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ASPEN HIGHLANDS #3 BLK 3 LT 8
Aspen Hig hla nds #3 Lot 8 Block 3 #017-013-78 Municipality of Anchorage P~ge DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Sile Wastewater DiSposal Syslem and/or Well Inspection Report PerFai! Number: ~ (,~ OOOO ~' ~> PID Number: O I~ -- O [~ '- ~ Name: ar' ~ ~O //¢~ Waslewaler Syslem: U New ~ Upgrade 'Ph°ne:(7j~) ~??-- 5'3~~ IN°'°fBedr°°ms:~ ~ Deep Trench ~ShallowTre,oh ~Bed ~]Mound ~O,,,er LEGAL DESCRIPTION s°g"'"".: ¢.%¢../sq. ~,. WELL: ~ Haw ~ Upgrade Grave, width: I5FL ,umberof~lines: 10istanc~elw O,assiHca~ion (Priv.te.A,8,o): / ,¢%e~h: CasedTo: T°lalabs°rpli°narea:9¢SQ. FI. Pipemaleriah SEPARATION DISTANCES u Septic U Holding ~S.T.E.P. SurfaCewater ~0'+ J~'+ j~+ LIFT STATION Line Remarks: ~ ~.¢.A. ~¢~ ¢~¢ BENCH ~ARK 17034 Eagle River Leop Road, Ne~ ~ Inspections performed by:EaaleRiver, Alaska99~_ ~ Dates: 1si ~- I~-~ ~. ~/~.,,.~~ 2nd 6- ~7-00 ' YC~XN Deparlmenl ol Heallh and Human Serwces approval 'I,.~'-,(,~ _ ......, .......... Reviewed and approved by: / ~ ~ Date: ~'~'0o 72-013 {Rev. 9/ga MOA 25 PERMIT NO SW000068 PAGE 2 OF 3 Hunicip. aLi~ of Anchom~ae DEPARTPJENT OF HEALTHAND NUBAN SERVICES ENVlRONPJENTAL SERVICES DIVISION P.B, Box 196650 ©anchor'age, a~eska 99519-66500Te~ephome~ 343 4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 8, BLOCK 3, ASPEN HIGHLANDS #3 P.LD. NO. 017--015--78 PERMIT NO SW000068 PAGE 3 OF : 3 Hunicip. el[it oF Anchom(lc~e DEPAIRTNENT OF HEA~_THAND HUP'FAN SEIRVICES ENVIIRONIViENTAL SEIRVICES DIVISION P.O. Box ]96650 OAnchorcge AL~lsk(l 99519-6650~ Telephone: 343-4744 ON-SITE WASTEWATER D~$POSAL SYSTEM AND/OR WELL NSPECTION REPORT LEOAL LOT 8,? BLOCK 3, ASPEN HIGHLANDS #3 P.I.D. NO. 017--015--78 MOUND SLOPE NOT 94'8'~MT1 MT2~94'8' MOUND SLOPE NOT TO EXCEED 3:1 ~ -- TO EXCEED ~:1 "J ~ ORIGINAL A B 2 .o, ST2 66.5' 63.5' V2 72.0' 65.5' 77.3' B.O.H. ~ ~ ~ ROBERT C. COWAN ~ ~ MT2 gO.O' 86.5' 'I ~%. .'" ~ ~ A B FCO 21.5' 24.0' ST1 61.5' 60.5' ST2 66.5' 63.5' V1 72.0' 65.0' V2 72.0' 65.5' MT1 54.0' 75.0' MT2 90.0' 86.5' MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196660, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Apr 18, 2000 Expiration Date: Apr 18, 2001 Permit Number: SW000068 Legal Description: ASPEN HIGHLANDS #3 BLK 3 LT 8 Design Engineer: 0003 S & S Engineering Owner Name: Eric Goller Owner Address: 13021 Midori Dr. Anchorage, AK 99516-3306 Parcel ID: 017-013-78 Site Address: 013021 MIDORI DR Lot Size: 28320 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 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: April 10, 2000 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 8, Block 3, Aspen Highlands #3 ROBERT C. COWAN, P,E. CIVIL ENGtNEErtS (g07) 604-2979 FAX (g07) 694-12! 1 It is requested that you issue a permit to install a septic system upgrade to serve the existing three bedroom dwelling on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 3-30-00 no water was found. After seven days of ground water monitoring, water was found at 12.~'. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 09577 Robert C. Cowan, P.E. RCC/bjj Enclosure o~ z 0 z © ,q <o, E I N¥'id-311S NOIS3(] ,09 : ,,!. ~>- ~ °~-r~s r~ NOlS30 'S 'I 'N Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: DATE PERFORME 3 6- 7- 8- 9- 10- 11 13- 14- 15- 16~ 17- 18- 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? DEFT"?IP ES. ATWRAT Monitoring? / ~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop , O -- ~' ~/~" ~ -~ " 'V~" 4~¢,~ I" PERCOLATION RATE TEST RUN BETWEEN pnin~te$/inch} PERG HOLE DIAMETER i FT AND ~ FT 3 '/'~_ ~ '/~. PERFORMED BY' - ..... CERTIFY THAT T/HIS TEST WAS PERFORMED IN ACCORDANCE ~L~rA~k~ ~IPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ 0 72-008 (~ev. 4/~) meem,q ROBERT C. COWAN, P.E. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 8, Block 3, Aspen Highlands #3 April 10, 2000 GENERAL: The scope of this project includes the installation of a pressurized absorption bed to serve the existing three bedroom residence located on the referenced property. The existing septic tank is to be excavated for verification of its integrity. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On ail leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing the/r own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 7034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, AIJ~,~.A 99577 Page 2 - S & S Engineering Lot 8, Block 3, Aspen Highlands S/D April 10, 2000 Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. Sewer rock shall be placed uniformly throughout the entire bed. The distribution piping is to be ofPVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel depth below the distribution pipes shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The distribution piping must be as shown on the design. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material must be installed between the final gravel layer and the native soil backfill, unless insulation is used, then the silt barrier should be installed over the insulation. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed at the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. The monitoring tube should not extend below the bottom of the gravel surface. Page $ - S & S Engineering Lot 8, Block 3, Aspen Highlands S/D April '~ 0, 2000 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation 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: T.vpe of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use ora type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the £mal leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever specifications applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 - S & S Engineering Lot 8, Block 3, Aspen Highlands S/D April IO, 2000 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pm-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance w/th these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage Page ~ of_ DEPARTMENT OF HEALTH AND HUMAN SERVICES ..... ENVIRONMENTAL SERVICES DIVISION / P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~q~o2q~ PID Number: ~/7o/~77 Name:,~.~c_/,U'- ~~ Wastewater System: D New ~ Upgrade Address: I~O~/ ~~, /~v~,, ABSORPTION FIELD ~,h .... ~ No. of Bedrooms: -~~1~ ~ ~I ~ ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other LEGAL 'DESCRIPTION s°" Rating: Total Depth from original grade: ~, 7 GPD/Sq. Ft. Lot: Block: Subdiv~ion: Depth to pips ~ttom from original grade: Gravel depth beneath pipe Township: ~ Range: ~ Section: Fill added above original grade: Gravel length': WELL: D New D Upgrade erave~ width: Number of lines: I Distance between lines: Classification (Private, A,B,C): ~/~ Total Depth: ~ Cased To: Total absorption area: Pipe material: ~/~ ~O Ft. ~ Ft. ~ SQ. Ft. ~ ~O~ ~V.~. Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: /'~ GPM [ Pump Set at:u/~ Ft. ICasing Height Ab°va Gr°und:~ ~Ft. TANK SEPARATION DISTANCES ~ Septic ~ Holding ~S,T,E,P, To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~(~ ~ ~ [ ~ / ~ Waif /~ /d~ / /0 ~/ ~ ~ ~ ~ Material:~~ Number°fC°mpa~ments: Su~ace , w.t., /¢¢ . /:~ ~ ~:~ '+ LIFT STATION Lot Size in gallons: ~ Manufacturer: Line ~' /~1 ~ ~ ~ ~ /~0I ~HQ~ "Pump on" level at: ~ "Pump off" level at: ~ High water alarm at: Foundation ~ ~ ' ~ ~ ~¢' R2"~ ~Z" ~ ~ ' Cu~ain , ~O~ ~ ~Z 'O ~ _ Pump Make & Medal ~ Electrical Inspections pedormed by: Drain '~/ O~ff [ ~, ¢.~, Remarks: BENCH MARK Location and Description: ~UG 1 G ~9'34 IAssumedslevatiOn: ~.~ Ft. ~i~ o~ A,c~o~age ~ . , ~ ENGINEER'S SEAL, . , ~g O. Nlllllg~* v ~.~, ~. , ~, ~ * ,. S & S ENGINEERING ~ ~ .~ ~ % 17034 Eagle River Lo~ Road, No. 2~ ~ ~/~~ ~ Inspections performed by: p.~. River~ Alaska ~577 D~tes: 1st ~ -Z-~ ~ ~-~/ ~~'~'~'~'~ 2nd ~ - z- Department of Hea NuiSances appel Reviewed and approved Date: Z l~~?.~? 72-013 (Rev. 9/91) MOA 25 Permil~q~. sw940248 Page 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES of 2 ENVIRONMENTAL SERVICES DIVISION .~ ~[: P.O. Box 106650 · ~nchorage, ^laska ~51~-6650 · Telephone: 343-4744 <~ :~-Site Wastewater Disposal System and/or Well Inspection Report ~ 01701378 Legal D~;~cription.~SPEN HIGHLANDS SUBD. #3, BLOCK 3, LOTp~,D No.: CO1 C02 99 6' ~] /-FINAL GRADE ~ IMPERMEABLE ~~ ~ I1'~" '~"'~ :,~' m~IMPERME~ BARR1EB 'DIST. PIPES LAID WFrHIN WE~,L EXIST. ....... 3'"'BDR'M: HOUSE DECK · 94.8'i WATER FOUND BOT SEWER ROCK, 6" UNDER ~ 6" OVER DIST. P~PES -28-94 i A B FqO lt.0 38.(; CO1 36.5 43.( C02 4i.0 43.£ M~t 42.5 43.C t~?i'"" '~8':0-'88':( MT2 56.5 41,[ MT3 78.0 46,f MT4 72.0 38z ~L SCALE NEw lZSO S.~.E.P. f' = ~0' PRESSURE DIS~TRIBUTION BED 72-013 A (1/93) * ~ i5:52 REMAX RRORERTIES SFXB P.2 RECEIVED AUG 1 6 19~4 M u m,,;~ p~:t!ty of Anchor a~Je OepL. Health & Human Se; PAGE 1 OF 1 MUNICIPALITY OF ANCHOP, AGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940248 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:KESLER KENNETH R OWNER ADDRESS:3340 PROVIDENCE DR., #366 ANCHORAGE, AK 99508 DATE ISSUED: 7/18/94 EXPIRATION DATE: 7/18/95 PARCEL ID:01701378 LEGAL DESCRIPTION: ASPEN HIGHLANDS #3 BLK 8 3 LT LOT SIZE: 28320 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE TWO FEET OF FILL USED IN THIS SYSTEM SHALL BE SAND WHICH MEETS THE REQUIREMENTS OF DHHS ENGINEERING BULLETIN 94-3, DATED JUNE 1, 1994. ISSUED BY: ~ . . DATE: DATE: ROBERT SHAFER, P.E. ROGER SHAFER, P.E. June 23, 1994 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: Aspen Highlands Subdivision #3; Block 3; Lot 8 Request you issue a permit to upgrade the septic system serving the three bedroomhouseonthe referenced pro[~rty. An adequacy test was performed on the existing septic system and due to the manner in which the system responded to the adequacy test it appeared the system was being influenced by ground water. A ground water monitoring tube was installed and ground water was determined to be encroaching the existing system. Therefore, the system is in non-compliance with Municipal Regulation. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavation water was encountered at 6 feet and after seven day ground water monitoring water was found at 5 feet. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your revi~t us. Sinc. ~~~Y"~A. Sha~e~, P.E. 'LSU/jk 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 I O~ NV7d 311S ,og = ~ o o r.,. ~ NOIIO':IS-X [ 0 0 L © cD ON-SIT~ WAST~NATER DISf(~/. SYST~ (I~S~U~TION an~ MAT~RIA~ SPECIFICATIONS R~: Aspen Highlands Subdivision #3; Block 3; Lot 8 1. The scope of this project includes the installation of a 1250 gallon septic tank effluent pumping (S.T.E.P.) system and a pressurized absorption bed to serve the three bedroom residence located on the referenced property. The existing 1000 gallon septic tank is to be excavated, pumped, crushed, and abandoned in place. The existing leachfield is to be abandoned in place. 2. Construction shall be in accordance with the approved site plan and 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 any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. $~PTICTANK XNS'~e.U.~TXON: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Page Two Aspen Highlands Subdivision %3; Block 3; Lot 8 June 23, 1994 4. Septic tanks installed with less than 4' of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10' from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ~RESSRIZED M0[~D SYST~ INSTALLATION: 1. Any peat or organic matter must be removed from the elevated mound site. 2. The bottom of the basal bed area as well as the top of the sand filter is to be within two inches of level. 3. The distribution piping is to be of PVC (ASTM D3034 or equal). joints are to be solvent cemented. Ail 4. The side slopes of the top layer of the mound system must not be steeper than 33% (3:1). 5. The top of the mound shall be covered with a minimum of 6 inches of topsoil and vegetated sufficiently to prevent erosion. 6. The distribution pipes are to be embedded in sewer rock. Care should be taken to backfill in such a way as to prevent damage to the piping system. 7. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 8. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. MINIMUM MATerIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Aspen Highlands Subdivision 93; Block 3; Lot 8 June 23, 1994 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the ~200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. Page Four Aspen Highlands Subdivision 93; Block 3; Lot 8 June 23, 1994 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION:~/t~J 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS PERFORMED BY:$ & S ENGINEERING 17034 Eagle River Loop Read ACCORDANCE 72-008 (Rev. 4/85) Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT t DEPTH? ,(~ O P SITE PLAN Depth to Water After J Monitoring? ~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: MUNICIPALITY OF ANCHORAGE DEPART~VIENT 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 /-/Lm, , . LOCATION ~ · I ~ NO, OF ~ROOMS I Wellp~ Abs°rpti°n ares Dwelling ~, PER~I~E~O'~/ ~Z Manufacturer ~ Mater~ _ ~ No ~ m ~ Liq. ca~llons IF HOMEMADE: Inside length Width Liquid depth ~ Well Dwelling PERMIT NO. DISTANCE TO: Z ~ ~ ~ Manufacturer Material Liquid capacity in gallons ~ Wel I~ I ~--~ ~ No. of lines / Length ~line Total en~ I~es Trench~t~ inches Distance b~li~es ~ ~ ~ Top of tile to finish grade Material beneath tile Total Cfedtiv~ ~sorption area Length ~idl~ Dop~h PR~IT NO. ~ ~ 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 line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: I' PIPE ~ATERIALS R~MA~KS 72-01~ ,. 3~78) · ~ 825 ~ Street, Anchorage, AK. ~9501 264-4720 Permit ~]C HANDWRITTEN PERMIT * * * LL AND/OR 0N-SITE SEWER PERMIT Applicant: ~)~/j ~~ Mailing Address: MUNICIPALITY OF ANCHORAGE Depart~ent f Eealth and gnv±ronmenta' ?rotection Location: Legal Description: . %7~ ~ /~ Type of Soil Absorption System Is: Trench: ~----" Drainfield: Maximum Number.of Bedrooms: ~.~ DEPTH Phone Number Seepage Bed: Holding Tank Soil Ratin~(sq.ft/br) ' ~ The Required Size of the Soil Absorption ~/ L .LENGTH ,_~]_~" GRAVEL DEPTH ~-~' tem Is :~' W I DTH 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 = [00~-.~ 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 t.hat 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 ~he 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 comple~ion. Other requirements may apply. Specifications and construction diagrams are available to insure proper .installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 2 * * * .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 understand th:at the on-site sewer system may require enlargement if modeled to Signe~ include more that/~bedrooms. I,ssued by:~/~-'~~~ ~LL~ SWP/024 (1/81) 26-~-~720 eecm~ W~ AND/OR ON~;~ ~R ::: :':" ':: '?: " ~a length d~sion Ls ~he ~g~h(in ~) of ~he ~nch or draLn~e~.7~ d~h DE a ~re~h DC p~ ~s ~he dLs~e ~~ ~h~ s~e o~ ~e g~u-~ ~ ~t~ o~ the e~vation(~ fleet)- ~ere L~ ~ ~ ~d~h ~OC ~e grave~ d~pkh ~$ the ~~ dup~h O~ gravel ~tw~en the ou~fa~ · 0~ ~e~td~cas ~hat the ~Lk ~iL~ s~ve, · * * ~(~) tN~PECrlONS A~ REQUIR~ * * * " ~a~k~t~g of ~y ~y~ ~LthOU~ ~al Ln~p~on ~nd a~vaL by ~hL~ Min~' d~sta~e be%w~n a wel~ ~4 any on-line ~age d~s~l gy$~ ??'~':"~:"'~ pUbli~ well. MLn~ d~S~ce from a pcLvaea well to a private .ia-RS feet ~d ~o a ~nity ~ line Ls 75 feat. Wa~l logs ace and ~st ~ ret~n'~ tO thLa de~c~ank w~thia 30 day~ o[ eha w~l/ avat~ab%e to Lns~e ~ro~r ~ ~-ti~y that: {3) ~ un~ecstan4 tha~ ~he~ s~e~ syst~ may r~ire .~'~ 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 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 POI.~~ DATE PERFORMED: ' "'~LOPE- ~ SITE PLAN 13 14 15 16 18 ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? 19 20 tMl~l'l'i ; "~ 7/- Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE DD (minutes/inch) CERTIFIED BY: 72-008 (6/79) ALASKA ENVIRON"'C. NTAL CONTROL SERVIC. ,, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB ~ ? ~' SHEET NO, CALCULATED BY, CHECKED BY SCALE OF DATE :' \-' !~: , ';'~,'< ' ,"" -. ! ................~ -~...~... ~t ~ .~ : .... ~. ~ ~ ~ : --x .' : ...... ---77... ~_ Box 1369, STAR ROUTE A ANCHORAGE, ALASKA 9950~ 344-?714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED at The RATE OF i)?.?:(~D PER FOOT. ProPErtY OWNer ~ WELL LOG: 3,20 S e.v'e.',,..,-~.!. .~o, za. Lt. ,bot v!_de;~/3 , 157--794' ,'.'.~e.L ~.-,7,.~.!,, /~.e/z._ h.otz,Z. 100 I.- COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRIL~~-~% WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR The SUM OF f ,,;/.5~{l.u{; *,, THANK YOU VERY MUCH. SERVICE CHARGE O F IYa% PER MONTH WILL BE BERNIE CLAUS OF RAMPART DRILLING WORKS Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anohorage.ak.us (907) 343-4744 Parcel I.D. 017-01-378 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: Lot 8, Block 3, Aspen Highlands #3 Location (site address or directions) 13021 Midori Drive Current Property owner(s) David Dodds Day phone Mailing address 13021 Midori Drive, Anchorage, Ak 9999516 Lending agency Mailing address Day phone Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: ~)~/~ NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72 025 (Rev Ol,00]' 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 based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & $ ENGINEERING 17034 Eagle River Loop Road Address Eagle River, Alaska 9957~. Engineer's Printed Name__ "~(~C/LT'- ~' (~'7 ' - -O Phone (~¢jz~_ ~c~ 7¢/ Please release conditional Health Authority. The items on the Conditional Health Authority approved 4/20/00 have,,.~;. OF /~/~. been satisfactorily completed. ~.~x~'"~..',: ............ ~ ~MP ¢ ".; ' '; ~ Approved fo~ ~ bedrooms, j~ ~ .~ glsapproveo, hI .' :': ......... Conditional approval for bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: Original Certificate Date: Reissue Date: 75025 iRev 01 00)' Municipality of AnChorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type .p~/v/¢7'~ If A, B, or C provide PWSID # ~ .,t:J- .~Parcel I.D.: OI7 - o).~- Well Log ~/'~ d' Date completed '11;)~./~z Sanitary seal Total.,depth 3 ~-O ft Cased to ¢./o FROM WELL LOG Date of test Static water level '~ ~.-O ft Well production o~. O g.p.m WATER SAMPLE RESULTS: Wires properly protected Casing height (above ground) f ~- -/- in. AT INSPECTION z.). 7 g.p.m Coliform O colonies/100 mi Date of sample: B. SEPT C/HOLD NG TANK DATA Tank TyPe/Material ~-r-4.,~ //.J' 7-,i. 4. L- Date installed ' ~ I ;~/el ¥ Tank size Cleanouts ',/r,.5 Foundation cleanout Date of pumping 3, / ~'//~ o C. ABsoRpTION FIELD DATA Nitrate ~4, 19 mg/I Other bacteria__° colonies/100 mi Collected by: S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle Ri'cer, Alaska 99577 5" O gal Number of Compartments Depression over tank ,V'o High water alarm __ Pumper /~-¥ //~ ~'~ System type [~ ¢-' O Date installed 6//-t/e~ Soil rating (g.p.d./ft2 or fl2/bdrm) Length .(~ I ft Width ) &- ft Gravel below pipe O. 5" ft Total depth ~ ft Effective absorption area~15- fF Monitoring tube¥~-J' Date of adequacy test /~//~ - ,v ~.~ Results (Pass/Fail) Fluid depth in absorption field before test ~dded__ Elapsed Time: m~depth in Any rejuvenation treat[~erfC(past 12 mo.) (Y/N & type) 72-026 (Rev, 01/00)* __ Depression over field ~' O For --.~ bedrooms gal. New depth__ in. Absorption rate >= __ g.p.d. If yes, give date __ LIFT STATION Date installed ¢/~/~Y Size in gallons~'~ 5-0 "Pump on" level at zf;~ .in "Pump off" level at 3 %. in Datum ~ o r- TO ,~ Cycles tested ~- E. SEPARATION DISTANCES Manhole/Access Y~J High water alarm level at q Y in Meets alarm & circuit requirements Y~-~J' SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /Oo '4-- Absorption field on lot ! o o '-,'- Public sewer main .k//~ Sewer/septic service line ~S- 4- On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank ~¢//4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~ 7 Property line z// Water main JO + Water service line Drainage ,,v ,/,~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line / o Building foundation ~ r{ Water main Water Service line ) ¢ ~ Surface water / 0 o Curtain drain /da,v& ¢,~v~, Wells on adjacent lots __ F. COMMENTS Absorption field Surface water ko ( G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date 6 /~ Driveway, parking/vehicle storage HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 0~/00)* Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.ancho rage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-01-378 1. GENERAL INFORMATION Complete legal description H A A# dr~ i~'(~.~, ~'2'-~.~ Expiration Date: Lot 8, Block 3, Aspen Highlands #3 Location (site address or directions) 13021 Midori Drive Current Property owner(s) Eric Goller Day phone 345-5038 Mailing address 13021 Midori Drive, Anchorage, AK 99516 Lending agency Mailing address Day phone Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:"~4/~/, NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well 3 TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The .Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 01i00)' 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 based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S ENGINEERING 17034 ~:agie River Loop ,'~v.d N'o. 204 Phone ~ ~) ~_ Address ~¢ R!v~r¢ Alaska 99577 Engineer's Printed Name_ ~0~/~ d'. d;o~4~ Date ~//b/ Condikio~al ~ealth Aukhotiky Approval is requested.' SeEkic system be upg=aded b~ June 15, 2000. ~here ls ~o eminenk (no ove~lowz~g sewage) and ~here wz]l be no adverse e~tb~"~' ~esulk o~ g=a~king Condlkional ~AA ~&'. .... ,'".,~-~ Approved for bedrooms. ~ ~:'~,'., __ D~sapproved. l~ ,C ,"::.: ...... xxx Condmbonal approval for 3 bedrooms, wmth the following stipulations ~he septic system o~ this lo~ shall be upgraded pu~sua~[ ~o ~he a~ached ~e~miE tlmes Ehe high bid f~om a minimum of 3 b~ds ~=om certified cont~acEo~s. ~he balance f" f ..... b .......... f ......... ty Approval has been issued by this Department. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date'. :2. o- © o Original Certificate Date: Reissue Date: 75 025 (Rev. 01 oo)* . . RECEIVED MunicEpal,ty of Anchorage Department of Health and Human Services APR 1 E 2000 Division of Environmental Services ..... 2~UNICIPALITY OF ANCHORAC4,1~]J]rE~] On-Site Services Secbon 825 L Street Room 502' P.O. Box 196650 Anchorage, AK 99519-6650I=NVIRONMENTALsERvICEs www.ci.ancho rage.ak.us (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: Lo-c- ~ 5' ~ c-~r 3 4-~ p~4 A. WELL DATA Well type PR,,,,~m~- Date completed ff/~t ~/~-z Total depth ~ ~ o ft FROM WELL LOG Date of test o1/;ufo / ~' z Static water level ~ 2, o Well production /, E- WATER SAMPLE RESULTS: Coliform ~9 colonies/100 mi Date of sample: ~/~-/co B. SEPTIC/HOLDING TANK DATA If A, B, or C provide PWSID # __ Sanitary seal ¥~' Cased to ~(a-h ft Nitrate 14.~. °t Collected by: ft g.p.m Parcel I.D.: ,O1'7 -o /7 ---/ Well Log ~/~ ~ Wires properly protected Casing height (above ground) ~ ~ in. AT INSPECTION ~. 7 g.p.m __ mg/I Other bacteria O colonies/100 mi TankType/MateriaI $ T~,p / Date installed ~f/~/~¥ Tanksize t Cleanouts ¥[,r Foundation cleanout Date of pumping ~/I C. ABSORPTION FIELD DATA Date installed ~'J ~-J 9~/ Soil rating (g.p.d./ft2 or ft2/bdrm) __ Length H } ft Width ~5- ft $ & S ENGINEERING 17034 Eagb River Loop Road NO, 204 Eagle River, Alaska 99577 gal Number of Compadments Depression over tank ~-,~ High water alarm __ Pumper /¢ ~- O,~ System type Gravel below pipe ¢ o~c' ft Any rejuvenation treatment (past 12 mo.) (Y/N & type). Total depth P- ~/z. ft Effective absorption area (*q&- ~t~ Monitoring tube~~J' Depression over field /''' o Date of adequacy test ~/~>[0o Results (Pass~ '~C ¢or D bedrooms Fluid depth in absorption field before test ~ in Water added o gal. New depth. ~ in. Elapsed Time: ~ min Final fluid depth ~ in Absorption rate >= O g.p.d. ~ 0 _If yes, give date __ 72-026 (Rev. 01/00)* LIFT STATION Date instail~d ~/~/~ "Pump on" level at Datum Size in gallons ~'~° in "Pump off" level at 3 2.. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on 1ct ) Absorption field on lot Public sewer main Sewer/septic service line '~- '~'/-/- in Manhole/Access ~,¢3 High water alarm level at ~ ~/ in Meets alarm & circuit requirements On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Building foundation 3 0 4- Property line ,~ ~ Water main ) o ~ Water service line Drainage ~ o o 4- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ¢ O 4- Building foundation 3 o Water Service line ! o ¢- Surface water / o o Curtain drain ~0..,~ ~:,~,~., Wells on adjacent lots /oo -,,- COMMENTS Absorption field Surface water Water main Driveway, parking/vehicle storage E"O +- G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date ~ / ,o/ oO HAA Fee $ ~¢¢'¢, '~ Date of Payment Receipt Number z:~'-'~, ~,7 Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)' 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 --~/~ -'7~ HAA# 'H/~ GENERAL INFORMATION Complete legal description Lot 81,Block 3i AsPe~: Hi,qhlands #3 Location (site address or directions) 13021Midori Drive Anchorage, AK Ken Kesler Property owner Mailing address 13021 Midori Drive Anchora~e~ Day phone AK 99516 563-3026 345-7150 Lending agency Day phone Mailing address Agent Address Day phone e 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 sy. stem. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of. this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm $ & $ ENGINEERING Address ~?o34 Eagle ,iv,r Loo ol~,~ ,~/'~ Engineer's signature ~ 6. DHHS SIGNATURE ~ Appr°ved f°r.---~- ~''~ Disapproved. Phone Date bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in par~,graph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:/sP~/J /--J/~/-//.~/~D3 ~$~'/.~-oc.~ .~ £o? ~Parcel I.D.. O/?0/?7? A. Well Data Well type ~ v,~'z"E If A, B, or C, attach ADEC letter. ADEC water system number Log present (~,1) ~/Es Date completed c)/22. Driller /"~,~,~,~)z~- /--'~/~.~/,o~ Total depth ,~_0 ' Cased to 2zo ' Casing height Sanitary seal (~N) ye-.~ Wires properly protected (~N) Date of test Static water level Well flow Pump level1 FROM WELL LOG /.~- SEPARATION DISTANCES FROM WELL TO: Septic/he~li¢~ tank on lot /d ~/' Absorption field on lot Public sewer main ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Sewer service line 0. o' Petroleum tank WATER SAMPLE RESULTS: Coliform ~ //~.~/ Nitrate ~./g- /~/~, Other bacteria Date of sample: ~P/q/q~ Collected by: S' /~ ~-,~q/,~¢~-,'~,',~' B. SEPTIC/I'IIBt~ItI~a-TANK DATA Date installed ? - ? - q 5' Tank size 1 ~ ~-o Compartments Cleanouts (~N) ~/~--~ Foundation cleanout (~N) V-~ Depression (Y~) High water alarm (~l) Y'~-J Alarm tested ~N) Date of pumping ,Z,,~ Eva ~-,9~/c- Pumper .,O/~ ~ /12(3 SEPARATION DISTANCES FROM SEPTIC/~ TANK TO: Well(s) on lot /~ To property line Surface water/drainage On adjacent lots Absorption field Foundation Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y(~ JQO High water alarm level Meets MOA electrical codes (~N) "Pump on" level at Manufacturer Manhole/Access (~N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot /4)~ ' On adjacent lots Surface water Date installed Length W.~' Total absorption area Date of adequacy test D. ABSORPTION FIELD DATA Width Water level in absorption field before test Peroxide treatment (past 12 months) (Y/~ Soil rating (GPD/Ft2) O Gravel thickness Cleanout present (Y~) Results (pass/fail) System type /~,~u.~D~ ~Z~ Total depth -2,5" Depression over field (Y~ ~ for ~:> After test /{,Jo Bedrooms If yes, give date ~ _..-----~/,,-~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /~ ?' To building foundation On adjacent lots /o Surface water /~o ' -~- Curtain drain ~ On adjacent lots /¢~ ' ~- Property line To existing or abandoned system on lot Cutbank ~O ~4' Water main/service line Driveway, parking/vehicle storage area //o E. ENGINEER'S CERTIFICATION /certify that/ha ve checked, verifie~~d HAA guidelines in' e~e~t.i}f ,..t!~:' ~,., ,?,,t:".~.'*~':'~/':~~"'zr";' ~~ ./~(s~,;:~ ~.,:,..~inspe°ti°n'~,~. Signature s & S ENGINEERI~// ~ ~ " _ , . 17034 Eagle River~ R~O. 2~ ~.::~.~~~.~~:i .............. ~' ~. H~ Fee $ '~.~ Waiver Fee $, ~::~iP~ ~~ ~ ~/~~~ Date of Payment Receipt Number 72-026 (3/93)* Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date .... // GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range). Location (address or dir(~ct, ions) (b) Applicant Name ~'~'E~) ,4Jo~/,~E',~' Telephone: Home -~¢5'',-~O¢-~/ Business Applicant Address /]02[7 i/f'~l~)~l ~)/~, /~d//,~ 71~, (c) Applicant i~ (check or~e):,Lending Institution []; Owner/builder~[' Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family'~ Multi-Family [] Number of Bedrooms ~"~ Other WATER SUPPLY Individual Well'J~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~Ji~ 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 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATtO~"~%~ As certified by my seal affixed here id as of the validation date shown below, I ~. / that my investigation" '" ' ~"~'~o~ Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, funct~ for the number of bedrooms and type of structure indicated herein. I further verify that based on the informat~in. ,ed 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 //~C~ Telephone ,~'~ Address /,~r2 A,/ ~.~ ,////E" ~,*"~'/7"¢" /~ /~,/ /~. Date DHEP APPROVAL Approved for "~/'~¢'~- bedrooms by ~ -'~'~¢" Date Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the 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 requirements. Employees 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. Page 2 of 2 72-025 (11/84) WELL DATA Well Classification Well Log Present 0~N) Total Depth .~.O MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) i~UNtCIPAUTY OF At'~"~l_Em-r FEBRUARY 1984 DEPT. OF HEALTH-~- '""' ENVIRON~ENT^L PROTECTtON 264-4720 RECEIVED Cased to Static Water Level ~ Casing Height Above Ground Electrical Wiring in Conduit ~N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole ,,~/~ Water Sample Collected by Water Sample Test Results Comments (~ If A, B, C, D.E.C. Approved (Y/N) Date Completed ¢- Z,~- ~'~-.- Yield -~'~"~ ' Depth of Grouting Pump Set At ~'~' Sanitary Seal on Casing N) Depression Around Wellhead (Y~ ~ ; On Adjoining Lots /o3 ' ' On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot B. SEPTIC/HOLDING TANK DATA Date Installed /~.-tO--~.- Standpipes~N) Air-tight Caps~N) Depression over Tank (Ye Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Sept~.~,di/ng Tank: To Water-Supply Well To Property Line ~ To Water Main/Service Line ,a//,~ Course ,~J/'~ Size /~"¢~ ~/~ No, of Compartments Foundation Cl~anout~) Date Last Pumped v .~-'~ -~ for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ! /5'/ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /,~' Width of Field Square Feet of Absorption Area Depression over Field (Y~__~ Results of Last Adequacy Test Type of System Design Length of Field Depth of Field ~ ! Gravel Bed Thickness Standpipes Present'N) Date of Last Adequacy Test Separation Distance from Absorption Field: /ob ' ! To Property Line /O / .-/c. To Water-Supply Well To Building Foundation Lot ,,V'/,,~. To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Existing or Abandoned System on · On Adjoining Lots To Cutbank (if present) ,'~//,~ Comments LIFT STATION Dat~ _.__ High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ~"~~Vent (Y/N) Pumpin~uring Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that l h~/)e~ e~J)ed)v, er~i..ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~..C,/..---('. ~'v~.-.-..-~ Date Company ~~ MOA No. Receipt No. ~~ ~/ Date of Payment Amount: $ ~ ~ Page 2 of 2 72-026 (11t84) ALASKA ui,UIROFIFIII FITAL COFITROL IFIC. (~n§in¢¢rinq 8 (~nuironmenl~ll $1ucli¢s March 13, 1986 Municipality of Anchorage Department of Health & Human Services 825 L Street Anchorage, Alaska 99501 Re: Lot 8, Block 3, Aspen Highlands The above referenced lot consists of a single family dwelling served with an individual well and on-site sewage disposal system. On 3/6/86, we performed an adequacy test, well flow and Health Authority inspection on the lot. Adequacy and well flow test data are attached. From the Health Authority inspection, we find that the separation distance from the well to the septic tank is 86 feet. The sewer system was installed in July 1982, per Lou Caputo of DeArmoun Excavating, who installed the system. The inspection report, done by John Fennedy of the MOA, is dated 12/10/82, which is the date he approved the system after awaiting the report from DeArmoun Excavating for the septic tank installation. The well was drilled on 9/26/82, which was after the septic tank was installed. The well is 320 feet deep and cased to 320 feet. Static water level is 245.3 feet. A water sample taken 3/6/86 is satisfactory. The lot slopes down to the south at approximately 2% slope, making the septic tank downhill from the well. Due to the extreme depth of the well and being cased to the bottom, and the tank being downhill, and that caulder couplings were used on the inlet and outlet of the tank (per DeArmoun Excavators report), we do not feel that the separation distance poses a threat of contamination to the water supply system. We therefore request that you grant a waiver to reduce the required separation distance from the well to septic tank to 86 feet. If you have any questions, please feel free to call me at 561-5040. Sincerely, Alan WJ~en Engineering Technician Approved by: 1200 UJcst 33rd Aucnue, ,~uJl¢ [~ · J~nchoro§¢, Alaska 99503 , /907) 561-5040 ALASKA ,,dlROFlmeF1TAL COF1TROL IFIC. ~IUDY ~ 13021 MIDCRI STREET ~ AI.ASKA SELLER-FRED N~N 03/25/86 ~UDY TFiZ/~ 13021 MIDCRI STREET 60103 LEGAL:ASPEN HIGHLANDS #3 BLCEK 3 LOT 8 ADEQU/~CY TEST I::CP, SEWER SYSTEM ADEQU/~CY TEST DATE-03/06/86 THE TYPE OF ABSGLI:rFION SYSTEM IS A TRENOt WITH AN AREA OF 656 SQFT. THE SYSTEM IS CAPABLE OF ,aCCEPTING #50 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 664 C~I~S. BASED UPON THE TEST DATA THE SYSTEM IS AZIEEPTABLE FCR A 3 BEDROCM I-DVE. SEPT IC TAINK ADEQUACY THE EXISTING SEPTIC TAN< NCLI..DE OF 1000 IS ADFJ~IJATE i=CR THIS 3 BEDROOM HOUSE. THE SEPTIC TA!NK/P~ PLANT HAS NDT BEEN PLM~ED WITHIN THE PAST YEAR. THIS REPCRT DOES NOT VERIFY THE INTECRITY OF THE PIPING FCR THE WATER SUPPLY CR WASTEWATER SYSTEM. FLO~ TEST ON ~gELL WELL FI.O~ DATE-03/06/86 A FLO,V TEST WAS PERFCR~ ON THE Xlrr_.LL. 664 PUM:'ED AT A RATE OF 3.7 (]PM OVER A IXJRATION OF THE DRAWfX),VN WAS 10.9 ' WITH A REODVERY TIIVE OF AND qHE STATIC WATER LEVEL WAS 245.3 FEET. THE V~ELL I S ADEQUATE FCR THIS 3 BEDRCI]M I"~. CALLONS OF WATER WAS 2 .$ HCURS. 60 MINUTES 1200 UJesl 33rd /~uenue, $uit¢ [~, Anchorocle, /~[eske 99503 ,(907) 561-5040 unicipal ty of nchor ¢ P.O. BOX 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES May 5, 1986 Alan Wien Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 8 Block 3 Aspen Highlands Subdivision Waiver Request, WR86-053 Dear Mr. Wien: Your waiver request for the subject lot has been granted. The minimum horizontal separation distance between the septic tank and well on the subject lot has been waived to 86 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw APPLI( NT FILLS OUT UPPER HA[ ONLY F~.~ , Phone Property owne~ p/~ ! Buyer ~:~ Address Zip Code Lendinglnstitution ~/~ /~1.~.~/ Phone Address ~~. ~ ~,'~ ~~ ZIpCode Street Locati~ ~ Type of Resi~nce Single Family Multiple Family No. of Bedroo~- ~ Other Water Supply ~,~ ~ Individual ~c~j~/ ) A~CH WELL LOG. A wall log is required for all wells drilled since June 1975. &j ~ F~{'~'~Is drilled prior to that date, give well depth (attach log if available). Community ~ Public Utility Sewer Disposal ~ individual ~ ~,/ ~ ~ ~' Year Indi~ual Installed: Public~ility t~ ~ ~ /~P~ WhenCO~ctedtoPubllcUtllity: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Fiel~Notes: I ~ DFPT BECE!_V_ED (~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( )DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE [ ~ -- [~ ~ ~ Goils ~n~ing Dnle ~wer Ins~nlled ~ell To Absorption Aren ~ell Log Heoeived ~ell ~o Tnnk ~plio T~k ~ize 72-023 (3182) November 16, 1982 ;~ir. Jim Fejes - Almond Inc. 6917 Old Se%;ard Highway Anchorage, AK 99502 Subject: Lot 8 Block 3 Aspen Highlands Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The water analysis report needs to be submitted to this office from the Chem Lab, 5633 ~3, Street, for our review. The permit for the installation o~ the on-site sewer will expire December 31, 1982. We have not received the as-builts of the installation in this office. If a private engineer inspected tile system, please sen~] us the report for our files and revie%;. Please notify this Department for a reinspection ~ben the note<] discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt Associate Environmental Speci'alist