level
Well production
Date completed f',~,o~ ~o I~ 70
..,.,,. , )
Cased to / 15- Casing height (above ground)
Wires properly protected ~)'N)
FROM WELL LOG AT INSPECTION
WATER SAMPLE RESULTS:
g.p.m. '7 -/- g.p.m.
Date of adequacy test ,,~ Results (Pass/Fail)
Fluid depth in a~fion field before test (in.); Immediately after
Fluid depthS____ (ins)Minutes later: Absorption rate =
P~rdxide treatment (past 12 months) (Y/N)
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed
Foundation cleanout (Y/N)
Date of Pumping
C. ABSORPTION FIELD DATA
Date installed
Length Width
Effective absorption area
Nitrate Other bacteria
.- S & $ ENGINEERING
~ ' - ~ Collected by: !7934 E---~
,-,,=r Loop ~,oad No. 204
Eagle River, Alaska ~577
Tank size Number of Compartments Cl.,Jee~ts (Y/N).~
Depression (Y/N) High wa~(WN)
Pumper
Soil rating~
· ,,,Gravel thickness below pipe
,,~Monitoring Tube present (Y/N)~
System type
Total depth
Depression over field (Y/N) __
For
bedrooms
gal. water added (in.):
.g.p.d.
If yes, give date
72-026 (Rev. 3/96)*
D. LIFT STATION
Em
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested ~
SEPARATION DISTANCES
Size in gallons
"Pump on" level at* ___-------~ ""~Pump off" level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
On adjacent lots
On adjacent lots
Septic/holding tank on lot
Absorption field on lot
Public sewer main L/ .(, Public sewer manhole/cleanout
Sewer/septic service line ~ ' - v/,~-~.~ ~,~,,,,~.~ n~'~Lift station ~-' / ,~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: /~ z~ L~ C. 5'~ ~.~
Foundation .... Property line ____-' ' -- - ' -- ~"~"~--__~__-
Water main/service line .... Surface water/drainage _. ~- Wells on adjacent lots
SEPARATION DISTANCE FROM ABSOR~ ON LOT TO:
Property line ....---~uilding foundation Water main/service line
Surface water ~ Driveway, parking/vehicle storage area
C.~in Wells on adjacent lots
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal records
in conformancTT)AT~ui~inoffoct/~ on this date.
Signature ~ /c~ ~, , . ~~
.
Engineer s Name ~
Date )// '35-/, ~' ~
HAA Fee $
Date of Payment (~ / /~q>~'--~/~ ~
Receipt Number /__~-~"--~ :~/,~J~ ~
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR% PID~ 014-132-15
Date Received: Jan 25, 1999
HA# HA990031 Permit
Legal Description: Lot 6 Block~5 Alpine VillaKe Subdivision
Engineer Robert C. Cowan PE~ S & S EnKineerinK
17034 Eagle River Loop Road, Suite 204, Eagle River. Alaska 99577
Applicant: Andrew Carroll
Waiver Requested: Update current waiver from 17' to 12' between the private
Reference Waiver # WR88-076 issued on
well and sewer service line on property.
January 4, 1988
Criteria: 1.
Geology:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal.Separation
TOTAL:
Points:
2. Special Conditions:
3. Other:
Waiver is Granted: Waiver is NOT Granted:
List Conditions or Reasons for above:
Date: By:
Rec ~: Amount: $
Name of Reviewer
Date Paid:
ROBERTC. COWAN, RE.
ROBERTA. SHAFER, RE.
January 22,
1999
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
MUNICIPALITY OF ANCHORAGE
Department ofHealth and Human Services
PO Box 196650
Anchorage, AK 99519
REFERENCE: Lot 6, Block 5, Alpine Village
JAN 2G 199,9
Mun cipality of
Oept, Health & Human Ser'v~ces
This is to request that you update the waived separation distance between the well and
the sewer service line at 12 feet for the referenced property. It appears that the
previous waived distance of 17 feet is in error.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/skh
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
po
0
:E____ROAD
's i~ )
,, s
11 277
0°07 oo
0" ru
o
0,~
~5.00
0
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0
'~ /2/' o ' o? oo "~/
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
~L~ - \ "~,~ - /~ HAA # ~p:~d~..~l~--~ '
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include IOt,.block, subdivision, section, township, range)
Locabon (aOOro~ or ~t~ ,. ~
(b) Property owner. ~. ; " .
Mailing Address''. '.," .".,..,.
(c) Lending Institution
Telephone · (home)
Telephone
Business
Mailing Address
(d) Real Estate Company and Agent
Ad dress
'Telephone ¢'¢ 7 -- '~ ~' Y ' ¢'¢ 0 ~
(e) Mail the HAA to the following address: (or check here/~, if hold for pick up.)
List contact person and day phone number below:
TYPE OF RESIDENCE
Single-Family/[~. Number of bedrooms '~'~'~
WATER SUPPLY
Individual WeliJ~ Community [] Public []
Note: If community well ,system must have written confirmation from the State Department of Environmental
Conservation attesting 'to th legality and statUs.
SEWAGE DISPOSAL
On-site [] Pubtic~ Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality 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
Address
Date /..~/z
Telephone
6. DHHS APPROVAL
Approved for
Approved
Terms of Conditional Approval
bedrooms by
Disapproved
Conditional
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 is not responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
A. WELL DATA
Well Classification
Well Log Present (Y~"~
Total Depth //~r Cased to
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST- FEBRUARY 1984
343-4744
Legal Description:
(;;~1'/u ~ ~' If A, B, C, D.E.C. Approved (Y/N)
/(~ rDepth of Grouting /V/"~
Static Water Level ,G;-'~' /
Casing Height Above Ground ~ ' Y' /
Electrical Wiring in Conduit (Y/~ 4(
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot 4)///4
To Nearest Edge of Absorption Field on Lot
r
Pump Set At ~/~
Sanitary Seal on Casingc.~/N)
Depression Around Wellhead (Y/~
; On Adjoining Lots ~/~
; On Adjoining Lots /O ,//'/
To Nearest Public Sewer Line ~7 / ~
To Nearest Sewer Service Line on Lot
Water Sample Collected by / ' /~-, ~
Water Sample Test Results
Comments J'V~.(! ¢'/~-.o
To Nearest Public Sewer Cleanout/Manhole
,/7 /
;Date / -7/z ~/¢?
B. SEPTIC/HOLDING TANK DATA
Date Installed Size
Standpipes (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Con.tact on File (Y/N)
No. of Compartments
Air-tight Caps (Y/N) FoundatiOn Cleanout (Y/N)
Date LasfPumped
-- , for
- ..... Temporary Holding Tank Permit (Y/N)
Holding Tank High-wa{er-Al~rm (Y/N) ~
SEPARATION DI,~TANOBS FRO~ SEPTI ~NG TANK:
To Water-Supply Well ~; .-," To Building Foundation
, Disposal
To Property Line ' . , To Field
To Water Main/Servic~e~rfe ____
To Stream, Pond/,.L~e' or Major Drainage Course
Commec~
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Square Feet of Absortion Area Statn_dp.~_qS'resent (Y/N)
Depression over Field (Y/N) Da.~f"l_ast Adequacy Test
Results of Last Adequacy Test /'
SEPARATION DISTANCE FROM ABSORPTION F~E~LD:
To Water-Supply Well ¢~/' To Property Line
To Building Foundation / To Existing or Abandoned System on
Lot / ; On Adjoining Lots
To Water Main/Service Line/~___
To Stream, Pond, La/~/dr Major Drainage Course
~;(~mDrimVeen~/saY~ Area, or Vehicle Storage Area
To Cutback (if present)
/
./
D. LIFT STATION
Date Installed Dimensions
Size in Gallons Manh~/N)
"Pump On" Level at ,~*Pump Off" Level at
High Water Alarm Level at .-~ Vent (Y/N)
Tested for .-~ Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes.~/~
Comments
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guid,
inspection.
Signed
Company
Date /Z:-,/
MOA No.
Receipt No. c~
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
/~"\ 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907)562-2343
FEDERAL TAX ID # 92-0040440
ANALYSIS REPORT BY SAMPLE for Work O~der $ 19070 Date Report Printed: DEC 29 89 @ 16:32
Client Sample ID:L6 B5 ALPINE VILLAGE
PWSID :UA
Collected DEC 28 89 @ 11:15 hfs,
Received DEC 28 89 @ 11:40 h~s.
Preserved with :AS REQUIRED
Client Name : A E C S
Client Acct: AKECSRP
P,O.# NONE RECEIVED
Req #
Ordered By : L. REID
Analysis Completed :DEC 29 89 Send Reports to:
Laboratory Supervispr.'S~.~HEN C, EDE 1)A E C S
Released By : ~C. ~ 2)
Special
Instruct:
Chemlab Ref ~: 9060 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Tested Result Units Method Limits
NITRATE-N 0,21 mg/1 EPA 353.2 10
Sample ROUTINE SAMPLE
Remarks: SAMPLE COLLECTED BY L. REID,
1 Tests Performed ' See Special Instructions Above UA=Unavailable
ND= None Detected '* See Sample Remazks Above
NA= Not Analyzed LT=Less Than, GT=Greatez Than
~,"~'~ ......'",~' Drinking Water Analysis Report for Total Coliform Bacteria )~0c~ ~-~.., ,
TO BE COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM I.D.#
PRIVATE WATER SYSTEM
Name
Mailing Address
City
SAMPLE DATE:
Phone No.
State Zip Code
Mo. Day Year
SAMPLE TYPE:
_CRoutine
beck Sample (for routine sample
with lab ref. no.
[] Special Purpose
.) [] Treated Water
~,~.-"Untreated Water
SAMPLE Time Collected
NO. LOCATION Collected By
2[ J
.I I
I I
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[~ Satisfactory
[] Unsatisfactory
[] Sample too tong in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received
Time Received
Analytical Method: Membrane Filter
* No. of colonies/100 mi.
Lab Ref. No. Result*
Analyst
READ INSTRUCTIONS
BACTERIOLOGICAL WATER ANALYSIS RECORD .... ~/ -~
Membrane Filter: Direct Count C~ Collform/100ml
BEFORE
COLLECTING SAMPLE
Verification: LTB BGB
Final Membrane 4~;te~ O
Rep°rted BY-~/~~'~
Collform/100ml
a.m.
p.m.
TNTC = Too Numberous To Count
OB -' Other Bacteria
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
.f
Location (address or directions)
(b) Property oWner
Telephone · (home)
Business
Mailing Address
(c) Lending Institution
Telephone
Mailing Address
(d) Real Estate Company and Agent (/t'-<~'1c4 '
Address
Telephone I ~ 0 ~ ~ ~ ~i'-- ~ O~
(e) Mail the HAA to the following address: (or check here.,~ if hold for pick up.)
List contact person and day phone number below:
TYPE OF RESIDENCE
Single-Family [~ Number of bedrooms
WATER SUPPLY
Individual Well'~i~/ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
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 legality 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
Date
Approved for '~ bedrooms by Date
Approved ~ Disapproved Conditional
Terms of Conditional Approval
The Municipality of AnchorageDepartment 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 is not responsible for errors or omissions
in the professional engineer's work.
72~025 fRev. 7/88) Back Page 2 of 2
A. WELL DATA
Well Classification '~ ~'~V0/,~'~
Well Log Present (Y~). Date Completed
Total Depth //.~" J Cased to //_5'
MUNICIPALITY Of ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description: I/~ !~rt~-
Depth of Grouting
If A, B, C, D.E.C. Approved (Y/N)
Yield /7Z- ~'/)/~
Static Water,Level
Pump Set At
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
SEPARATION DISTANCES FROM W~L~L:
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
Sanitary Seal on Casing~)'/N)
Depression Around Wellhead (Y~
; On Adjoining Lots
~t/\ ~ 'On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
/5'
; Date /'~, '"]-~'~"
'B~EPTIC/HOLDING TANK DATA
D~,~talled _____ Size. _ No. of Compartments
Standpi~,~N) _____ Air-tight Caps (Y/N) __ Foundation Cleanout (Y/N)
_Depressi0n Qve"r,~(Y_/N) __ __ Date Last Pumped _____
Pumping/Maintenance .~,~ct on File (Y/N) ~; for ~__
H~ding Tank High-Water/N) ~ Temporary Holding Tank Permit (Y/N) _
SEPARATI~;~,IS~A~CES FR0~SE- ¢; ~"" :: ''"~ING TANK:
To Water-~'~pp'lY W~!~ : ?' i~,:.:,::. ~uilding Foundation __~
To Prope~t~Li~e,~__ To~l Field __~
To Water~ain/Servlce Line~'".: ' , ~
To Stream' Pdn~' Lake'Or Majo~ Drainage Course ~
Comments ' ', ' ,'.::~ ,~ ~
72-026 (Rev. 7/88) Front Page 1 of 2
l C. ABSORPTION FIELD DATA
X,,~.oils Rating in Absorption Strata Type of System Design
D~e~nstalled ~__ Length of Field
Width ~____ Depth of Field
Gravel Bed Thickness
Square Feet of'A~.sortion Area Statndpipes Present (Y/N)
Depression over Fie'~Y/N) _ Date of Last Adequacy Test
Results of Last Adequac~T~st
SEPARATION DISTANCE FR"OM~ABSORPTION FIELD:
To Water-Supply Well ~ To Property Line
To Building Foundation ~ To Existing or Abandoned System on
Lot ~n Adjoining Lots .~-,
To Water Main/Service Line ~ To Cutback (if present) ,.//~
TO Stream, Pond, Lake, or Major Drainage Course '"'~~ jJ
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for ~
Meets MOA Elect,.deal~Codes (Y/N)
Comment~
~Y/N)
JJ "Pu m P vO~"t ~,i~i)~tping Cycles da ring stx,~.'
**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./¢,.
Si ne
Company
Date
MOA No. ~ ~
Receipt No. o~
Date of Payment
Amount: $
Receipt No.
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88) Back
,/!~ ~r r.,~.J ~ Page 2 of 2
CHEMICAL & GEOLOGICAL LABORATORIES OF, ALASKA, INC.
TELEPHONE (907) 562-2343
5633 B Street
Anchorage. Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
[] PUBLIC WATER SYSTEM I.D.#
PRIVATE WATER SYSTEM
Name ~(. Phone No.
Mailing Address
City State
Mo. Day Year
SAMPLE TYPE:
/Routine
iJ Check Sample (for routine
with lab ref. no.
Lq Special Purpose
sample
Zip Code
Treated Water
Untreated Water
SAMPLE
NO.
I
3
LOCATION
Time Collected
Collected
TO BE COMPLETED BY LABORATORY
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.
Date Received /c;~ -/~//- ~'
Time Received //
Analytical Method: Membrane Filter
* No. of colonies/100 mi.
Lab Ref. No. Analyst
J
Result*
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICAL WATER ANALYSIS RECORD
Membrane Filter: Direct Count
Verification: LT/~
Final Membranb Fi~ter/lCesultsX
TNTC = Too Numberous'To Count
OB = Other Bacteria
_BGB
_ Dale
Time:
C°illorm/100ml
Coilformll00ml
PART ! OF 2 REMAINDER TO FOLLOw
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
= 563~ B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907)562-2343
1~~/.,,~ ""~/' _~"~.,. ~ FEDERAL TAX ID # 92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order # 10909
Date Report Printed: DEC 19 88 @ 12:58
Client Sample ID:L6, B5 ALPINE VILLAGE
PW3ID :UA
Collected DEC 13 88 @ 17:55 hrs.
Received DEC 14 88 @ 10:00 hrs.
Preserved with :4 DEG.C
Client Name : AECS
Client Acct: AKECSRP
P.O.# NONE REC'D
Req #
Ordered By : R.P.
Analysis Completed :DEC i4 88 Send Reports to:
Laboratory Supervlso~ :STEPHEN C. EDE 1)AECS
Released By : /~/~ ~ /// 2)
Special
Instruct:
Chemlab Ref #: 3716 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Tested Result/Units Method Limits
NITRATE-N ND(O.IO) mg/1 EPA 353.2 10
Sample ROUTINE SABLE
Remarks: SAMPLE COLLECTED BY R.P.
1 Tests Performed ' See Special Instructions Above UA-Unavailable
ND= None Detected "See Sample Remarks Above
NA= Not Analyzed LT=Less Than, GT-Greater Than
Municipality of Anchorage
Department of Health and Human Services
Tom Fink, 625 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
January 4, 1988
Alaska Environmental Control
Services, Inc.
1412 West 33 Avenue
Anchorage, Alaska 99503
Subject: Waiver Request for Lot 6 Block 5 Alpine Village S/D
Waiver Request ~WR88-076 ~
Dear Mr. Reid:
Your request for waiver of the required 25 foot separation
between the private sewer line to the well has been approved.
The waived distance is 17 feet.
This approval applies to the existing well and private sewer
line only. Any future upgrade to either will require all
separations be met or another approval from this department.,
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
DJR/ljw
ALASKA E FIUIROFImEFITAL ¢OFITROL S RUICE$, IFI£.
~n§inecrin§ $ ~nuironm~ntal $ludi~s
December 19. 1988
Municipality of Anchorage
Department of Health & Human Services
825 L Street, 5th Floor
Anchorage, AK 99501
ATTN: Dan Roth
RE: Lot G, Block 5, Alpine Village
From the Health Authority insection, we find the separation
distance from well to private sewer service line to be 17 feet.
The drilling date of the well is unknown due to no well log
available. The well existed when the house was connected to
public sewer on October 24, 1984. Connection was done by the
owner at that time. Well and casing depth has been verified to
be 115 feet. On December 13, 1988, a four hour flow test showed
a static level of 53 feet, yield of 4 gpm, and a total drawdown
of 18 feet.
The attached waiver request from AWWU to ADEC indicates the wells
in this area have extensive layers of clay and gravel mixture.
Water sample results are satisfactory.
We request that you grant a waiver of 17 feet for well to private
sewer line.
If you have any questions, please call.
ACW/sr
Sincerely,
Alan C. Wien
1412 W6S'C 3312C% Av6nu6 · AnchoR~xqe, Alaska 99503 · (907) 279-5553
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ANCHOI
Tony Knowles
Mayor
.GE WATER & WASTEWA'I .R UTILITY
3000 Arctic Boulevard
Anchorage, Alaska 99503
(907)
October 17, 1983
Mr. Reford G. Reid
Construction Grants Project Engineer
Alaska Department of Environmental Conservation
437 "E" Street (Second FlOor)
Anchorage, AK 99501
Owned by the Municipality
of Anchorage
Re: Zurich LID #137
Dear Mr. Re id:
The Anchorage Water and Wastewater Utility seeks ADEC approval to
construct, maintain and operate portions of the Zurich LID #137
sanitary sewer closer to drinking water sources than established
separation distances specified in State Wastewater Disposal
Regulations. In request of a regulation waiver and in accordance
with Title 18 of the Alaska Administrative Code, Chapter 70 (18
AAC 72.021C), Anchorage Water and Wastewater Utility submits the
following report for your review and consideration.
Well locations
The alignment of Zurich LID #137 passes close to drinking water
sources (wells) at sixteen locations. These locations are
graphically illustrated on the attached project plan drawing
sheets 3 of 4 and 4.of 4 (Attachment A) and legally described
below.
Alpine Village Subdivision
Lot 1 Blk 4 - approximate distance between water well and
proposed sewer line is 30 feet, distance to cleanout is 24 feet.
Lot 12 Blk 5-'- approximate distance between water well and
proposed sewer'.line is 48 feet.
Lot 13 Blk 5 - approximate distance betw~en"water well and
proposed sewer line is 54 feet.
Lot 14 Blk 5 - approximate distance between water well and.~.,
proposed sewer line is 48 feet, distance to manhole is 60<feet.
Lot 16 Blk 5 - approximate distance between water well and
proposed sewer line is 64 feet.
Lot 18 Blk 5 - approximate distance between water well and
proposed sewer line is 52 feet, distance to cleanout is 56 feet.
Lot 1 Blk 5 - approximate distance between water well and
proposed sewer line is 63 feet, distance to cleanout 'is 54 feet.
Lot 2, Blk 5 - approximate distance between water well and
proposed sewer line is 97 feet,
Lot 3 Blk 5 - approximate distance between water well and
proposed sewer line is 87 fee'f,
Zurich LID ~137
October 17, 1983
Page 2
~Lot 6 Blk 5 - approximate distance between water well and
proposed sewer line is 45 feet,
Lot 7 Blk 5 - approximate distance between water well and
proposed sewer line is 23 feet,
Lot 8A Blk 5 - approximate distance between water well and
proposed sewer line is 44 feet.
Jovon Subdivision ~'~-
Lot 4 - approximate distance between water well and proposed
sewer line is 68 feet,
Lot 5 - approximate distance between water well and proposed
sewer line is 65 feet,
Lot 6 - approximate distance between water well and proposed
sewer line is 55 feet.
O'Brien Subdivision
Lot 7 Blk 6 - approximate distance between water well and
proposed sewer line is 43 feet.
Within the subject well radius "waiver" areas, all sewer pipe
will be 8-inch ductile iron pipe Class 50 with a wall thickness
of 0.27. The subject pipe has a working pressure of 350 PSI plus
a surge allowance of 100 PSI. This particular sewer trunk is a
gravity system which will be 0.0 PSI working pressure, making it
.ideal for construction within well radius. On a gravity system
there is more static pressure on'the outside of the piPe than on
the inside, thus giving mor.e concern to infiltration than
exfiltration. Ductile iron pipe has a life expectancy greater
than other conduit ~materials because of its structural strength,
resistance to abuse, abrasive elements and corrosion.
Manholes and cleanouts constructed within the protective well
radii are of special construction (see sheet 2 of 4 for details).
The sewer line, within the manholes, is mechanically sealed and
gasketed 'to-Prevent leakage of any sewage into the manhole,
subsequently preventing any leakage of sewage out_of the special
manholes. ~ ~'
We were able to obtain drilling logs for two of the subject wells
from the Municipal Department of Health and Environmental~ ~ '~
Protection. The well log (see attachment B) for Lot 7, Block 5,
Alpine Village, indicates the depth of the well at 128 feet. The
well log for Lot 3 Jovon Subdivision indicates the depth of the
well at 129 feet. Both well logs reveal quite extensive layers
of a clay and gravel mixture. The presence of these layers of
clay provides, an impermeable layer betWeen the sewer pipe and the
bottom of the subject wells.
Zurich LID #137
October 17, 1983
Page 3
This essentially completes our request for a waiver. Should you
require any additional information or have any questions
concerning the above information, please contact AWWU at your
convenience.
Sincerely,
Enigneering Design Supervisor
Anchorage Water & Wastewater Utility
TK:AES:jmd
attachment(s)
DEPT. OF ENVIRON MENTAL CONSERVATION
November 14, 1983
BILL SHEFFIELD, GOVERNOR
~phone: ~0~ 274-2533
A~d~.,,: 437 "E" Street
Suite 200
Anchorage, AK
99501
Ms. Vicki L. Sloppy
As si stant Administrator
Anchorage Water & Wastewater Utilities
2000 Arctic Boulevard
Anchorage, AK 99503
RE: Well Radius Waivers
Zurich LID 137, S82-12
Dear Ms. Sloppy:
Thank you for the engineer's report in request of well distance regulation
waivers for the referenced project under your letter of October 19, 1983.
The construction of the referenced project will consist of furnishing and
installing an estimated 1,950 L.F. of 8 inch ductile iron sanitary sewer
line, in portions, north from Lore Road in Bern Street, Zurich Street,
O'Brien Street and Lake Otis Parkway.
In accordance with Title 18 of the Alaska Administrative Code Chapter 72
(18 AAC 72.021.a), a Mr. A1Sundquist, P.E. and engineering design supervisor
for AWWU, submitted a report for ADEC's review and consideration to waive
established separation distances to construct, maintain and operate portions
of Zurich LID No. 137 closer to drinking water sources. More particularly,
construction of the referenced project will require a waiver to encroach
upon the well radius of 14 wells adjacent to this project. The wells are
located along Bern Street, Zurich Street, O'Brien and Lake Otis Parkway
from Lore Road to E. 74th Avenue. In recognition of the report and the
preliminary p?ans for the proposed sewer lines, the following separation
distances are approved instead of that required in Table A of 18 AAC 72.021.
1. Separation distances of 30 and 24 feet between a private well on
Lot 1, Block 4 of Alpine Village Subdivision and proposed sewer
line and nearest cleanout respectively.
2. Separation distance of 48 feet between a private well on Lot 12,
Block 5 of Alpine Village Subdivision and proposed sewer line.
3. Separation distance of 54 feet between a private well on Lot 13,
Block 5 of Alpine Village Subdivision and proposed sewer line.
e
Separation distances of 48 and 60 feet between a private well on
Lot 14, Block 5 of Alpine Village Subdivision and proposed sewer
line and nearest manhole respectively.
Ms. V. L. Sloppy
Well Radius Waivers, S82-12
November 14, 1983
Page 2
5. Separation distance of 64 feet between a private well on Lot 16,
Block 5 of Alpine Village Subdivision and proposed sewer line.
Separation distances of 52 and 56 feet between a private well on
Lot 18, Block 5 of Alpine Village Subdivision and proposed sewer
line and nearest cleanout respectively.
Separation distances of 63 and 54 feet between a private water well
on Lot 1, Block 5 of Alpine Village Subdivision and proposed sewer
line and nearest cleanout respectively.
8, ~Separation distance of 45 feet between a private water well on Lot
6, Block 5 of Alpine Village Subdivision and proposed sewer line.
9. Separation distance of 23 feet between a private water well on Lot
7, Block 5 of Alpine Village Subdivision and proposed sewer line.
10. Separation distance of 44 feet between a private water well on Lot
8A, Block 5 of Alpine Village subdivision and proposed sewer line.
11. SeParation distance of 68 fe~t between a private water well on Lot
4.of Jovon Subdivision and proposed sewer line.
12. Separation distance of 65 feet between a private water well on Lot
5 of Jovon Subdivision and proposed sewer line.
13. Separation distance of 55 feet between a private water well on Lot
6 of Jovon Subdivision and Proposed sewer line.
14. Separation distances of 43 feet between a private water well on Lot
7, Block 6 of O'Brien Subdivision and proposed sewer line.
The Department finds that the special manhole and cleanouts detailed in the
preliminary plans as an acceptable solution to the separation distance
problem between manhole-cleanout and well. Within the special manhole, the
sewer line's flanged pipe is mechanically sealed and gasketed to prevent
leakage of any sewage into the manhole. With the above in mind and by
reviewing the pertinent characteristics of pipin~ m~terials to be used, the
pipe's most feasible alignment and the limited soil information available,
this Department finds..~he above separation distances as adequate protection
of the private water sources.
Please forward copies of the final plans and specifications when they are
avai 1 able.
Sincerely,
Construction Grants Engineer
GM/djf
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR..~)~f.,f_(~
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONDEPT' OF HEALTH &
825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL P~OTECTION
ENVIRONMENTAL SANITATION DIVISION OCT 3 0 1980
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEt~ ~/~IL~'~
DIRECTIONS: Complete all parts oil page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER I PHONE
Charles and Shirley PerraultI 349-6641
MAILING ADDRESS
1657 E Dowling Rd
PROPERTY RESIDENT (If different from above) PHONE
vacaQt
2. BUYER PHONE
none as yet
MAILING ADDRESS
3. [.ENDING INSTITUTION PHONE
MAILING ADDRESS
4. REALTOR/AGENT PHONE'
Bonnie Mehner 277-1553
MAILING ADDRESS
Jack White Co, 3201 C St, Anchorage, Ak 99503
5. ~EGAL' DESChlPTION
Lot 6, blk 5, Alpine Village Subd
STREET LOCATION
7506 Zurich St
6. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One [] Four
[] Two [] Five
[] Three [] Six
[] Other
7. WATER SUPPLY [] INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTI LITY
* ATTACH WELL LOG, A well log is required for all wells drilled ·
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
[] ONE
[] TWO
NUMBER OF BEDROOMS
[] THREE [] FIVE
[] FOUR [] SiX
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] INDIVI DUAL/ON -SITE
I--I PUBLIC UTILITY
Connection Verified
I--lSeptic Tank or [] Holding Tank
Size: If Tank is homemade
give dimensions:
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE I NSTA.LL~ED
INSTALLER
SOl LS RATING
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES
WELL TO:
[] OTHER
Absorption Area to nearest Lot Line
Septic/Holding Tank
Absorption Area
ISewer Line
Nearest Lot Line
5. COMMENTS
I~/APPROVED FOR 3 BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED ~~
BY ~----~. ,
DATE
72-010 (Rev. 6/79)
Mu cipali
of
Anchorage
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF FIEALTH AND ENVIRONMENTAL PROTECTION
November 4, 1980
Charles/Shirley Perrault
1657 East Dowling Road
Anchorage, Alaska 99502
S~bject: Lot 6 Block 5 Alpine Village Subdivision
Approval for your individual sewer and water facilities
cannot be granted until the following items have been
completed:
~)
(2)
The water analysis report be delivered to this
department from Chem Lab, 5633 B Street, for
our review.
The sewer system on the subject property is to
close to the well.
(3)
Ail neighboring sewer systems will need to be located
so that we can.determine if there is a proper distance
between your well and any other sewer systems.
(4)
If your sewer system can not be upgraded so that there
is a 100 foot separation between the well and leaching
area, a holding tank will need to be installed.
(5)
If the leaching area can be relocated so that it is a
~00 foot separation between the well and any other
wells, you will need to obtain a soils test and a
permit from this office.
(6)
The septic tank needs to be pumped with a receipt submitted
to this office. The total number of gallons pumped
need to be on the receipt to verify the size of the
tank. This will need to be verified by a registered
engineer prior to submittal.
Charles/Shirley Perrault
November 4, 1980
Page Two
(7)
If there is any construction done on the sewer system,
a permit must be issued by this department.
Please notify this department for ~ reinspection of the noted
descrepancies. If there are any further questions, please
call this department at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc:
Bonnie Mehner
% Jack White.Company
3201 C Street 99503
November 12, 1980 R&tVl No. 051001-87
Mr'. Chuck Perrault
1657 E. Dowling
Anchorage, Alaska 99503
Re: Adequacy Test on Existing Sanitary Sewer .System; of a 3 Bedroom
Residence with Average Load of 450 GPD, Consisting of a Septic Tank
with a Seepage Pit, Lot 6, Block 5, Alpine Village Subdivision
Anchorage, Alaska '
Dear Mr'. Perrault:
Per' your request of October' 29, 1980, Dan Cooper' or R&M Consultant.s con-.
ducted a test of the sanitary sewer system on tile above described property.
Tile test indicates acceptan,_e rates determined under conditions at the time
tested. Actual system perfor'lnance over' long periods of time depend on
factors which cannot be ew~luated by this test thus our office cannot
warrant [hu suitability or' fitness of the system tot either an extended period
of Lime or' for user' demand in excess of tile expected llow fluted herein.
f::aclors at't'ec:ting sy~lem [.)er'rorman(:e i~/clude:
" l\ctual use dema~d on the system;
F:lucluations ill groul~dv, ater levels;
Physical conditions of the septic tank, leach fiutd, trench or
seepage p~l ,~!~cJ ~oit.
It should be nc)Led tt},~l ~hil~_~ ~ sc~pLi¢ t. ank ariel leacl~ field disposal system is
one of the mo~t r'elidble metl~ods of sewage treatment and disposal it is
nearly cer't~,in that the le..~ll field o~' seepage pit will fail sometime during
the ~sulul life of the slr'~ciure. Studies indicate leach fields, trencf~es and
pils I~ve a file expecta~cy of ten to twelve years under optimum conditions.
All septic systems have a finite hydraulic loading capacity which can be
expected to decrease witt~ time.
Because tile house on the lot is not occupied, we assume that the seepage
pit was not at its normal degree of saturation. Because the house was not
occupied, 600 gallons of water' were added to saturate the system. During
this test the liquid I~vels in the septic tank and seepage pit were monitored
as water- was added to the system. The measurements and calculations are
summarized on the following table:
DATA & CALCULATIONS FOR SEEPAGE PIT TEST
F I RST DAY
November' 4, 1980
SUBJECt: 3 Bedroom House x 150 Gl'D/Bedroom + .50 (;Pl) = 500 GPD Required Flow
TIIq~E OF PUMPER ARRIVAl,: Time
Time
1:!50
2:20
Septic' Seepage Ga 11 OhS t;,, I ions Ga l I cms
Tank Pi t Removed Removed Added
I, evel Level from Tank trom.~it Lo ?iL_
i0.0
10 .O
t I. 05 1400
9 u5
(;a I lon.~,
t i-<)m 'J'al~k
Ad,iud
?00
Water Added to Seepage Pit
Liquid Level Measurements Taken from Top of Standpipes.
GalIons Total Septic 'lank
Time Added _G.9_~..l_o_n~ _I,!~(iU__i~. Lew, l
2:04 0 0
2:17 50 50
2:29 · 50 100
2:41 50 150
2:53 50 200
3:06 50 250
3:18 50 300
3:30 50 350
3:42 50 400
3:54 50 450
4:06 50 500
,6l
9 6
9 4
9 25
9 O5
8 95
8 8
8.6
8.45
8.7t 5
8.
Seepage Pit
L~h[uid Level
6.25'
5.65
5.65
5.65
5.65
5.65
5. b5
5 . 65
5 . 0
5.6
5 . 0
I I~IRD DAY
I,i,tu~,l I.,'v,'l
I i,]ui,I l,,'vul
I,, ,.
FOtJRIH [.)AN'
November 7 1980
'l'ime' 2:50 p.m.
Final Septic Tank L. evel' 6.85'
Final Seepage Pit Level' 6.2,5'
980
perrault
4
The meter used during the test was a Rockwell 5/8" standard water meter
which had previously been calibrated by R&M Consultants, Inc.
The total daily load for the 3 bedroom residence is 450 gallons; surge
capacity is 360 gallons.
The Municipality requires the system to accept a surge capacity of 8090 of the
total daily load at a rate of ten ('10) gallons per minute, tested for a two
day period and to accept the total daily load in twenty-four (24) hour.s.
Failure Criteria is as follows'
o Water rises excessively in septic tank at or' before 80% of total load
is added.
o Effluent overflows the system.
o Water level does not. return to within one inch of static level.
During both days of testing, the system accepted 500 gallons of water and
returned to the original level by the next (Jay, ho~'.rever, the level ii~ the
septic tank rose 1.4 feet higher each day.
Due to uncertainties about the pl~sical layover of tt~(', t, ystcm ~r~d ho~ the
system was working an additional day of te~t~9 ~-', done. I)~r'incj
~esting water was added to the septic ta~k alter d ~eeke~tJ ol ~c)
Fit I tt [)AY
Noveml)er 10
10: 4b 0 (l (~ '~
I 1:00 $0 ',() b.a
11:49 50 250 O.4S
I 2: 0 l 50 300 b, 45
12: I ~ 50 ~%0 b.4
12:25 50 400 b. ~
12: 36 50 450 6. 1
12: 49 50 5uO 5 . 8
[,l. qu ~,t I.cvcl
q. 25
S. 0
,..~.,,, ~z, 1980
.~..~uck Perrault
~ 5
SIXTH DAY
November' 11, '1980
Time' 2:[50 p.m.
Fir~al Septic Tank Level' 6.25'
Final Seepage Pit Level' [).40'
The fifth and sixth day test along with the information obtained on days
three and four indicates that the system is accepti~g effluer~t at a rate of
200 to 280 gallons per' day.
Based on Municipality requirements, the average load on the .:;ystem lot a 3
bedroom residence can be expected to be 450 gallons per day or 0.3'1 gallons
per minute.
We can therefore conclude that the systen~ is ~ot di:;posin(.j of uf'l'luer~t at an
ade'quate rate for a typical :~ bedroom residel~ce.
Current Municipality of Anchorage ~'egulati{)r~,~ will ~ol permit ~pc2radir~ of
any existir~g septic systems LJIIIE~sS Et m~r~m~m~ ser:)ar'ation of 100 ieet car~
mair~tai~ed betweer~ all port~ons of the t~u[)t~c t,~btem dt~d ex~'~tir~l
wells. Si~ce this minir~um sepdratio~ ~:~r~ot t~ r]~ai~tair~ed the ~r~ly
immediate solution is ir~s[altat~()[~ ~1 d L~00O-qlallor~ ~)l<ti~(] tar~k
tio~al sur'vict,.
Richard
Senior
RSG/ki~