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HomeMy WebLinkAboutATELIER BLK 1 LT 1 MUNICIPALITY OF ANCHORAGE ,x,cnr On -Site Water & Wastewater Program �o`� Is, PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997` hftp://www.muni.org/onsite Department On -Site Wastewater Disposal System Permit Permit Number: OSP231048 Effective Date: 4/13/2023 Work Type: Septic Upgrade Expiration Date: 4/12/2024 Tax Code Number: 04103115000 Site Legal Address: ATELIER BLK 1 LT 1 G:2142 Site Mailing Address: 9361 ATELIER DR, Anchorage Owner: MUCHA JOYCE M & Lot Size in Sq Ft: 65320 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4 This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: S S v fl I �� Date: Issued By: �� Date: �3 2 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 041-031-15 Property owner(s) Joyce Mucha & John Allen Mailing address 9361 Atelier Drive, Anchorage, AK 99507 Site address 9361 Atelier Drive Day phone Legal description (Sub'd., Block & Lot) Atelier, Block 1, Lot 1 Legal description (Township, Range & Section) Lot Size 65,320 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank n Upgrade ❑X (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. 1 further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: %�7 9 �- Waiver Fees: Date of Payment: 3� 3 r I -ZOZ 3 Date of Payment: Receipt Number: 0 k n ct C' Receipt Number: Permit No. 050 Z 3 oLt $ Waiver No. Permit App_:- : .,:c; Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E‐mail: steve@panengak.com Mailing: P.O.Box 1807, Palmer, AK 99645 Telephone: (907) 745‐8200   FAX: (907) 745‐8201 13 March 2023 Subject:   Atelier, Block 1, Lot 1 Septic System Upgrade Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic system on the subject property. The proposed system will serve an existing four bedroom house. Currently the lot is developed.  The existing system will be reused as a reserve based on CAT III. Currently there are no wells within 100 feet of the proposed installation. 1. Soils. A test hole was performed on this lot by Pannone Engineering Services (2/22/23), and groundwater was monitored for at least seven days. Ground water was observed at a depth of 8.0’ at the time of the test and seven days later. Bedrock was not encountered in the test hole. Based on the results of the percolation tests, overall soils appearance and the selection of the proposed drain field; an application rate of 1.2 gallons/day/square feet was used for a conventional wastewater system in the area of the test hole (See attached soils log). 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed septic tank and drain field upgrade will maintain at least 100 feet from all surface water. 4. Topography: See attached site plan for area topography.  There are no steep slopes in the vicinity of the septic system. 5. Drawing Markings: The Drawings are marked “For MoA Review Only”. When written notification that the review is complete and no further comments are received from MoA On‐Site Department, the note will be removed and “For Construction” drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at 745‐8200. Sincerely, Steven R. Pannone, P.E., F. ASCE Owner/Civil Engineer SRP Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231048, Curtis Townsend, 04/13/23 DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM NO. BEDROOM: 4(600 gpd) TANK SIZE: 1250g (MIN) PERC RATE: 2.0 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: WIDE TRENCH 0.5' ED MIN LENGTH: 100 LF USE: (2EA) 50LFx5.0'WxO.5' E.D., 2.0' TD TOTAL AREA: 500 SF of Anchorage REVIEWED FOR CODE A B B R E V I AT MMw, ansrol TH TEST HOLE (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. MT MONITOR TUBE NO. TYP TYPICAL ET EXISTING TANK WELL 200'+ NORTH SEPTIC AREA (E) / DECOMMISSION 1000g SEPTIC TANK (E) WELL 200'+ NORTH AND INSTALL 1250g (MIN) SEPTIC TANK (P) 1 / INSTALL DOUBLE CLEAN OUT AND DIVERTER \ l < \ _VALVE 10' UTILITY EASEMENT �— TH-1 \()a `CO m ` \ cc)` \ C UPGRADE DRAIN FIELD (P) FLOW \ \ (2ea) 50LF x 5'W x 0.5'ED x 2.0'TD SPLITTER \ INSTALL CO AND MT AT EACH END l f �1 \ \\ PLACE FILL TO CREATE 3.0' COVER OR PLACE RIGID INSULATION \ 3BR HOUSE (E) REUSE AAS RESERVEIN WITH \ \/ \ \ . WITH CAT III TREATMENT �\ MAPPED DRAINAGE WAY j (NO SURFACE WATER) SHED / DRIVEWAY / / o \ > \ / _ \ 10'x10' 14WEL1- (E) UTILITY EASEMENT � WELL/SEPTIC 200'/ N WELL (E) 3 NOTES: PANNONE ENG SVC, LLC uction P.O. BOX 100217 ANCHORAGE, AK 99510 DRAWN BY: PHONE (907) 272-8218 FAX (907) 272-8211 DRM JOYCE MUCHA & JOHN ALLEN ATELIER, BLOCK 1, LOT 1 9361 ATELIER DRIVE PLAN ANCHORAGE, AK Date 3/20/2023 Scale 1 "=50' P.I.D. NO 041-031-15 PERMIT NO Sheet 1 OF 3 04/15 Municipality of Anchorage SPECIAL PROVISIONS TO SPECIFICATIONS REVIEWED FOR CODE G OSP231048, Curtis Town. I. SCOPE AND SPECIFICATIONS: 1.1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MOA COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 1.2. CONTRACTED WORK WILL BE IN COMPLIANCE WITH MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) DIVISION 10 & DIVISION 20 AS APPROPRIATE. 1.3. SCOPE OF WORK: INSTALL NEW SEPTIC TANK AND SOIL ABSORPTION SYSTEM. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 8 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 8 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 1.4. STRUCTURES DEPICTED ON THE SITE PLAN ARE BASED UPON ONE OF THE FOLLOWING: CONCEPTUAL PLOT PLAN DEVELOPED BY OWNER; A PLOT PLAN DEVELOPED BY RLS; OR A SURVEY AS -BUILT. 2. CONSTRUCTION SPECIFICATIONS: 2.1. ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN 2.2. EXCAVATE THE DRAIN FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE AND END OF TRENCH BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL. 2.3. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO t1" PRIOR TO INSTALLING THE PERFORATED PIPE. 2.4. ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4 FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER. 2.5. ALL INSULATION SHALL BE 2" THICK DOW HI -40 INSULBOARD OR ENGINEER APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK OR LINES. 2,6. GEOTEXTILE SHALL BE MIRAFI 1405 OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2 FEET MINIMUM. 2.7. COVER THE DISTRIBUTION PIPE WITH A MINIMUM OF 2" OF SEWER ROCK AND COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL. 2.8. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS. 2.9. SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MINIMUM SLOPE AND 3:1 MAXIMUM SLOPE AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MOA CODE. 2.10. RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE AND END OF SYSTEM. 2.11. MAINTAIN 5' SEPARATION BETWEEN PERCOLATION HOLE AND THE DRAIN FIELD TRENCH. 2.12. EXPOSE, PUMP AND FILL LOG DISPOSAL CRIB OR CONCRETE TANK WITH SOIL TO ABANDON LAW WITH MOA CODE IF NEEDED. 3. CONTRACTOR RESPONSIBILITIES: 3.1. THE CONTRACTOR SHALL FAMILIARIZE THEMSELVES WITH THE SITE CONDITIONS AND LOCATIONS OF ALL LOT LINES, EASEMENTS, WELLS (E & P), SEPTIC SYSTEMS (E & P) AND SHALL MEET MINIMUM SEPARATION DISTANCES OR AS NOTED. 3.2. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 3.3. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 3.4. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 3.5. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 3.6. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 3.7. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 3.8. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 4. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WILL BE PERFORMED IN ACCORDANCE WITH THE APPROVED PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY: TITLE: DATE: NOTES: PAMONE ENG SVC LLC Date construction � P.O. BOX 100217 ANCHORAGE, AK 99510*.. • • • 3/10/2023 PHONE (907) 272-8218 FAX (907) 272-8211 Seale DRAWN BY.�.`� ,, NTS DRM ••• •• ••,••• JOYCE MUCHA & JOHN ALLEN P.I.D. N oa.D. N 1s ATELIER, BLOCK 1, LOT 1 �• A. anW*,9a PERMIT NO. 9361 ATELIER DRIVE $749 OsPxxxxxx PLAN ANCHORAGE, AK •••.-••'`«. Sheet 2OF3 04/1, SOILS LOG - PERCOLATION TEST WAS GROUND WATER ENCOUNTERED? Y IF YES, AT WHAT DEPTH? -8.0' DEPTH TO WATER AFTER MONITORING? -8.0' DATE: 3/3/2023 DATE PERFORMED: 02/22/2023 for Municipality of Anchorage REVIEWED FOR CODE COANC OSP231048, Curtis Town 04/13 SEE PLAN SHEET FOR LOCATION READING DATE TEST HOLE 1 NET TIME FILL NET DROP FILL 1 — 4.53 2 ORGANICS OR 4 MIN 3 6.00 3 1:05 — GRAVEL AND 4 GW/SM SAND WITH SOME SILT 5 10.53 6.00 6 1:13 — 7 — 6 1:23 8 10.53 POORLY 1 GP/SP GRADED 9 — GRAVELAND 1:33 10 MIN COURSE SAND 10 3 1:33 SOILS LOG - PERCOLATION TEST WAS GROUND WATER ENCOUNTERED? Y IF YES, AT WHAT DEPTH? -8.0' DEPTH TO WATER AFTER MONITORING? -8.0' DATE: 3/3/2023 DATE PERFORMED: 02/22/2023 for Municipality of Anchorage REVIEWED FOR CODE COANC OSP231048, Curtis Town 04/13 SEE PLAN SHEET FOR LOCATION READING DATE CLOCK NET TIME WATERTIME LEVEL READING NET DROP 1 02/22/23 1:00 — 4.53 — 2 1:04 4 MIN 10.53 6.00 3 1:05 — 4.53 — 4 1:13 8 MIN 10.53 6.00 5 1:13 — 4.53 — 6 1:23 10 MIN 10.53 6.00 1 1:23 — 4.53 — 2 1:33 10 MIN 9.99 5.46 3 1:33 — 1 4.53 — 4 1:43 10 MIN 9.75 5.22 5 1:43 — 4.53 — 6 1:53 10 MIN 9.63 5.10 1 1:53 — 4.53 — 2 2:03 10 MIN 9.58 5.05 3 2:03 — 4.53 — 4 2:13 10 MIN 9.57 5.04 PEROLATION RATE 2 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 3 FT AND 4 FT COMMENTS: Test hole excavated by DEAN CONSTRUCTION PERFORMED BY: PES. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 construction DRAWN BY: JOYCE MUCHA & JOHN ALLEN ATELIER, BLOCK 1, LOT 1 9361 ATELIER DRIVE ANCHORAGE, AK DRM SOILS LOG Date 4/10/2023 Scale NTS P.I.D. NO 041-031-15 'ERMIT NO. DSPXXXXxx Sheet 3OF3 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-66.50 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ,5'/,C/~z/(~',~. PID Number: Name: //1/~/-/~ fL ? ,Z:~/z~-/j ~'~o/~/~.~ Wastewater System: [] New ,l~ Upgrade Address: ~.~o/ /~r~-~.~- ~. ABSORPTION FIELD ~: ~ No. of Bedrooms: ~HO~, ~ ~~I ~ ~ Deep Trench ~ Shallow Trench ~Bed ~ Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION so" Rating: O. ~ GPD/Sq. Ft. ~-~ Lot: BlOCk: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe / / ~T~~ ~. ~ Ft. , ~ Ft. Township: ~ Rang~ I Soction~ Fill added above original grade: Gravel length: - ~ ~ ~. ~ Ft. ~?.~ Ft. WELL:~ New D u ao-pgr~"e Gravel width: Number of lines: Distance between lines: Classification (Private, A,B,C): ~/~ Total Depth: Cased To: Total absorption area: Pipe material: F~/~ ~, Driller: Date Drilled; Static Water Level: Installer: Date installed: Yield: ~ GPM Pump Set at:~/~ Ft.II Casing Height Above/Ground:/~ TANK SEPARATION DISTANCES ~Septic ~ Holding C S.T.E.P. To Septic Absorption Lift Holding =ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~~ ~ Material: Number of Compa~ments: WelY Sudace Water ~ /~ ¢ ....... LIFT STATION~~ Remarks:'~ ~'o~,,~ p~¢ ~o~.~'r,o,~ BENCH MARK / Location and Description: Assumed Elevation: E~8~SEAL Department of Health and Human Services approval '" Reviewed and approved by: Date://-2)- 72-013 (Rev. 9/91) MOA 25 Permit No.Sw940592 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SEFIVICE$ ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 · Anchorage, Alaska 99519-6650 ° Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Descriptio~TELLER SUBDIVISION, BLOCK 1, LOT 1 PID No.: 04105115 95.8~--,, CO1 C02 /98.4' ~ FINAL GRADE -~ ~ 1000 GAL SEPTIC · (co3& 90.5 MT2' · 86.0' WATER FOUND 9-22-94 A Si FCO 4.5 43Jl C01 15.5 46J0 C02 20.5 51i0 CO8 52.O 79i5 6.04... .53-,5... -.90.~0. MTt 43,5 73i0 MT2 46.O 83j5 SCALE 1" = 40' 72-013 A (1/93) * SOt~PTION'"t ROBERT C, COWA,~ CiE -880] PAGE 1 OF 1 DEPARTMENT OF HEALTH AND HUM_AN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940392 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SOUKKLA MICHAEL & KAREN OWNER ADDRESS:9361 ATELIER DR, ANCHORAGE, AK 99503 DATE ISSUED:10/ll/94 EXPIRATION DATE:10/ll/95 PARCEL ID:04103115 LEGAL DESCRIPTION: ATELIER BLK 1 LT 1 LOT SIZE: 65320 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (18AACS0). 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: PRIOR TO CONSTRUCTION, IT MUST BE CONFIRMED THAT THIS IS NOT B ,DRO0 BY: ROBERTSHAFER, P.E. September 26, 1994 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAINEXTENSIONS 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 DISPOSALSYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 "L" Street P. O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Atelier Subdivision; Block 1; Lot 1 9361 Atelier Drive, Anchorage Request you issue a permit to upgrade the septic system serving the three bedroom house on the referenced property. During an inspection of the existing septic system, the monitoring tubes within the system indicated the system was completely saturated. An adequacy test was performed and the system appeared to be 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. The 1,000 gallons septic tank is to be placed outside the protected well radius. 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 10 feet. Attached is the proposed upgrade design. Proposed system is to be built over existing system. Portion under new system to be removed and filled with pit run material. The only other alternative on this lot is a hOlding tank, due to poor soils and steep slopes. We do not anticipate any adverse effects on neighb:oring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. Sincerely, .~ Robert C. Cowan, P.E. RCC/lt 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 ~> '- o~o° ~ ~ ~ / x, ~ ~ <~ I ~~ z~o · . 0 OZ'- w ~ ~ ~ ~ / I ~ ~ ~ ~/ / 0 / ~ w~w ~ ~ ~ ~ '-__ Z ~ II d Ii / ~ d - 1~ ~~ / 'o ~o~ z ~ - O~ ~ O~ OJ ' UZL~ I z~ ~o_~ / / ON-SITE WAST~ DISPOSAL SYSTEM C~DNSTRUCTION PRACTICES MATERIAL SPECIFICATIONS ~: Ateliler Subdivision; Block 1; lot 1 G~IERAL: 9361 Atelier Drive, Anchorage 1. The scope of this project includes the installation of an absorption bed to serve the proposed three bedroom residence for the referenced property. The existing septic tank is to be excavated to verify its integrity. If of poor integrity, the tank is to be abandoned and a new 1000 gallon septic tank installed. The existing leachfield is to be abandoned in place. The portions of the existing system to be under the proposed bed is to be removed and filled with approved sand to level. 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. SMIC ~ INSTALLATION: 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. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 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. 1. 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 (roughed-up) before gravel (sewer rock) placement. 2. 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. 3. Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum of twelve (12) inches. 4. The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. 5. 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. 6. Monitor tubes shall be of four (4) inch diameter and installed at the locations shown on the design. The portion of the monitor tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. 7. 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. Page Three MINI~JM MAil,rIAL SP~IFICA~IONS: 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: 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. INSPf~"TIONS: 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. Page Four 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. 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 1"5.o, H. 3 4 5 7 8 0 ~ ~o 12 13 14 17 2O DATE PERFORMEE Township, Range, Section: WAS GROUND WATER V:r-c ENCOUNTERED7 SLOPE SITE PLAN IF YES, AT WHAT OE.T.? Io' Depth to Water After , Monitoring? ,lC) Date: I'~' [ Gross Net Depth to Net Reading Date Time Time Water Drop I ! ; $o - S~/y'' :fro io ~,,,, ~ ¥y " :SO /o,,,,,,~ '~ ~lq" ~ " /--~OD~,o ~o :~ - ~ y~," - I~;OL SM,- T¥¥" 1" : o ? .c~ ~ ~/~" l " ~IZ ~ ~V~" i~ PERCOLATION RATE 5 {minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN .-~ FT AND ~' FT COMMENTS PERFORMEDBy:E~leRi"r,Ala'k'''577 __, ~/~ ~CERTIFY THAT,THIS TEST WAS PERFORMED IN 72-008 (Rev. 4/85)  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION /;~ ' ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ~_~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT I~o~ ~ MAILING ADDRESS DESCRIPTION ~LOCATION~ NO. OF BE~OOMS ~ ~.u~,.~e~..~~~. ~,~~ ,o. of~om,~r,m~,~ Liq, c~llons IF HOME.DE: Inside length Width Liquid depth ~O~ DISTANCE TO: Well ~ . ~ . ?r~/ Dwelling PERMITNO. ~ Manufacturer ~ ' -' Material Liquid capacity in gallons ~Z DISTANCE TO: ~ Foundation ~{ Nearest lot Hne PERMIT NO. ~Z~ No.o, ,ines~ Len~ of each lin~. Total la,ho . of ,~es. Tren~th Distance betw~)~s ~ ~ ~ ~ ~ ~ I ~ Material be~th tile inches ~ ~ Top of tile to finish grade ~ ~ ~ inches Total effective~~absorption area Length Wid~ Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER L ' APP~ DATE LEGAL 72-013 I"::1F' P L I C FI N T L..OCFt'T I ON L... Iii:". r~,:i I::1L M I C'HFIEL ':'i.:,OUKKFtL. Ft FITEL. IER [)R L:t B:t. Fr'rELIER S,.."[:, LOT S t2:E C.;5.52~D :.:.'!;(;:!LIFIRE F:'EET T"r'F:'E OF:' ,-:,r'l Z L l::lEV~ ORE:T I ON .: ~: I E.I'I ]: :E; "['RE:NL-.:H MFI',:.:',IMUH I'.~IJMBE:R Of:' [.:.:E[:,ROOMS = Z:: SO I L.. RFI'I" I t",IG ,:: :.:::; L"::! F:'T,.."E:R ::, = ::[.;2:5 'THE R[!:'(;:!LIIRE~[:, :~.'];IZE: OF THE SOIL. FIE:'.:.!;ORF'TION S'T'STEM I':];: E::, E: F" '"'11"' II-II ==~ ::IL. ~-Zn L,._ E:C I'-.I ~'_~ 'T H = ]:J: ;E:.: C?i F-: F-i ",.,' E:C L.. .r.::, .F£ F' 'T' II-] .... ~?:B: 'T'HE LENGTH [:,IMEIq'SION IS THE LENG'I"H (IN FEET::, OF: ]'HE: TREI'.~C:I-~ OF.: [:,RFIINI::'IEt...[:,. THE DEF'TH OF FI TRENCH OF.'. F'IT IL--., THE: D I'.:.;TRI"~CE BETWEEN THE: SL.IRFFICE OF' THE GF. tOLIND FIN[) THE BOTTOM ©F' THE E',:.::CFI',,,'FtTION ,::IN FEE]":.',. THERE I':]; NO "~:E]" I.,.IIDTH FOR TRENCHES. THE GRFIVEL [:,EPTH IS THE MINIMI...IM [)EPTH OF GRFI'v'EL 8ET[,JEEI'.,I THE OIJTFFII....L PIPE FII'.~[:, THE 8Cd"'I"OH OF: THE E',:-::C.:FI',,,'FITION (IN FEET). PE:F::M I ]" RF'F'L. I CRNT HFIS:; THE RESF'ON'.'S I B I L I T"r' TO INFORM 'TH I :E; [:,EPAR"f'MENT [:,t..IR :t.' NG THE INf'STFtL. LFITION I I"~:SPEC:TIONS OF RN'¢ I.qELLS, 8D..TFICENT TO THIS F'ROPERT¥ FIN[:' ]"HI.']i: NUHBER OF' RESIDEI"~CES THFrT 'THE WELL. WILL SERVE. .................. : .... 'T' IF-II ~::::::~ ,::: ;D'.:: '.::, I I'-,I S F" F,Z C.:: -T' ICi I'-,I .'.-]-.; F-t F: F_:' F;-': F.,:" E;FICKFi' LL I NG OF: FIt",l"r' S'¢:.:.;TEM W I THOI...IT F I NFIL. I NL:;F'ECT I ON FIND RPPRO'v'RL B"r' THI' [:,EF'F:IRTMENT 14]:LL BE '..:.i;US.IECT 'TO PROSEC:LITION. MINIMUM DISTFtNC:E: E:ETI,.IEEN R WELL AN[:, AN"r' ON-SITE SEWAGE DI:F.;POSRL S"r'S'T'EM IS.'; :l..e~O F'EET FOR FI PR I ',,,'RTE I.'.IELL.; OF,.' ~...5~ TO 2C~C.~ F:'EET F'ROM R PUE:L. IC 1.4EL. L DEF'EN[:'ING UF'ON THE: T"r'F'E OF PUE:L. IC W[.:::I..J .... I.'.IE:L.L. LOGE; FIREE RE:C.:¢JIRED RND MLIE;3' E:E RETURNEE:, TO THE DEPFIR'I"MENT klITH!N ::!i:C~ OF' THE WELL. COMF'L.ETIC~N. OTHER 'REI]:!LtIF'EHENTS MFI'¢ FIPPL."r'. '.:J;PECIFICFITIONS RN['.' CONS'rRUCTIOI'.4 [>IFIGF.:RM:.:.3 FIRE FI ',,,' I::~ I L.I:::IBLE TO ]: N'.:N;IJF,.".E F'Rf.]PER I NSTFIL. LFIT I ON. I E:ER'T' I F:'T' 'T'HFI"[' ::L: I FIM F'FIMILIFIR t4ITH THE: RE6!UIREMENT:?, FOR ON-SITE SEI,.IERS FIND NELL..:.:.]; FI':'!!; I'::'01:;?.TH E:'¢ THE MUN I C: I F'81.... I T'¢ OF' RNE:HORRGE. 2: I 1.4IL..I .... tNS:;TFIL..L THE S'¢?STE:.M IN RCCORDRNCE 1.4ITH THE CO[:,ES. :ii:: I IJN[:,EF..::~.';"f'f:tI'.~[:, THFIT ]'HE ON-GI]"E :SEI.,.IER S'T':.'.STEM MF:I"r' RE:I]:!I...I!F.:E ENLRRGEMENT IF 'I"HE I:;?.E:[-.';IE:,ENCE: IS REMODELE[:' TO I NCLLI[)E:. MOF..'E THI=IN ]: 8E[>ROOf'IS. FIF'PL. I CRNT M I CHFIEL. SOIJKKFILFI Performed For Legal ~escrintion: Lot 1 Bl°ckL1 This Form Renorts Soils LOQI y~ 2204 Cleveland gn~hoca~e, Alaska 9950~ TOm Taylor Date Performed 7-30-77 Subdivision ~e!icr ,,, P~'~colati nenth Feet 10-- 12-- 14 . 16 18 20 '' m Soil Characteristics 6 :: Peat Brown Gravelly Sand Bottom of test hole Was Ground Water Encountered?__ I~ Yes, At what Denth? No Readinq Date Grnss Time Net Time Depth to H20 Net Dron Percolation Rate )linute Prnposed Installation: Seenaoe Pit Drain Field Deoth of Inlet Depth To Bottom Df Pit Or Trench CnM~ENTS- 125 square fOot required per bedroom from minus 6" to 15'. Test Performed By David Paul Data Certified '204 r'~],-.x'~.;and kncb..,:age, l~,ia~.),a 9~,03 Date per,~or~:,ed 7-30-'7'7 ;r ~Orl:,~,d ~O~ 'r3m Taylor .................................... ;sinn~.At.~l.jer.,.,~..' ' ~ ' .... ' ' ' t- I Block~ ..... Subdiv~ e,~hdkx,~s~on .~c;~1 'escr'~ption' Lo Percolation ,est ........... 't~is ['orm Renorts Soils Loo ........ ~_~_ ...................... r'erth Soil Characteristics ~ ~ e t 6" Peat ........................................... 8 ?0 $,'es Frc, ur~d k'ater I ~ yes, At what Denth? ....................... I '1'~1 '!' i ' i I i I ,.. ~ Gro~s Time !,',~,tT4r:,e tenth to ~0 L'et I Percolation Rate Hinute . Frr, nesed Inst~'i--iatioh-' Seenaae Pit B,'a~n Field ~,er.,th of Inlet Dent~ Fo B('ttr. m Of Fit Or Test WATER WELL LOG FOSS DRILLING ASSOCIATED 909 CHUGACH DR. #37 ANCHORAGE, ALASKA 99503 WELL OWNER Michael D. Soukkala WELL LOCATION Lot 1Blk. 1 Atelier Subdiv. MUNICIPALITY OF ANCHORAGE DEPT. 0~:' t ]~;:AL'I'H & ENVIRONMENTAL PI'~'OTECTION USE OF WELL Domestic JUL 9 RE, CEIVED SIZE OF CASING 6" DEPTH OF HOLE 76 FT. STATIC WATER LEVELArtesia~T. G. P.M. 25 REMARKS CASED TO WITH 76 FT. 68 FT. OF DRAWDOWN. DATE COMPLETED 7/3/79 PUMP TO BE SET AT 74' 0 to15 15_to55 55, to2_4__ y.~_to?6 to Alluvium] grey color~ medium hardness Heaving Silt;.brown color~ soft~ with water Alluvium; grey color, medium hardness Sand and gravel~ grey color: with water to to to to to to to 'tO MUNICIPALITY OF,ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~IRONMENTAL ,SERVICES DIVISION OCT 2 7 1997 Parcel I.D. RECEIVED GENERAL INFORMATION Complete legal description Location (site address or directions) = Property owner Mailing address Day phone Lending agency Mailing address Agent. Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ '~ TYPE OF WATER SUPPLY: Individual well /~ Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: 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 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)~)f this inspection. Alaska Water & Name of Firm Wa~,tewater ~¢t~vices//~ I Phone 847_i Brooj ~gej~/ ///A~~ Date bedrooms, Address Engineer's signature DHHS SIGNATURE /~ Approved for Disapproved· Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date/-// The Munici~)ality of A~-:h°rage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates. based only upon the representations given in paragraph 5 above by an independent professional enginee~: registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their lending i~'$titutions 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 AqUN~ayALITY Of AN~, Municipality of Anchorage ENVIRONMENTAL SERVICES DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division OCT 2 7 1997 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 RECEIVED Health Authority Approval Checklist Legal Description: LoT Parcel I.D.: Oz-?// - O~>-//~' A. WELL DATA Well type Log present (~) Total depth ~-6 t Sanitary seal (Y/N) Date of test Static water level Well production Date completed Cased to ~' If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (~N) FROM WELL LOG AT INSPECTION /o,//'~/?~_ 2.C> g.p.m. F,/ ,vu~. g.p.m. WATER SAMPLE RESULTS: Coliform F Date of sample: / (.3// Nitrate l. ~-4- ~/~ Other bacteria Collected by: '~, ~./~. B. SEPTIC/HOLDING TANK DATA ,umb ro Com,;rtr.;n Foundation cleanout (Y/N) '~/ , Depression (Y~ [L)o High water alarm (Y/N) ~/~ Date of Pumping /t::)///~ ~" Pumper C, ABSORPTION FIELD DATA Date installed /O//?'/,~°"/?/'/ Soilrating(~t2orft2/bdrm)(:::~,~ Systemtype /-~(~:~ Length ~ Dr,r->' CCI , ~,~' So,,~-/~'r 7.. F~'~..~ Width I Gravel thickness below pipe ~, ~ Total depth c~.S' /v'o~ /~r~Cme. v~, Effective absorption area ~'(o~. ~" Monitoring Tube present (Y/N) ~ Depression over field (Y/I~ /~Jo Date of adequacy test /0//~'/~:?'- Results pf{-~S '7-~ ~.r::::~ ~,~, tPNa~s~s~/Fai') For bedrooms Fluid depth in absorption field before test (in.); I" '" ~/~ ~ J 0 Immediately after ~ ~ gal, water added (in,): Fluid depth tiS" 3" (ins) Minutes later: ~ ~ ~. Absorption rate ~ ~ = g,p,d, Peroxide t~e~t~e.t (p~t 12 month~) (Y/~ ~oT [~0~ ~f ye~, ~iv~ d~te ~/e 72-026 (Rev. 3/96)* ~IGulO ~v~C I~ goT~ ~ Eo~[ ~ ~,t ~ W~ Date installed ~ Size in gallons....------------ Manhole/Access (Y/N) ~ "P I at* __ "Pump off" level at* High water ~ ~~.._ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line /¢)?/ ~, .~--~zco~,', ~o On adjacent lots /oo '4- On adjacent lots ~/z,~ Public sewer manhole/cleanout Lift station sEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ ~4- Property line /~0 ~4- Absorption field Water main/service line Surface water/drainage Wells on adjacent lots /oo -,~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain ENGINEER'S CERTIFICATIOI ce~i~ that I have ~termin~ ~h~ field inspections and mview signature/~~~U ~~// Engineer's N~me HAA Fee $ Date of Payment , / b/~-~'~/~7 ?2-025 (Rev. Waiver Fee $ Date of Payment Receipt Number 0 F,g. '%. CN Z CT&E Environmental 8ervioes Clleat Sample ID Sempte Remark-~:" 97~45200! AK Water & Wastewater Services LI, BI Ateliea' L1, ~1 Atelier DriVing Water 0 ¢ilant PO// Printed I)ate/?Jme 10123197 15:15 Collected Date/Time 10/17/97 12:50 Re~alved Date/Time 10/17/97 14:45 Technical Director: 8taphen C, Ede PaL 0.100 m;/L EPA ]00.0 At La,able Prep Limits Date 10 ~ox ~0/17/97 OeP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES. . Division of Environmental Services -~ - On-Site Services Section P.O, Box 196650 Anchorage, Alaska 99519-6650 _-, . 343;4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1, GENERAL INFORMATION Complete legal description' Location (site address or directions) 9361 AT~li~r Drive Anchorage, AK Property owner Mailing address Lending agency Mailing address Mike So~kkala 9361At~lier Drive Day phone 337-1242 Anchorage? AK 99507 Day phone ..:: ~Agent i.' ;~ .:': "r:::"::'i.,,,i,:~ Address ";"ii: '" '.'. ~nless otherwise t~['HAA Will b'e held for pickup. ¥~':: 2. NUMBER OF BEDROOMS:. 3. ~PE OFWATER SUPPLY: IndividUal well .... .'."".. ' ...... comm~'~ty.well - Public Water ::... NOTE: If community well system, provide wfi~en confirmation from State ADEC '. ....... ing to the legali~':and status of system. ' ......... , . ':~:"~:';' 'W~E-o'~~ WXSTEWATER'D'isPOSAL:---"-' ', ', ,'~'' ...... " ~..: L:~'~:-:'~:~' Ifidividual on-site :.~,~.' ' pub B~la Bodnar/ VISTA REAL ESTATE . Day phone 4241 "B" Street AnChorageS' AK 99'503' ' ' Written (' ( STATEMENT OF INSPECTION BY ENGINEER ' As certified by my seal affixed hereto and as of the validation date shOwn. below, I verify that ~ny 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 wate~ 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. ~ S & S ENGINEERING : " Name of Firm ~.7n_34 _=_,el,, m,,,,. L~ Road No. 204 Phone 6' ~1 ~ - glo/'7 '~. Eagle River, Alaska 99577 '~- Address Engineer's signature ~7~. ~z~Z ~ Date "/'/<~ ~/ 6. DHHS SIGNATURE .......... ~ 'Approved for .~. DisapproVed. · : Conditional approval for t / / / / / ! bedrooms. bedrooms, with the following stipulations: Additional Comments ,M~ic~'~ality of'".A.'~'~hLrage Department of Health and Human serVices (DHHS)issues Health Authori ',:,A;~. rovai ~e~flc~,t.~' bast~t only upon the representations iven in 'am m h 5 above by an indel:~ndent ~ · ...... -. ,.. ,. g P g P ~ro~0al e~'i[~r registered in the State of AlasEa The DHHS does this as a county to umh~m of hom~ and their lending ihstitutions in order to ~tis~ ceAain f~eml and s~te ~uiremen~:' Employ~ of DHHS do not .~i~/conduct mspect!ons or anal~e data before a ce~ifimte is i~ued. ~.~e Mu~icipali~ of~Anchomge i~ not ;:~;~F~;~ms~nSible for effom °r omi~ions in the prof~ional engin~fs w0~':~:g?~"~'~ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /~TE¢./~'/~- ,.~-o/~.j i~'~-oc/~ /~ L~7-/ Parcel I.D. A. Well Data Well type Log present (~N) Total depth Sanitary seal (~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed '7 -~ - ?~ Driller Cased to ?(,, ' Casing height Wires properly protected ~)N) Date of test Static water level Well flow Pump level1 FROM WELL LOG 7 -2 SEPARATION DISTANCES FROM WELL TO: Septic/~ tank on lot Absorption field on lot Public sewer main Sewer service line lq ' AT INSPECTION g.p.m. ? g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform O E'o ~ ~,u/~///'/4Z) ~/Nitrate Date of sample: /0 -Z~ ~ ~ /, 2_2 /,~,¢,/Z- Other bacteria Collected by: ~' g~' ~'-/,J6-~xJ~'~'3./x/6- B. SEPTIC/I=I~I!~Bi~ TANK DATA Date installed /rJ - Z¢' _c)c/ Tank size /0~o ~,~ Compartments ~-- Cleanouts (~N) Y'~'~ Foundation cleanout ~N) y'~-s' Depression (Y~ High water alarm (Y(~ ,&.)O /U//cJ- Alarm tested (Y~ /,,J//d Date of pumping /J/~- AJE/,u 7'~xJl~ Pumper SEPARATION DISTANCES FROM SEPTIC/~ TANK TO: Well(s) on lot /d,,~ ~ On adjacent lots /~:~ ~ To property line 7,5"' ' Absorption field /¢' Surface water/drainage /¢~ ' -/- Foundation ,/.~ ~ Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed ~ Manufacturer J Size in gallons ~ Uanhole/Acce~~/N) __ I at~'""~ ~ m 0fi,, Level at vent (Y/N) "Pump on" leve Pup High water alarm level .-~'~------Cy~es tested Meets MOA electrical codes (Y/N)~_~ SEPARATION DI~ LIFT STATION TO: Well on lot ~ On adjacent lots D, ABSORPTION FIELD DATA Date installed Length :~7, 5' ~ Total absorption area ~"(,,2. ~- Cleanout present ~N) Date of adequacy test ,XJ,//q- ,qc"-/,d ~'y,J'T'Ez~ Results (pass/fail) Water level in absorption field before test /U/,4 Peroxide treatment (past 12 months) (Y(~ ]d~ ,~/~ /O -2~' -~q Soil rating (GPD/Ft2) ~. Width /&- ~ Gravel thickness \/~-s J ! System type ~'£O,~PT'/OX,) Total depth ~'-..~ ' Depression over field (Y(~ for /J/~ Bedrooms After test If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /6~ To building foundation On adjacent lots Surface water Curtain drain On adjacent lots /O~J ~/- Property line /-/4)~ To existing or abandoned system on lot Cutbank 5'0 Z/.. Water main/service line /~ ~- Driveway, parking/vehicle storage area z./~ ~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in e~,~n~ d~) ~is inspection. .qin t_.=na, ure ' ,~ .... ~,~ .......................:..~: ,/~0 t~ ...... ~, ........ ii:~:'"; .~:::-:~:: :~?:~ ......... .:.....: ......:~ ~' ~ · '$~j:" :~:E: .::::::'"'"':3::~, E:i:~ '::~:~: :E:~ ~:?E ~ ~ Engineer's Name ~ g*~'~ ~' ~ ~]~ CE-8801 /.~;ff HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back 10,'25/94 09:3? ,::'r&E Ei"~LqRONMENTAL LAB SE~UICES -, 9076941211 COMMERCIAL TESTING &'t~'~GI CO. ENVIRONMENTAL I. A~ORATORY Drinking Water Analvsis. R,2poK fo~' Total Colitb~n .~ac~,c.'"' ....... .~a ~ IN~TRUCTiO~;,f 0~ ~VER6"~ JI~' i~EFO~ COLLECTING q0.104 ANCm¢';~At~. Al< [-,9518 TEL: (907) -562.2343 MU,ST BE CON~LETED B'f WATER SLrPFIS,1]SR /~RIVATE WATER SYSTEM ~ $ AkS'lE DATE: /,,MTPLE /}< Routine '"Repeat Sample ([or routine sample w/th lab ?eL no. ) Year LOCATION T!m¢ Coileeted I'7:,'Z..o Treated Water Time Received Anaiy~is Began TO BE COlVIPLE'IZ.D BY LABORATORY Aazalysis ;bows this Water SAMPLE to be: Urt~atisfactok-y .$~mp. le ovtr 30 ho,~rs old, results may oc ur. reliable Sample leo long. in u'ar. nt; sampls shottld not be over 48 b. our$ old =t ~xa. min~ti~n to ind, fcate reliable resets. Please send new $amplc via ~pe=iai deliveO, mail. An~yticat Method: ..?.~MeS~.bra.ne Filter iq M-MO-MUG AJI~J YS~/, [-] b'axed Tim< BACTERIOLOGICAL WATER 7~NALYSIS Rti:CORD 5D, CO-SfOG Re)ult: Total Co,i forth Verificatiou; LTB ;BOB Fecal Colifo~ Coafi~matioa Final ~embr=ne Filler R~ult~ ._ Reposed Ey ..,~ t ' Date Coif Colotq¢~/100 ' co.~or-=:o,~ ,,,. PART ONE OF _Z?:_2-_/.:~'r=, .~,e.~ ~WO TO FOLLOW ~NYi.~ONMk'HTAL S~AVI~.='~ iN ALASKA. COLO~,-',DO, UTAH. tLLIN.,~IS. OHI,D, MAP-.YL.A*ND. WEST V~P-.Gi,"I1A, N.~W J~P~SEY. $OU~k{ CAROkINA 10/25/94 09:36 C:T~E EN~JlRC[NHENTAL LAB SERkJICES -~ 9076941~11 NO. 104 DD2 CT&E lief Matrix Commercial Testing & Engineering Co. Environmental Laboratory Services ~.~s- ~ LABORATORY ANALYSIS REPORT WkT~R Client Name s & s EHGiNEERIMG WOliK Order 10290 PWSID UA STEPHEN C~ EDF COLLECTED Bi': Ss. Nib. rat e ~N Qr.! A1 l~u~able Ext, Anal Resu] te Q',~ ~.. i Urli u ~ Metl~od J.d m.~ t ~ Da I:. ~ Dat~ Init · I ,22 mg/L EPA '35'J .2./300. 0 10 1C)/'21/'.',4 Mci,', 5633 8 Street, Anchorage, AK 99518-1600 -- Teh q907) 562-2343 Fax: (907} 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, ~LORIDA, iLLINOIS, MARY~ND, N~W JERSEY, OH{O, UTAH, WE~T VtRGtN;A