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HomeMy WebLinkAboutAUDUBON HILLS BLK 1 LT 1#015-231-46 AUDUBON DRIVE AUDU B O N HILLS SUBD I V I S I O N BLOC K 1 Taylor L. Dosch No. 189892 R E GISTEREDPROFESSIO N A L L A N D S U R VEYOR ∆ Municipality of Anchorage Page 1 & 3 Building Safety Division On-site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.androrage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SK030300 PID Number: 015-231-46 Name: William and Paulette Missal Wastewater System: Tank Only Aaow.: 12000 Audubon Drive Anch, AK 99516 ABSORPTION FIELD pone Number of Sediocom: 345-7520 Four 4 Existing Trench LEGAL DESCRIPTION � Rab Total Depth tram api W Grade: Bbdc Lot gmedNmuon: 1 GPo�Ir DepM to WPe bollan tan pgny Veda: Ft. Grovel dePlt bniaetlt pipe: 1 Audubon Hills Ft. Ft Township: Ratge. sectea ill abavaNUW Vede: vel larylh: Ft. Ft. Well: Existing well WKM ties: letancebetewn inw: Ft. FL clewxmason (pdvate, A a, cR TOW Depitt: cesso b: uee: pe e: FI. Ft. FF Odlen Dude Drilled: sebc WSW levet: DOW Installed: — FL Acreage Systems 8/11/2003 Yield: pump sett COW* p Ground Above Gre: TANK GPM p,, SEPARATION DISTANCES ® Septi ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding utsoinninas From Tank Field Station Tank sewer uns Anchorage Tank 1, 250 wen 100' >100, N/A N/A >25' Steel Two (2) Swi o,water 100' >100' N/A N/A LIFT STATION - NONE ON LOT latus >5' >10' N/A N/A GeL Fo neeton >5' >10' N/A N/A in. n In. Curtain Drain None Oted RarwW: Tank OnlY Re laced Under This BENCH MARK Permit. Existina Se tic Tanks Top of Concrete Foundation Pumped,,Crushed and Backfilled. Westernmost Pillar Back Deck. Named Elevation: 100.0 FL Engineer's Stamp ••••••xu�1e OF••4• .•� P�� "�q e 49 In Inspections performed by: NEA Dates: Yt 8/11/03 : MICHAEL E. ANDERSON � ••• CE 2nd 8/11/03 / D3 ff O. -4381 •••ih�� Department of Health and Human Services approvaI O "s�a,����•• Reviewed and approved by: e, � . (]„ Data: (J1� rorse> Municipality of Anchorage - Page of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030300 PID No. 015-231-46 N89 58'18"E 165.00' 10' Utility Easement LOT 1. BLOCK 1. AUDUBON HILLS SUBDMSION 0 C Abso tion Trench m c � 2 3 w m S2 !n c A S1 CDN m rn Audubon Drive AS -BUILT PLAN Four Bedroom Home ,i.; A B .? :.•,. ! - M S117.1 128.4 ..... `•`<.' S2114.4 134.0 Existing t' Well 14 OF Audubon Drive AS -BUILT PLAN v r Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030300 PID No. 015-231-31 N N N U 1,250 Gallon �AbsoExisting ieotic Tank Absorption Trench NM Septic Tank and Cleanouts Only Placed Under This Permit. Existing Septic Tanks Pumped, Crushed and Backfilled. i PROFILE AS -BUILT Smie: 1"=10' MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW030300 Legal DescriptionVkIJDUB'ONHILCS BLK ;1 tT 4; Design Engineer: 0014 Anderson Engineering Owner Name: William & Paulette Missal "qL 1r,h"3b(,I" Date Issued: Aug 06, 2003 Expiration Date: Aug 05, 2004 Parcel ID: 015-231-46 Site Address: 012000 AUDUBON DR Lot Size: 50427 SQ. FT. Owner Address: 12000 AUDUBON DR Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516-2420 This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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: 9 — 9 — Date: 81C 03 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-8850 www.ci.anchorage.ak.us (907) 3437904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-231-4e Permit Number SW 050,100 Property owners) William .l. and Paulette Missal Day phone 345-7520 addressMailing 000 Auiubon Drive Anchorage .. 99516 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 1 Block 1_ Audubon Hills Subdivision Legal description (Section, Township & Range) Lot Size r LiZ1 Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Four (4) Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 19 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) r; Permit Fees: `� C C Waiver Fees: Date of Payment: "5-- OX Receipt Number. Y9$'94 (Rev. 12Kq J Date of Payment: Receipt Number. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) August 5, 2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1, Block 1, Audubon Hills Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The septic tanks on Lot 1, Block 1, Audubon Hills Subdivision are near failure and must be replaced. There are currently two tanks on the lot. The first was placed in the late 70s and a 500 gallon tank was added in 1985. We are proposing to replace both tanks with a new 1,250 gallon tank to serve the four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic tank to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the existing septic system and the location of the new tank. Also identified on the plans are the locations of the existing well on the lot. Drainage arrows are shown indicating the current patterns. The drainage patterns will be maintained after construction. The ground surface on the lot slopes at varying grades from the southwest to the northeast. The new septic tank will be constructed near the location of the existing tanks and as parallel with the slope of the land as possible in conformance with Municipal requirements. The new septic tank will be constructed a minimum of 100' from the proposed well on the lot and the existing wells on the adjacent lots. If the system is constructed in accordance with our design the following statements apply: i. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. Lot 1, Block 1, Audubon Hills Subdivision August 5, 2003 Page Two 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, n i�ijc� L E a44 , Michael E. Anderson, P.E. Attachments T24 9 t h MICHAEL E. ANDE880N I. No. CE -4381 j BaY+ kN YB'E 794-00 M NH915H WE IMM 889159151 E 2U.00 101 On E.mt Bk 611 PB p, ,%tlu Euti 1 N F P 4t. 4t} AUDUBO HILLS SUBDIVIS N �fl f 96.05 190.00 d 108.51 190.00 s ^'^ TRACT A-1 40 K� TRACT A-2 N8915T45-W %w Bunt /%twuft 10J:9% ...... 8735 !,`e..o•.. OW&W °! 49th AREA MAP .5.. E; .p.S.. T6p. �`$ SCALE 1" = 100' $•`.... No. CEJ981• j ��' N89 58'18"E 165.00' 10' Utility Easement J C. Abso ton Tranch 1 Remove Existing 500 Gallon co and Concrete Septc Tanks. Replace With New 1,250 Gallon g Tank and 2 Post Tank Cleanouts. N O r m Bedroom v Home ui M r.. J. I a. Existing Well A- �•iv ,y. **aV%sulkrot Audubon Drive--�P�E.�.. . ai aem SITE PLAN �....... •� q • MICHAEL EANDERSDN ...��, SCALE V - 4V ��'1%,...... LOT 1, BLOCK 1, AUDUBON HILLS SUBDIVISION ONSITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 1, BLOCK 1, AUDUBON HILLS SUBDIVISION GENERAL: The scope of this project includes the pumping, crushing and abandonment of the existing septic tanks on the lot and the procurement and placement of a new 1,250 -gallon septic tank at the location shown on the site plan. Work also includes the placement of 2 post tank cleanouts. The existing septic tanks must be disposed in accordance with Municipal and ADEC requirements. The new septic tank must be constructed a minimum of 100' from any surface water and 100' from the well on this and adjacent lots. A minimum of 4' of cover is required over the septic tank. In lieu of cover 2" of direct bury insulation and 2' of cover may be placed. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for !revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own; systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,250 -gallon septic tank must be procured from a certified septic tank manufacturer if the existing tank is found to be defective. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 1, Block 1, Audubon Hills Subdivision August 5, 2003 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: -NOT REQUIRED The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than T of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. Lot 1, Block 1, Audubon Hills Subdivision August 5, 2003 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits, and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. J. ,i MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I� ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑ NEW �s K REW 0,S � _�ti7�'1[u� 5CUPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDR OMS l L Well -� Absorption area Dwelling PERMIT 110. DISTANCE TO: O Y Manufacturer !,� EQ Material No, of compartments W< 0 Liq, capacity in gallons IF HOMEMADE: Inside length Width Liquid depth d Y DISTANCE TO: Well Dwelling PERMIT NO. Jaz _ _ < Manufacturer ` Material Liquid capacity in gallons O w= DISTANCE TO: Well Foundation s Nearest lot line �� PERMIT NO. 41cf2 J- � No. of? nes Length each l2ea 'j' Total .n�gnJ of nes Trench width Distance betwevi s /V FW Q 'S ' �J •l inches Q H Top of rile to finish grade Material beneath life Total effective absorption area O it�ias „;. Length Width Depth _ PERMI'T1NO. W G F Type of crib Crib diameter Crib depth Total effective absorption area Lu � — W Well Building foundation Nearest lot lineDISTANCE TO: J Class • epth Driller Distanceeto lot line PERMIT NO. J 1 / •` i DISTANCE TO: Building f�etion Sewer line Septic tank / 3� Absorption areals) OTHER I „� PIPE MATERIALS =e SOIL TEST RATING a ' INSTALLER 5p E'v a S7 REMARKS 1. 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NID"I-H (F:T.) f:..~ I-, ;~, t. I:" t=:' J~, F:2 'W _ ~,,=-" '~" .:: .............. (F T, ) C:3F~:AVEI .... VOL. UMIL--. (CU. YDS,, ) TANK SIZE (13ALEJ) SrlZJ r.-,.~.. :., . ....... ........... · :A, ZNE:, F~:-r.~ F'T,, /BR) I (::ertl fy t. ha'!:..: 1,, I am familJ, ap v~i~LJ'l '~-HE-..~ F'eqLtJ. PC.~meFJ'~.'::: {,:';F' C) Iq '-' E; J. 'L G E:eu,~eps and :,',]Eel. is aS SCat FoPCh by 'kl":e HLmicipa].ity oF An(zhoragEa (MOA) and the State of' Alas:.ka~ f:2. :[ ~.-~J.].:l. :i. ns'La].], t.,qG]j' , i:;y:::'t, em in e,c:c:c)r'clar'~c:Ee v.~J.'Ll"~ a].]. I~CJA (:::(:)cie::: and r'egL.:]..:.:i-:Lc)ns.' ............ des:i, gn c::p J.t..ep:i.a. o{ '{:.hi~ [:)cer'mi4.:., 5, :I: '~J. ]. ]. ac:lhE:,r,:.:,, 'Ln .a.l. I ME]A and Stai: ~.:., o{ / ..... '." 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[,~]:~:':~JS-' RF: :OOF[: ~:~v :l "pcp ':'-"F: - r-'~ ...... :-"c-,r,,~, ' ......... MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 9950'~ 2~4-4720 SOILS LOG - PERCOLATION TEST [~'~OI LS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 7 8 SLOPE DATE PERFORMED: /0 ',90~ ' ~'~' _ SITE PLAN 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER SL ENCOUNTERED? 7~/~ .0 P IF YES, AT WHAT DEPTH? I~.Q' Gross Net Depth to Net Date Time Time Water Drop ~PERCOLATION RATE (minutes/inch) TEST R1 FT AND ~ FT ! 7;~.00~1 ;6/79) CERTIFIED BY: DATE:  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 MAILING ADDRESS LEGAL DESCRIPTION Well [ AbsorPtion area Dwelling PERMIT ~' Manufacturer ~~' f .... M~teri% ~ ~ ( ~o. of com,.rtm~s ~ k}q. capacitg in ~tlons Inside length ~idth kiquid depth ~ ~ ~ DISTANCE TO: Well ~ Dwelling PERMIT N~ ~ -- ~ Manufacturer ~. Material Liquid capacity i~ gallons ~ Well Nearest lot tin~ I ~ ~ DISTANCE TO: ~, ~ [~ Foundation~~~-- PERMIT NO. ~ ~ Z No. of lines [en~t~ ~f ea i ToI~I lengthlof Trench ~h '~ (O ~ ~n~ ~e~ wi~ ~inches Distance between lines ~ Top o~tile to finish grade Material beneath tile Total effective absorp~e~ ~ ~ ' ~ ~ ~ inches Length ~ Width~ Depth PERMIT NO. ~ ~ Type of crib Crib dia~ Crib depth Total effective absorption area ~ Well Building~dation Nearest lot line ~ DISTANCE TO: ~ ~~ D~~~ Driller ~ Distan~ot I,ne m B~ild~ng f~nda~on Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER ~ iNSTALLER REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) r'IU" I C I F-nL_ I TY OF ArJC QF_r-1GE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION I fy , 625 'L' STREET, ANCHORAGE, AK. 99501 264-4720 WELL Fn 04E> CA44—S I TE SELJEFZ FEFZF 1 I T PERMIT NO. ( 780609 ) APPLICANT WESLEY CLUBB SRA BOX 1624 R 99507 349 5252 LOCATION AUDUBON DR LEGAL L1 B1 AUDUBON HILLS SID LOT SIZE 55000 SQUARE FEET 'TYPE OF SOIL ABSORSTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSQ FT/BR)=/1225 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: fl (f y ©EFTH= E LEr4GTH= 4 :" GAR' rEL QEFTH= f THE LENGTH DIMENSION IS THE LENGTH (IF! FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN 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 CIN FEET). FEQU I FREL? SEPTIC TFir-4F< S I =E= 1►300 C3=iL_L_OrJ- 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 C 2 7 I r-1SFECT I Or -4S nFcE FSE(PU I FRED --- 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. ,WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS .OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. VSPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. FEFZP1 I T EXP I FcES E]ECEMOEfZ =Ly 1nD r t 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 THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: ----.f APPLI ANT JSSUED SYA CLUBB 7-/3--2 V3. 2 Performed For Wesley Clubb leoal Oescri~tion: Lot 1 This form Renorts Soils LDo 2204 Cleveland Anchorage, Alaska 99503 Date Performed Block 1 Subdivision Audobon Hills Yes 7-12-78 Percolation Test neath Feet N 10-- 16 18-- 20--- Soil Characteristics Gravelly Sand Brown Silt Gravelly Sand Bottom of Test Hole Was C-round Water Encountered? ... 1¢ Yes, At what Denth? No Readinq Date Gross Time Net Time Depth to H20 ~et Percolation Rate )Ii nute Proposed Installation' Seenaoe Pit Drain Field Deoth of Inlet De~th To Bottom Of Pit Or Trench Cmv,;JENTS- 125 sq. Ft. drainage area r_e_q_gjred per bedroom from 13' to 16' Certified 5~:___c_~_L_ .............. Date: 7-12-78 2833 ~-~t 72nd Avonue DAILY DRILLING LOG PENN JERSEY DRILLING CO. Anchorage, Alaska 99502 2',~, ~ ui:b OWNER OF LAND ........... :..; ............ .~. ..................................................................... ADDRESS .................................................................................................................. WELL--SITE ............................................................................................. DATE--STARTED ......... :..i::..:~.....:.., .......... :A....:::...i.~ ............................................ DATE--ENDED .............................................................. ~'- .................. STATIC LEVEL OF WATER FT ....................................................................... X~RAW DOWN FT ................................................................................................... GALS. FER HR ....................... ~...-....:]..:i .................................................................. ~D OF CASING ....... ~ ........ ~.2 ...... 2 ......... 2 ......................................................... c KIND OF FORMATION: FROM ............. J~'. .......... FT. ~"~ ~ ~v ?c,.,~ ,- c, ! 1 ..................... FROM .............:2 .......... FT. TO ...... ~.:~ .............. FT....Z:.:.::...,:-:.-.' ....... v.::..~... FROM ................. ......... FT. TO .......................... FT ........... t. ............ : ............... FROM ............... ~ ........ FT. TO.....:i!J. ................ FT....~'.'.:"L~': ........................... FROM .............~ ............. TO.....LL: ................ FT....'.:.:i ...... :::...;. ................. FROM .......................... FT. TO .......................... FT ......................................... FROM ......................... .FT, TO .......................... FT ......................................... FROM .......................... FT, TO .......................... FT ......................................... FROM .......................... FT, TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT, TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ....................... : ................. FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. FROM .......................... FT. FROM .......................... FT. FROM .......................... FT. FROM .......................... FT. TO .......................... FT ......................................... TO .......................... FT ........................................ TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... MISCL. INFORMATION: Pump ,.f~,~ot~ t.t,. D.~~ S'.-~ .~Z~'--~--./_.,.~ ~. u.. ~ '--- StaticWator Lovol _~L~-..~II. I)Jl~ll;rgo-z_~~ __OP..M, Mix. Pump On: Tirol ,,,)/'~ --'l~,te/~ump Off:. ~,, ,~ ~ ,~'Tlmt//.~./_~._l/~'.:_~_.~_Dato WATER PIEZO- FLOW WATER P1EZO. FLOW TIME LEVEL TUBE GPM REMARKS TIME LEVEL TUBE GPM REMARKS "C~ 2.~- ,, /~z,~ .~' / / / zz / ! · ~.- ~.. / ~'/ · I~--1 ' I //~ ~111111~11~. ~ ~ ! ~, MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH , . DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block; subdivision, section, township, range) Locatio~address or ~irections) (b) Applicants Name ~/0~.~ C~t~ Applicants Address ~C~ ~ Tel_~_~one- Home Business (c) Applicant is (check one) Lending Institution ~--~ ; Owner/~t-]~t~r-.~. ; Buyer Other (=plain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Telephone ,._~-'~i-I,.~i (f) Mail the HAA to the following address: 2. Type. o.~ .Residence Single-Family.?~, Number of Bedrooms 3. Water Supply Individual Well~ Multi-Family ~--~ Other (describe) Community~ Public~--~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite ~ 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. [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 ~nd 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 regula- tions in effect on the date of this inspection. Name of Firm/~/~..~_ ~ C~_~J~i~ ~_~ ,~A30/~Telephone .~_~/~'"'~Z~ Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ftEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN TI~E STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. ~MPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA. BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ae MUNICIPALITY OF ANCHORAGE (MOA) HEALTH ALFfHORITY APPROVAL (HAL) Well Classification ~dct~ Well Log Present ~/N) Total Depth ~ / Static Water Level /_~/ Casing ~ight Above Ground ~9,~ Electrical Wiring' in Conduit ~/N) Separation Distances from Well: To Septic/Holding Tank on Lot ./~ CHECKLIST - FEBRUARY 1984 i:[.. *-~- Legal Description: ~% ( ~kl ~on ~i ~ ~te ~leted ?/~/7~ Yield Card to ~'F' ~pth of Grouting/~~F///o~ Sanit~y ~al on Casing ~) ~ession ~nd ~l~ead (Y~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ~3/~% To Nearest Public Sewer Cleancut/Manhole ~3//4 To Nearest Sewer service Line on Lot Water Sample Collected By ~, ("~oAc~f_~ ; Date Water Sample Test Results Con,re nts?~F ; On Adjoining Lots ~K3o ; On Adjoining Lots B. SEPTIC/HOLDING TANK DATA Date Installed $~/~'/~ Size Stand, ires A r-tight Saps Depression over Tank (Y~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ~'1~% ; No. of Cc~partm~=nts Foundation Cleanout for Holding Tank High-Water Alarm (Y/N) a"./.~r Temporary Holding Tank Permit (Y./N~ separation Distances from Septic/Holding Tank: To Water-Supply Well ;2~' To Building Foundation ~ To Property Line ~,~0~ :~'~ To Disposal Field ~-' '') To Water Main/Service Line A3~ To Stream, Pond, Lake, cz Major Drainag~ Course Receipt ~ ~;Q'~: ~ ~o un t: q ~_~ o~ [Page 1 of 2] 2-15-84 C. ABSORPTIC~N 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 Absorption Area Depression over Field (Y~ Date of Last Adequacy Test Results of Last Adequa~f Test ~A~{A . f~.%~ ~t~ Separation Distance from Absorption Field: To Water-Supply Well ~' To Property Line ~f.~' Standpipes Present d/N) To Building Foundation ~t To Existing or Abandoned System cn Lot ~ ~°) ; On Adjoining Lots >~O! To Water Main/Service Line ~/e4-- To Cutbank(if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ~£a_~u~[ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for ~ ~ Electrical Codes(Y/N) Dim~ ns ions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) PumpinD Cycles during Adequacy Test. Meets MOA Conm~nts ** Check Permitted Bedroc~ Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA Signed . .Date /!' ~--~¢ Company ... A~C5 MOA No. ~Z q -b~ ? KB1/d5/s [Page 2 of 2] effect 2-15-84 ALASKA EI1UIROIlm I]TAL COFITROL SERVICES, IRC. · ~nclineerjncI ~ I~nuironmental Studies OCTOBER i1 1984 NANCY CLUB8 5RA BOX 8 ANCHORAGE ,aK 99516 SELLER - RICK BEVIN5 BUYER - SUBDIVISION - AUDOBON HILL5 BLOCK - 1 LOT - 1 ADEqJACY TEST FOR SEI'~R SYSTEM THE TYPE OF AB6ORPTION SYSTEM I5 A TRENCH WITH AN ,Z~EA OF 384 5~T. THE sYSTEM IS .~.APABLE OF ACCEPTING 100 GALLON5 OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 59 GALLONS. THE SYSTEM IS UNACCEPTABLE BECAUSE THE 5URGE CAPACITY IS LESS THAN 75 GALLONS. THE SYSTEM I5 NOT CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. SEPTIC TANK ADEI~UACY THE EXISTING SEPTIC TANK VOLUNE OF 1000 GALLON5 IS INADEQUATE BY 250 GALLON5 FOR THIS HOUSE OF 4 BEDROOMS. 1200 UJcs! 33rd Aucnu~, Suite ~. ~nc)mro(l¢, Alosko 99503.{907) 561-5040 MUNICIPALITY OF ANCHORAGE MUNICIPALITY Or ANCHORAGE DEPARTMENT OF HEALTH& ENVIRONMENTAL PROTECTION DEPT. C, : ~":" ~= 825 L Street - Anchorage, Alaska 99501 ~:i ~'~/',~0~":,' L,'qT>.L i i.CTtON ENVIRONMENTAL ENGINEERING DIVISION t',;,AY ~ ':~:'i7~) Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~'R~JI~1 L~'s~ DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten {10) days for processing. 1. PROPERTY OWNER I PHONE MAILING AD DR ESS PROPERTY RESIDENT (If different from above) PHONE PHONE 2, BUYER Wesley W./Nancy M Clubb 279-0622 x206 MAILING ADDRESS Post Office Box 4-2090 99509 3. LENDING INSTITUTION I PHONE First National Bank of Anchorage % Jorge B. O'Hoyt1279-0622 x208 MAILING ADDRESS Post Office Box 4-2090 99509 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION Lot 1 Block 1 Audoban Hills Subdivision STREET LOCATION _ . NHN Audoban Drive 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other :~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six 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 E~Z INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date 1978 If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE INSPECTOR DATE DATE INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SlX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE [] PUBLIC UTI LITY Connection Verified []Septic Tank or [] Holding Tank Size: ~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSOR PTI ON AR EA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOl LS RATING Septic/Holding Tank [Absorption Area ISewer Line Nearest Lot Line 5. COMMENTS DATE ~PPROVED FOR 3 BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~ J BY (T~c LEGAL DESCRIPTION 72-010 (Rev. 3/78) Municipality of Anchorage --' DEPAR1, .NT OF HEALTH & ENVIRONMENTAL PR~., '-~CTION POUCH 6-650 ANCHORAGE, ALASKA 99502 279-2511 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. TYPE OF LOAN ]2. ASSESSORS PARCEL NUMBER [] VA [] F.H.A. ~CONV [] I 3. LENDING INSTITUTION 4. REALTOR OR AGENT ~ First National Bank of Anchorage N/A P.O. Box 4-2090 Anchorage, AK 99509 Jorge B. O'Hoyt 279-0622 X208 ~ 5. SELLER 6. BUYER Wesley W., and Nancy M. Clubb N/A P.o. Box 4-2090 Anchorage, AK 99509 i ~ 279-0622 X206 7. LEGAL DESCRIPTION 8. LOCATION/STREET ADDRESS Lot One (1), Blk One (1), AUDOBON HIT.T.q NHN Audobon Drive, Anchorage, Alaska 9. TYPE OF DWELLING 10. WATER SUPPLY 11. SEWAGE DISPOSAL SYSTEM ~]SINGLE FAMILY RESIDENCE 3 BDRMS [] PUBLIC UTILITY [] PUBLIC UTILITY [] MULTI-FAMILY RESIDENCE BDRMS ~] PRIVATE 0N-SITE ~0N-SITE YEAR INSTALLED INSTRUCTIONS TO REQUESTOR I. Complete items 1 to 11 above 3. Send to address above 5. Response will be returned to lending 2. Remove the carbon 4. Please allow 10 davs for processing institution DATE RECEIVED DATE OF INSPECTION TIME OF INSPECTION INSPECTOR TYPE DEPTH YEAR DRILLED PERMIT REFERENCE -- FT. ~ CONSTRUCTION BACTERIAL ANALYSIS LAB REFERENCE NO. YEAR INSTALLED INSTALLER TANK SiZE MANUFACTURER ~ 'DIMENSIONS CRIB CONSTRUCTION ~ [] PIT ~ TOTAL LINE LENGTH TRENCH DEPTH GRAVEL DEPTH ~ [] DISPOSAL O. '" FIELD ~ FT. FT. FT. TOTAL ABSORPTION AREA PERMIT REFERENCE SQ. FT. 72-010 (11/76) SEPTIC TANK _ .ORPTION AREA SEWER LINES .OT LINES OTHER ~- SEPTIC TANK ABSORPTION AREA WELL ABSORPTION LOT LINE ~ FOUNDATION TO SYSTE~ TO: [] APPROVED [] CONDITIONAL. APPROVAL [] DISAPPROVED [] UNABLE TO INSPECT DATE INSPECTOR DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. DATE SIGNATURE