HomeMy WebLinkAboutALPINE WOODS BLK 6 LT 3
Municipality of Anchorage Page
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: *~l.~c~~ PID Number: ~)15 ' ~3~t''' ~'~,~
Name: K;~ KI.~ Wastewater System: ~ New ~ Upgrade
Address: ~ I I
~ ~v~ A~. ~ ~1~ ABSORPTION FIELD
Phone: (~O~ ~--~ ~No. of Bedrooms: ~ ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other
Total Depth from original grade:
LEGAL DESCRIPTION ~oilRating: ~ GPD/Sq. Ft. ~,S' +~ ~.~ ~.~ ,
Lot: 3 Block:c ~ S~bdi¢~ion: . Depth to pipe bo.om from original grade: Gravel depth beneath pipe
~ ~.25 +~ G.~ .~5
Township:__ [Range: Isection'. "il'~ed a;°~e original grade: Gravel length:
~ ~ - Ft. Ft.
Number of lines: I Distance baleen lines:
~ New ~ Upgrade .Gravel width: ~ Ft. + [ ~.5 Ft.
Classification (Privet Total Depth: Cased To: ]Total absorption area: Pipe material:
Driller: ~ ~ Static Water Level: Instal[er: Date installed:
~,~,~: ~,~ [~u~Se,~,: ~,. [Ca~,,O~~.:. ~ ~' TANK
SEPARATION DISTANCES ~ Septic ~ Holding ~S.T.E.P.
From Tank Field Station Tank Sewer Lines
Surface
wat.~ ~'~ /~'~ /~'~ - LIFT STATION
LOt Size in gallons: I Manufacturer:
Foundation SI' JO 1' 5't . -- "Pump on" level a,:~, I "Pump off" level at: M High wa~l~;m at:
Cu~ain ~ Pump Make & Model ~ Electrical Insect[ohs pedormed by:
Remarks: I~ ~ ~ ='o~ ~.O.~. BENCH MARK
aa~,~ ~ ~;~ ~"~;a ~~ Location and Description: ~~ Floc
Ii ....
Depa.ment of Health and Human Se~ices approval
Reviewed and approved by: ~~--~ ~, ~~Date: ~- ~ ~'
///
72-013 (Rev. 9/91) MOA 25
PERMIT NUMBER: AS :BUILT DRAWING PARCEL ID NUMBER:
SW990098 ' 015-234-43
APPROXIMATE LOCATION A B "
OF CULVERT OUTFALL "~"i' 43.3 50.4
~ -- S2 50.3 55.2
........ MT1 3614 38,-~--]
ALPINE WOODS S/D
LOT 4, BLOCK 6
PHONE: (907) 337-6179/F~: (907) 338-3246
AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
PREPARED FOR: PHONE NUMBER:
PERMIT NUMBER: AS BUILT DRA INg PARCEL ID NUMBER:
SW990098 = 015-234-4,3
~5 08 (~/4" ~,; .' ' :;7',;,0 ,;/~,~,, ',,:, 7, ',"0',":;'',,'''., ,. tO;:, '.: :':;:," %.'0~ ,~.'/' ~
ALAS~ WA~R A~ WAS~WATER CONS~TANTS, INC.
6901 DE~RR ROAD, SUITE 2B, ANCHO~$E, AK, 99504
LEGAL DESCRIPTION:
ALPINE WOODS SUBDIVISION, LOT 3, BLOCK 6 ,j
PROFILE AS-BUILT OF SEPTIC SYSTEM UPGRADE ,.,
KIP K~PPER 279-9641 '..
DATE:6/21/99 Ig~WN By: [SCALE: ] PAOE:
A.C.G. N.T.S. 3 OF 3
FROM : RLASKA WATER & WASTEWRTER PHONE ND. : 9073~83246 Jun. ~8 19D9 10~04~M P~
Cll~rrY OF .~~OIt~GE- 'BUN~I~tG ~FE~;, Di~;I~O~t
DO ~OTl~t~Ot'E ~ .~O~C'Z. I
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: May 17, 1999
Expiration Date: May 16, 2000
Permit Number: SW990098
Legal Description: ALPINE WOODS BLK 6 LT 3
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: Kip Klapper
Owner Address: 6300 DOWNEY FINCH DR
ANCHORAGE, AK 99516-2461
Parcel ID: 015-234-43
Site Address: 006300 DOWNEY FINCH DR
Lot Size: 39024 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.
Received By:
Issued By:
Date: 5 -/~-~,,,~
Date:
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B - Anchorage N Alaska 99504
(907) 337-6179 - Fax (907) 338-3246
Consulting Engineers
May 5, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Sewer Upgrade for Lot 3, Block 6, Alpine Woods Subdivision
(Bottomless Intermittent Sand Filter - ISF)
To whom it may concern:
The existing 4 bedroom house is served by an onsite septic system, and a community well. The
existing bed is surcharged and must be upgraded prior to the sale of the house. Comments
regarding the proposed upgrade are summarized as follows:
1. GENERAL: A test hole was excavated adjacent to the existing bed for the purpose of
determining the percolation rate of the soils underneath it. The intent was to rebuild the bed so
that a gravity flow could be utilized. Based uicon the percolation rate, it appears that a new
conventional bed would require at least 1500 fi~ of absorption area. Given the 100 foot setback
from the drainage ditch, the topography uphill from the bed, and the location of the property line
it is not possible to fit a conventional bed in that area. The options were to either explore possible
sites east of the house or install an innovative system over the existing bed site. We propose that
the a 10' by 36' ISF bed be installed in the same area of the existing bed (see design). All existing
piping, filter fabric, contaminated material, etc., is to be removed completely and buried on site.
2. SOILS: On April 27, 1999, a test hole was excavated and a percolation test was performed
next to the existing bed. As can be seen from the attached log, the soil below the organic and fill
layers is a SW material to a depth of approximately 4.5. At 4.5 feet, the soils transition to a
ML/SW material to a depth of 15 feet (bottom of test hole). Ground water was encountered at a
depth of 11 feet at the time of excavation. A percolation test was performed between 6.0 feet to
6.5 feet, and determined the rate to be at 24 minute/inch.
3. TRENCH DESIGN: Bottomless Intermittent Sand Filter (ISF)
a. Percolation Rate: 24 minutes/inch
b. Allowable Application Rate for ISF: 2 gallons/day/fl2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 300 ft2
f. Effective Depth below pressure pipes: 2.5+ inches
g. Width: 10 feet
h. Length: 36 feet.
i. Effective absorption area = 360 ft2 (>300 fi2 OK)
j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank".
k. Air Supply Line: "Wasteflow" emitterline, 1/2 inch I.D, "Anchorage Tank".
1. Sand Material: In accordance with M.O.A. latest standards
m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and
less than 1% passing the #8 sieve.
We are proposing to excavate down to a depth of 6 to 7 feet (remove all contaminated material),
place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand.
On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals
midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a
programmable timer so that flow can be intermittently dosed to the ISF.
4. SURFACE WATERS: There is a culvert outfall with surface water flowing from it to the
west of the existing and proposed septic system. A 100 foot setback from the outfall and
creek/stream will be flagged by a registered land surveyor prior to construction in order to insure
the separation distances will be met..
5. TOPOGRAPHY: As can be seen on the attached topography site plan, there are no slope
concerns.
6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the
construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation &
Maintenance Manual". The contractor should read this document prior to construction. Copies
are available at the Municipal Onsite Services office (5th floor, 9th & L St.).
7. CLOSING: I am open to any suggestions from your department, which would be an
improvement to the proposed design. I am unaware of any adverse impacts this installation would
have on adjacent wells or septic systems. If you have any questions, please contact me at
337-6179. Thank you f~ your assistance.
I I
eresid. ! G~~ss'x'p~' S'
/ ",N'",, ", ~LP~.E WoODs sip ..//.-' \
LOT 6, BLOCK
~ ..~/~/ AL~ WOODS S/D I LOT 5. "L~K 2.
",,,, ...... ,o.,,.oc.,, /
............ :
WELL AND PRIVATE SEPTICS. , /
~I,AS~ WA~~ W~WA~ CON ~ ~ '
.o~ ~..~ ~u= ,., ~c.o~ ~..~
ALPINE WOODS SUBDIVISION; LOT 5. .
~E or wo..: /
SITE P~N FOR SEPTIC SYSTEM UPGRADE (BO~OMLESS ISF)
~EPAREO mR: PHONE NUMBER:
~,, ~,,~, ~-~' ~0~,_"'. ~-'~:...':,..~
,
)ATE: . . D~WN ~: S~E: PAGE:
s/si.. , ~.~... ~ = ~oo' ~ or ~ '~~~
DOWNEY FINCH DRIVE N.TES,
THE AIE C[MPRESSDR ~I'IALL bE LDI::ATED WITHIN THE
B~EMENT OR THE GARAGE, THE CDNTEACTDR SHALL PEOVI1]E
A 0-10 PS[ PRE~URE GAUGE AT A LBCATIDN VHICH
READIl_Y ACCE~I~t_E FRDM VITHIN THE HQU~E, NBTE, A 30
PSI GAUGE VILL NDT
THE AIR CDHPRESSDE SHALL RE A THRHAS INi1USTRIES NnI~EL
5070~ AS SUPPLIED IW ANCHrlRAGE TANK, THE AIR LINE
) [ % "~ SHALL ;BE 1/~ INCH ]~IA, H/}PE ¢1 PIECE). INSULATE
~ [ \.. ~'~ INCH FI]M4 PIPE ~/RAP (R3 VALUE), INSIDE A ~ INCH SCH,40
IL / '~ '~ PVC JACKET, THE LINE SHALL bE I~URIED TI:] A HINIHUN
, L ! % %-.. THE CRNTRDL PANEL FOR THE STEP TANK SHALL '~E
~ ' ~,, ',-% [NSTALLEI1 VITH A AU~*nLE/VISUAL I.])[CATDR VITHI. THE
/ EXISTING 1250 GALLON SEPTIC--,. %.,%. "~FD~' /
APPR XIMATE LOCATION OF EXISTING~ ~ / ! ,"//~\ ~.--*INSULATED /
CONTAMINATED MATERIAL THAT IS
ENC. OUNTERED IS TO BE REMOVED.
] ;' SAND FILTER TO BE INSTALLED IN
THE SAME AREA OF THE EXISTING
// BED. (SEE ATTACHED DETAIL)
/ NOTES:
/ 1. A MANDATORY PRE-CONSTRUCTION SITE VISIT SHALL BE ARRANGED
/ BY THE CONTRACTOR WITH THE ENGINEER,
// 2. THE CONTRACTOR SHALL HAVE THE SOUTH PROPERTY ENE AND THE
100 FOOT SETBACK FROM THE CULVERT OUTFALL &: CREEK, FLAGGED
BY A REGISTERED LAND SURVEYOR PRIOR TO CONS'I'RUCTION.
/ ,:3. THE EXISTING SEPTIC TANK IS TO HAVE THE INTEGRITY VERIFIED. IF
/ OF GOOD INTEGRrfYo INSTALL A 500 GALLON EFT STATION AF'fER THE
/ TANK. IF OF POOR INTEGRITY, ABANDONED COMPLETELY AND INSTALL A
/ 1500 GALLON S.T.E.P. STATION (500 GALLON LIFT STATION NOT NEEDED~,
LEGAL DESCRIPTION:
ALPINE WOODS SUBDIVISION; LOT ,5, BLOCK 6, ........... : ....
DESIGN OF SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF) ......
PREPARED FOR: PHONE NUMBER:
KIP KLAPPER 279-9641 tOO~:~,~i....[~E-7053 ...-'
J.L.~. 1 = 50' 2 OF 5
P~N VIEW
~,~~ ~ /' / ~//~~
I
/
~e~ -- PROFILEVlEW
ALPINE WOODS SUBDIVISION; LOT ~, BLOCK 6, .:~.~.,
~E OF WORK:
6901 D~'BARR ROAD, SUITE 2B * ANCHORAGE. AK. 9950~'
PHONE (907) 337-6179 * FAX (907) 338-324.6
LEGAL DESCRIPTION: ALPINE WOODS SUBDIVISION; LOT 3, BLOCK 6, ~.~.~."
DATE PERFORMED: 4/27/99 v~
DEPTH ~TEST HOLE
2--y~ SOIL C~SSIFICATIONS ~
~ ~GH ~CL~
/
i o~% GROUNDWATER~
~ ~%tuML/SW LENSES .... i1' ~4~9g / SITE P~N
11-- C'E?;~ E EA CLOCK NET TIME WATER LEVEL NET DROP
~ 4/28/99 - PRESOA!KED PERC CAVI~ FOR 4+ HOURS PRIOR TO TE~.
oo ,, 5 12:30
15-- ~[
, B.O.H. 5 1 :Ol 6"
~_ - .............. ~ ...... ~:3~ 3o M~N. 4-~/4" ~-1/4"
17~
18~
~o-~ ,~ST,U,,~TW~, ..o ,T. ~,j ~.~ ,T.
OO,,,,TS= ~ / /
DEPTH TO DATE
GROUNDWATER
11' 4/27/99
1 1' 4/28/99
11' 5/4/99
,,1WWC, Inc., May 1999
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504
Phone (907) 337-6179 ~ Fax (907) 338-3246
Onsite Wastewater Disposal System Standard Construction Specifications
I. REFERENCE PROPERTY: Alpine Woods Subdivision; Lot 3, Block 6,
II. DEFINITIONS:
1. Property owner: The legal property owner or his/her representative.
2. Engineer: Alaska Water & Wastewater Consultants, Inc. or AWWC, Inc.
3. Contractor: The company hired by the property owner to install the septic system.
4. DHHS: Municipality of Anchorage, Department of Health & Human Services
5. M.O.A.: Municipality of Anchorage, Department of Health & Human Services
IlL RESPONSIBILITIES:
· Property Owner Responsibilities:
1. The property, owner shall contract with the contractor to perform the work outlined in these
specifications and plans, in accordance with the attached DHHS permit. There is no contractual
relationship between the contractor and the engineer. The engineer shall inspect the work as, required by
DHHS to document the installation. Final acceptance of the contractor's work rests with the owner and
the DHHS.
2. This well and/or septic system design is for a single family residence only. The homeowner is
responsible for notifying the engineer if the residence is used as a duplex, business, or multi-family
dwelling. In such cases, the installation permit must be obtained from the State of Alaska, Department of
Environmental Conservation.
3. The validity of the design site plan is limited by the accuracy of the as-built survey provided to the
engineer by the property owner or his/her representative. The property owner shall notify the engineer
regarding any known inaccuracies associated with the as-built survey. The engineer assumes no
responsibility for the accuracy of the survey.
4. The property owner is responsible for notifying the engineer of any unplatted easements, not shown on
the as-built survey, which the new well or septic system may encroach into.
5. The property owner shall notify the engineer of any seasonal groundwater or surface water runoff
conditions, known to him/her, which could potentially effect the operation of the septic system. The
proposed septic system must be at least 100 feet from any streams, ponds, creeks, swamps, bogs, or any
other surface water as defined by the DHHS.
6. The property owner is responsible for notifying the engineer if, to his/her knowledge, any of the
adjacent properties are used as a duplex, business, or multifamily dwelling. The new septic tank and
leachfield must be at least 100 feet from any private well, 150 feet from any class "C" well, and 200 feet
from any community well, unless appropriate waivers are obtained.
1 of 4
A WWC, Inc., May 1999
construction non-compliance does not relieve the contractor of his/her responsibility to correct such a
deficiency.
· Septic Tank, Holding Tank, or Lift Station Installation:
1. The burial rating of the tank shall be adequate for the actual burial depth encountered.
2. The tank shall be level and sufficiently bedded to prevent settling or shifting of the tank.
3. All standpipes on the tank shall extend a minimum 6f 12 inches above final grade.
4. Tanks installed with less than 4 feet of cover shall be insulated.
5. The sewer service line from the house to the tank shall be sloped a minimum of 1/4"
per foot, unless prior approval is obtained from the engineer.
6. The inlet and outlet lines from the tank shall be bedded in drainrock or the soil shall be adequately
compacted to prevent future settlement of the soil.
7. A foundation clean-out will be installed, 1-4 feet from the house, if one does not currently exist.
8. Post tank clean-outs shall be installed per MOA reqtlirements. Does not apply to holding tanks or lift
stations with pressurized lines.
9. All tanks shall be anchored to resist buoyancy forces in high groundwater areas. This applies when
there is not adequate soil cover to resist buoyancy forces. Engineer shall make this determination.
10. The final soil cover shall be graded so that there is positive drainage away from tank.
11. All holding tanks and lift stations shall have an audible and visible alarm inside the residence.
12. All lit~ stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical
Code.
13. The contractor shall remove the old tank, or abandon it in compliance with the Uniform Plumbing
Code (UPC). The contractor is solely responsible for the abandonment procedure.
Installation of Conventional Absorption Bed & Trenches:
1. Excavate the proposed bed/trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level (2 inch maXimum variation between high and low spots). If
the sidewalls or bottom of the excavation become Smeared, they must be raked or scarified before
placement of the filter sand or drainrock.
2. The trench or bed should be at least 5 feet from the test hole excavation.
3. All soil tests and excavation depths are advisory to ithe design and are to be verified in the field by the
engineer. If design changes are necessary, and the changes effect the contractor charges to the property
owner, the contractor shall obtain approval from the prOperty owner prior to proceeding with the work.
4. Once the drainrock is installed, the distribution piPe is to be placed level (0.02 feet difference between
high and low shots) with the perforations faced downward. Drainrock is then to be placed over the
distribution pipe, to provide a minimum of 2 inches of cover over the pipe. The drainrock shall not be
pyramided over the drainpipe but shall be the same elevation over the entire trench/bed width.
5. A silt barrier must be installed between the final drainrock layer and the native soil backfill. The silt
barrier shall cover the entire drainrock surface.
6. Monitor tubes shall be installed at the locations sho~m on the design drawings, and extend a minimum
of 12 inches above final grade. The portion of the monitoring tube extending through the drainrock shall
be perforated from the bottom of the trench/bed to the invert of the distribution pipe.
7. Backfill over the final drainrock layer must not bei less than 2 feet. Insulation must be installed when
the backfill depth is less than 3 feet. The insulation !shall cover the entire width of the trench/bed, the
contractor shall "shoot" the final grades to ensure cover depth is adequate, prior to notifying the engineer
that the work is complete. The final cover over the d~ainfield must graded so that there is no potential for
water to pond over the trench/drainfield.
4 or4
A WWC, Inc., May 1999
7. The property owner and/or his contractor shall report to the engineer any observed condition which
would put the septic system in violation of State or Municipal regulations.
8. Unless specifically agreed upon otherwise, the property owner is responsible for final grading of the
areas which settle after construction. Prior to awarding the contract, the homeowner should communicate
to the contractor any expectations regarding, but not limited to, post construction site clean-up,
re-landscaping, and restoration of any asphalt, fences, trees, decks, eot. that are effected by the
construction. If the property is being sold, the property owner shall ensure that the aforementioned items
are addressed with the buyer, and, if the work is to be completed after the sale of the property, that
necessary funds are escrowed to fund the completion of the work.
9. If the property owner intends to install the septic system he/she must first have obtained approval from
the Municipality of Anchorage, DHHS (343-4744). Homeowner installations typically require more time
for engineer inspections. The homeowner should discuss the additional costs, associated with such
inspections, with the engineer, prior to starting the project.
10. The property owner is responsible for payment of all the engineer inspection charges. The number of
inspections will vary depending on the actual field conditions encountered and the construction methods
used.
· Contractor Responsibilities:
1. The contractor is responsible for locating all buried utilities, easements, property lines, and surface
waters; and shall ensure that all setbacks are flagged by a registered land surveyor prior to construction.
2. Construction shall be in accordance with the approved site plan and design drawings, and any special
provisions noted on the municipal sewer permit. The contractor is responsible for notifying the engineer
of any discrepancies noted on the design plans or drawings, prior to starting work. The installation,
materials, and workmanship shall comply with all applicable State & Municipal regulations.
3. The contractor is responsible for field verifying the separation distances to all adjacent wells and septic
systems, shown on the design drawings, prior to starting construction. Any encroachments that would
effect the installation, for which waivers do not exist, should immediately be brought to the attention of
the engineer.
4. Ensure that all materials being used are in compliance with the most current guidelines established by
the Municipality of Anchorage. This includes, but is not limited to, the following:
a. Drainrock
b. Sand filter material for conventional beds, trenches, or mound systems.
c. Sand filter material and pea gravel for Intermittent Sand Filters (ISF).
d. Anchorage Sand and Gravel (AS&G) "block pea" material for Upflow Filters.
It is recommended that the contractor provide the engineer with current sieve analysis' from the
sand/gravel supplier to document the suitability of the material. The engineer assumes no responsibility
for ensuring that the materials delivered meet the MOA requirements.
5. The contractor shall ensure that the septic tank, lift station, or holding tank purchased has a burial
depth rating suitable for the actual installation.
6. Notify the engineer at least 24 hours prior to starting construction. If deemed necessary, a
preconstruction site visit shall take place. The cOntractor shall coordinate with the engineer any
2 of 4
I;
F-'. ~2
R'ECE I,VED '
,,J'UN' 2 2 '1999
Municipahty ut AOcl~o~age
' Oept. Nealth & Human Services
~ 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 ,~ DISTANCES
~=='~Ct'-~ ~ ~ ~0 SEPTIC ABSORPTION
Address ~ TANK FIELD WELL
Phone(s) I Permit No. INo, of Bedrooms WELL ~ ~
~ot. 18.ock ~ I S~o~l ~ CmO* FOUNDATION ~1 ~'
Township, Range, Section
AS-BUILT DIAGRAM (Show Iocatio~f ~ell, septic system, prope~y lines, foundation,
driveway, water bodies, etc.) ~~~
S .T,C
M~ CapacitYcompa,mentsin gallons ~ ~~J ~ ~1
TYPE OF SYSTEM ~
original gradeDepthto pipe bottom fro~. ~J~, FT Total depth from original grade~ ~ ~ ~ ~'~ '~
Fill added above original grade I Gravel 0epth beneath pipe
I Total absorption area[ ~SQ FT/ 'Distance between lines ~FTJ ~ '~ a~ ' ~ ~-- ~
Numberofiines ~ ~ ~
Soil rating Pipe material
WELLS ~¢ ~~E~ )
~ PRIVATE ~THER (Identify)
II
Classification (A,B,C) ~
Total Depth ~ Cased to
Installer Date installed: J
~x~o~ ~~ ~ "' .... ~ I
'~~~ Inspections Pe~orm~ b~: ~~%
I Eagle River, Alaska 99577 . caddy that this inspeaion was pedormed according to all ~ ...~.~;,~
Municipaland State guidelines in elfect on this date: ~ ~/~ ~~ ~~~~"'~'" ?
72-013 (3/85)
June 21, 1990
ROBERT SHAFER, P.E.
ROGER SHAFER
CIVIL ENGINEERS
(907) 694-2979
FAX 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
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Lot 3; Block 6; Alpine Woods Subdivision
Request you issue a permit to upgrade the septic system on the
referenced property.
A brief history of this property is as follows: At the request of the
property owner's realtor, Charlotte Schlosstein - Re/Max Properties, we
were contracted to obtain a Health Certificate on the referenced
property. However, the house currently has 4 bedrooms and the septic
system was installed for only $ bedrooms.
When we visited the site to perform a soils test to increase the size
of the leachfield the snow cover on the westside of the property had
melted sufficiently to expose flowing water within a drainage ditch.
We consulted with your office and were informed that this drainage
along with the drainage along Downey Finch Drive, was to be considered
a surface water source. Therefore, the existing septic system is
encroaching the 100 ft. required setback distance to a surface water
source.
We then performed a soils test near the house, 100 ft. away from the
surface water. However, when computing reserve area required to
upgrade from a 3 bedroom to a 4 bedroom system, we found there was not
enough reserve area on the property due to the required 100 ft. setback
to the drainage along Downey Finch Drive. We performed another test
hole excavation near the existing leachfield to explore the option of
expanding the existing system and obtaining waivers to the surface
water. However, water monitoring on this second test hole on June 19,
1990 revealed the existing system to be encoraching groundwater.
During our site visit on June 19, 1990 we found there to no longer be
water flowing along Downey Finch Drive. There was also very little
water within the drainage ditch to the west of the property with no
water at all observed in some locations of the ditch.
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Page Two
Lot 3; Block 6; Alpine Woods Subdivision
June 21, 1990
We ask that you reconsider the classification of water along Downey Finch
Drive. We fe~l this water is only intermittant and flows only during
Spring break-up or periods of heavy precipitation. Therefore, we do not
fe~l this should be classified as a surface water source and there should
not be a 100 ft. required setbck to septic systems or reserve areas.
We propose to culvert and bury 80 ft. of the drainage ditch along the west
end of the property. This area is where the ditch is well defined and all
drainage is concentrated. Burying this portion of the drainage ditch will
alleviate the 100 ft. s~tback requirement, allow more room for a leachfield
upgrade, and increase the septic reserve area.
If you have any questions, or if you require any additional information for
your review, please contact us.
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, 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
2O
/5'~q.~ i IJ~ Township, Range, Section:
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT
DEPTH? pOi
Depth to Water Alter,
Monitoring? ~ I Date: ~'~'~
Reading Date Gross Net Depth to Net
Time Time Water Drop
~ '~,,~ ~ ~ - ~ '!~~ ~ -
PERCOLATION RATE '~ ~;;~' (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN '~ FT AND ~ FT
COMMENTS
PERFORMED BY: e o e ~c~.t~.tMI=l=l~l~ RTIFY THAT T~I~ TF. qT Wa~ PERFORMED IN
....... ~ ....... L o / ---',';'- L '--
ACCORDANCEW ~~e~~~~ECT ON THIS DATE DATE'
Eagla River, AlasKa yyal/
72-008 (~ev. 4/85) /~ / /
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
NAME
MAI LING A'DI~R ESS
LEGAL D ESCR II~T~O N
I ~ Well ~ ~ I Absorption area I Dwelling
~ Z I Mar factu~er I Material
m lLiq. ipac~ty in gallons IF HOMEMADE' Inside length I Width
DISTANCE TO: Dwelling
3~?-.5~Z4--l- [] UPGRADE
INO. OF BEDROOMS
PERMIT NO.
No. of compartments
Manufacturer
PERMII NO.
DISTANCE TO: Wel!~, ~O :oundation ~ ~ Nearest lot lin&
No. of lines th of each line ength of lines Distance between
inches
Total effective absor
Top grade tile
inches
Length Width Depth PERMIT NO.
Type of crib Crib depth Total effective absorpt
Nearest lot line
DISTANCE TO:
Class Driller Distance to
DISTANCE TO: ilding foundal line Septic tank
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
R E M~R'KS'---
P~ ~_~." L. IPr
·
APPROVED ~'.d/~ ,~ ~ ~ DATE
- ( . /78)
LEGAL
Department
Permit ~ ~
Applicant:
Location: ~f
MUNICIPALITY OF ANCHORAGE
~ Health and Environmenta3
Street, Anchorage, AK.
rotection
,J501
825 -
264-4720
* * * HANDWRITTEN PERMIT * * *
~ ON-SITE SEWER PERMIT
~ ~.~t~J,~r/~j'~ Mailing Address:
Legal Description: ~'~-T'. '2~-//-~'~ Lot size: /%,,
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms:~...~'~1%~oil Rating(sq.ft/br) Z~y
The Required Size of ~ Soil Absorption System Is:
DEPTH ~'~d' LENGTH {'~)~ ~r
._ GRAVEL DEPTH ~ WIDTH
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 excavation(in feet).
REQUIRED SEPTIC(HOLDING) TANK SIZE :-~"'/~) GALLONS
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.
* * * TWO(2) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection.and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a 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 this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * *
I certify that:
(1) 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 system in accordance with codes.
(3) I understan~P-t~f~--T~he on-site sewer system may require enlargement if
the ~~odeled to include more ~o~ ._
Signe~: Issued by:
Applicant '
Date:,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
tO
fl
42
13
14
COMMENTS
PERFORMED BY:
SLOPE
DATE PERFORMED:
SITE PLAN
ENCOUNTERED? L
O
P
E
IF YES, AT WHAT
~"~O VV~t~"~ DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
~:,oo .
::15~o '~ :5~,~ -~,; ~J'~" /"
,,~ ,.,.' '.,;,;,? ,,,. ' .... .,~, ,, .,
PERCOLATION RATE ~ (minutes/inch)
' TEST RUN BETWEEN ~'- ET AND ~[
~ FT
72-008 (6/79)
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
PER.O..EO FOR= kl--/'/O= EX(--
DATE PERFORMED:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15 ·
16
-- SLOPE
20
COMMENTS
SITE PLAN
WAS GROUND WATER (,,.~-~... ~.~Wl~.
ENCOUNTERED?
L
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND -- FT
PERFORMED BY: ,'~. ~l~'u't ~J~
CERTIFIED BY: DATE:
72-008 (6/79)
z '1 ,, ~ 7 ')Z:~ so,is LO~
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 I~. Street, Anchorage, Alaska 99501 264-4720
'SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
'~~~ t~----'~ ,~('C,~ ~T~ DATE PERFORMED:
10
11
12
13
14-
15-
16-
17-
18
19
20
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
O
P
E
IF YES, AT WHAT
~/0 Vv'P~'T~P-. DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~ (minutes/inchl
· TEST RUN BETWEEN ~"'*' FT AND 4 · FT
PERFORMED BY: ~~~~~/~~~~
CERTIFIED BY: DATE:
72-008 (6!79)
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
015-234-43'~ HAA'#
GENERAL INFORMATION
ComPrete legal description
Lot 3; Block 6; Alpine Woods Subdivision
Location (site address or directions)
6300 Downey Finch
Anchorage, AK
Property owner
Mailing address
Lending agency
Mailin. g address
Agent
Address
Kip Klapper
6300 Downey Finch Drive
Dayphone 279-9641
Anchorage, AK 99516
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 4
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:
xx
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
Address
Engineer's signature ,,
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 disposa?.sys_tem is in com~_liance with all
ordinances, and regulations~ r~.eff~ct O~l~l~3~)~l~/rf"'A inspection. Municipal and State codes,
Name of Firm "'"-~-~-~-/~/¢~a/~,'4;' ~,~ _ Phone -~ 7 ~/~ ~'
Alaska Water &
to, closing for
DHHS SIGNATURE
-, ~ Approved for ~ ~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-.02~(Rev. 1/91) Back MOA~Z1
Municipality of Anchorage JUN 2:
DEPARTMENT OF HEALTH & HUMAN SERVICE~u~IclP^u~Y
Environmental Services Division ~.NVtI[Ot'~NtP'NTN'$EP'VIC~I~~
825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 343-4744
Health Authority Approval Checklist
A. WELL DATA ·
Well ~-~p~' (. O ~,4v-~ ~ "f'~'-- If A, B, or C, attach ADEC letter. ADEC water system number
Log presen~ Date completed ....
Total depth . ~'"'--.,_ Cased to~-- Casing height~eve ground) . '. __
Sanitary seal (Y/N) ~ Wires p r~/~Jy protected (Y/N) . . __
WATER SAMPLE R~
Colifo;m J
t~~e of sample:
Nitrate
B. SEPTIC/HOLDING TANK DATA
Date installed 0/////4 ~ Tank size ~ O (.~
Collected by:
FoundatiOn cleanout (Y/N) ~' ~ ~¢~ Depression (Y/N)
Date of Pumping A//,4- Pumper
Number of Compartments ~- Cleanouts (Y/N)
~ ~ High water alarm (Y/N) yE <j
C. ABSORPTION FIELD DATA
D'ate installed
Length
Width I
Systemtyp, -T-sIE Bce~
Effectiv® absorption area '~ (~ 0 ~/? Monitoring Tube present (Y/N) 7 Depression over field (Y/N)
~~ Results(Pass/Fail) For ~_
Fluid depth in absorption~ water added (in.):
Fluiddepth ~ T~ ~ g.p.d.
~past 12 months) (y/N) If yes, give date
72-026 (Rev. 3/96)*
Size in gallons / ~ ~
"Pump on" level at* /'~ ~ ' ·" "PumP off" level at*
*Datum ~>crt"t'13~ O~ ~'~---'
LIFT STATION
Date instalied
Manhole/Access (Y/N) ~/~" ~
High water alarm level at* ~'"
Cycles tested l~ (~-.
E. SEPARATION DISTANCES
SEPARATIO~ FROM. WELL.ON I~OT TO:
Septic/holding tank on Iot~'"'"-~__ On adjacent lots
so rption field on Iot '~'~~_~~
Ab
Public' sewer main ~ Public sewer ma~lhele/.~anout
S~ Lift station
sEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation 5 / '~ Property line ~ 0 1 '~ Absorption field
Water main/service line 10'4- Surfacewater/drainage /00~ Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ! O / '~ Building foundation / '~ ' ~
Surface water
Water main/service line /
! ~ / .,~L. Driveway, parking/vehicle storage area '~ / _-t--
Curtain drain
ENGINEER'S CERTIFICATION ~ '~' .~~~~
,~,i~thatlh~de~in~ ,eldinspectionsandreviewofMunicipalreco~~~~
SignatUre
Engineer's.Name
Date
HAAFee $. ~/-'~ '~-~
?
.... '"'-~eoeiptNumber ~-"~-'7 ~-~'~/ )
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
P, ROPERTY OWNER AGREE1WF~NT
FOR THF~ ~NANCE OF AN
ON-SITE WASTEWATER DISPOSAL
SYSTEM
Anchorage Department of Health and Human Se--~ic%, (DHHS) and the property
This agreement is made for the purpose of mainmlnlng an on-site wastewater disposal
system on the subject property.
The property owners agree to ~e following:
Submit to the Municipality of Anchorage, on an annual basis, an inspection and
operation statement from a registered professional engineer. This inspection and
operation statement shall verify that the engineer,has inspected all effluent and air
pumps, timers, and alarms, and that any deficiencies have been repaired and that the
system is functioning as desigaed.
(Signature) (Signature)
(Printed Name)
.......... Notarize Here
............
Slate o ~/f~z2__. On this ~ day of
~,~ "~/t~Z~}~-~'""-' personally appeared before me,
/ ~ '~ Z~ho is personally kno~ ~o me
whose identity I proved on the basis of
__ whose idincicy I proved on the ~ach/affima~ion of
, a credible witness
to be the signer of the aboy~ document,
&
and he/she acknowlgitged that he/I/tLe signed,it.
' /// ~.~otary Public ~. .
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 lOt, block, subdivision, section, township, range)
LOT 3; Block 6; Alpine Woods Subdivision
Location (address or directions)
6300 Downey Finch Drive
(b) Property owner
Mailing Address
(c) Lending Institution
Mailing Address
Jon Mills
.Telephone'(home) 345-5006 Business
6300 Downey Finch Drive_: AnchcJrag~_; A£aska
Telephone
RE/MAX PROPERTIES ATTN: Charlotte Schlosstein
(d) Real Estate Company and Agent
Address ¢~fl0 ¢_.o~__Hour~-qt.
Telephone 276-2761
(e) Mail the HAA to the following address: (or check her~ I~,if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Number of bedrooms 4
Single-Family [~
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 I-NX 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
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'S
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 lOt, block, subdivision, section, township, range)
Lot 3; Block 6; Alpine Woods Subdivision
Location (address or directions)
6300 Downe~ Finch D,~ve
(b) Property owner
Mailing Address
TelephOne (h'ome)
Business
(c) Lending Institution
Telephone
Mailing Address
(d) Real Estate Company and Agent
Address 2600 Cordova St
Telephone 276-2761
RE/MAX PROPERTIES
ATTN: Charlotte Schlosstein
S~it¢ 100 Anchorage, Ak. 99503
(e) Mail the HAA to the following address: (or check here E~,~f hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
~ 7~34 Raffle R~e~' Lam3
Eagl~ River, Alaska 99577
2. TYPE OF RESIDENCE
Single-Family E~ Number of bedrooms
WATER SUPPLY
Individual Well [] Community ~X 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 J~ 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
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Well Classification
Well Log Present (Y/N)
Total Depth Oased to
Static Water Level
Casing Height Above Ground
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:
Date Completed
Depth of Grouting
Electrical Wiring in Conduit (Y/N)
SEPARATION DISTANCES FROM WELL:
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 ~ ~''~' 5. t
If A, B, C, D.E.C. Approved ¢:;~N)
Yield
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
,¢
; On Adjoining Lots
"~' '~ ; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
; Date
B. SEPTIC/HOLDING TANK DATA
Date Installed ~"~'~ Size
Standpipes ~[;~'N) ~
Depression over Tank (Y/~;'
No. of Compartments
Air-tight Caps(~N) '3r Foundation Cleanout~C~N)
I,~ ate Last Pumped I'~
t~//~ ; for "----
Pumping/Maintenance Contact on File (Y/N). /
Holding Tank High-Water Alarm (Y/N)I~/
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
'~t 4" To Building Foundation
[ ~ t.~ To Disposal Field
To Water-Supply Well
To Property Line
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
Comments
Temporary Holding Tank Permit (Y/N)
I Cc:~t~
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absortion Area
Depression over Field (Y/4~
Results of Last Adequacy Test
' ~__~'e'-~ Type of System Design
Length of Field
Depth of Field--~'~
Gravel Bed Thickness
c:>"Z.-i,==, ~ Statndpipes Present4~3~)
Date of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well ~-'c;'~>t "~
To Building Foundation ~'
Lot ~ t Jr--
V
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Water Mai n/Service Li ne ~, ~ t ~
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Cutback (if present)
Comments
D. LIFT STATION
Date Ins~ Dimensions
,Size in Gallons -~- Manhole/Access (Y/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 (Y/N)
Comments
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
_~ & _~ ~_NGINEERING
17034 Eagle Ri~er Loop Road No. 204
inspectibn.
Signed
Company
Date
MOA No.
Receipt No.
Date of Payment
Amount: $
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
72-026 (Rev. 7/88) Back
DEPT. OF ENVIRONMENTAL CONSERVATION
3601 C STREET, SUITE 322 /
ANCHORAGE, ALASKA 99503
STEVE COWPER, GOVERNOR
TO: S & S ENGINEERING
ATTN: ROGER
July 13, 1990
PWSID: 213598
According to the records on file in this office, Alpine Woods
Subdivision Water System is in compliance with
the State of Alaska Drinking Water Regulations.
Sincerely,
EVnEvR~roE~meCnR~aI~ Field Officer
VEC:bam
APPLI 'NT FILLS OUT UPPER HA. ONLY
Address Zip Code
Address /~ ~ :. ~--j~/~ Zip Code
Realty Co. & A~nt /~E..'A] ~ Phone
Address Zip Code
Type of Resi~nce ' '~
~ Single Family ~1/-- }
~ Multiple Family No. of Bedroo~ ~
~ Other ~.
Water Supply
~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach log if available),
~ Public Utility ~
Sewer Disposal
~lndividual Year Individual Installed: J ?~
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date
Inspector Inspector Inspector Inspector
Field Notes:
~ ,~ C..~ T ~' C', dP,
~2) APPROVED-BEDROOMS 'CONDITIONS OF APPROVAL
( )DISAPPROVED ~,:~~
Soils Ratin . ~ Date Sewer Installed Well To Absorption Area ,'~.,4~ Well Log Received
,~ ~l~ WelltoTank
72.023 (3182)
: STATE OF ALASKA
DEPARTMENT OF 'ENVIRONMENTAL CONSERVATION
CONSTRUCTION AND OPERATION CERTIFICATE
for
PUBLIC WATER SYSTEMS
APPROVAL TO CONSTRUCT
Plans for the construction or modification of
Jn
by T'F,,r'clc NY wR J FE_c
public water system located
Alaska, submitted in accordance with 18 AAC 80.100
have been reviewed and are
[] approved.
~_//z~..o..[~ conditionally approved (see attached condltlons).Addit±onal pump tests be
~on~ted o~f wells #3 and #4 to show draw do~ and recovery rate.
~ ~ - TITLE -- ~ DATE
If construction has not started within two years of the approval date, this certificate is void and new plans and
specifications must be submitted for review and approval before construction.
B. APPROVED CHANGE ORDERS
Change (contract order no. or descriptive reference)
Approved by Date
C. APPROVAL TO OPERATE
The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any ~a~rc~
is made available to the public,p~u ~ .~ ~1 -
The construction of the ~L P_T/~- ~t) ODD ~' _/z)/~Tl~:/l~ ~-)~ ]P3 .public
water system was completed on_ rc_/. ~.t4~ rw I , /~'~ (date). The system is hereby
granted interim approval to operate for 90 days following the completion date.
BY TITLE DATE
As-built plans submitted during the interim approval period, or an inspection by the Department, has confirmed
the s~stem was constructed according to the approved plans. The system is hereby granted final approval to
TITLE DATE
18-0407 (Rev. 11183)
DISTRIBUTION: 1. WHITE - ENGINEER (Complete Section C) 2. YELLOW - WATER SYSTEM FILE (Complete Section C)
3, PINK - ENGINEER/MUNI-BOROUGH (Complete Section C)
4. GOLDENROD - blUN!-BOROUGH (Com01ete Section A)